Optimizing Weight Loss with Ozempic: The Critical Role of Resistance Training

At Sussex Performance Centre, we are committed to helping our clients achieve sustainable, healthy weight loss through evidence-based practices that prioritize overall well-being. With the rise of weight loss medications like Ozempic (semaglutide), many individuals are experiencing rapid fat loss, but this comes with a potential downside: the loss of fat-free mass, particularly muscle.

This article explores how Ozempic and similar GLP-1 receptor agonists work, the risks of muscle loss, and why resistance training, a cornerstone of our programs at Sussex Performance Centre, is essential for preserving fat-free mass during weight loss. We’ll also highlight how our facility supports clients in achieving their goals with tailored exercise and nutrition strategies.

Understanding Ozempic and GLP-1 Receptor Agonists

Ozempic, containing the active ingredient semaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist originally developed to manage type 2 diabetes. It works by mimicking the GLP-1 hormone, which regulates appetite, slows gastric emptying, and enhances insulin secretion, leading to improved blood sugar control. A significant secondary effect is weight loss, as it reduces hunger and calorie intake, making it an attractive option for those struggling with obesity. In clinical studies, patients using Ozempic lost an average of 14 lbs (6.4 kg) over 40 weeks, with some trials showing up to 17.3 kg (38 lbs) of weight loss over 68 weeks.

Other GLP-1 agonists, such as Wegovy (a higher-dose semaglutide formulation approved for weight loss), Mounjaro (tirzepatide), and Zepbound, operate similarly, with tirzepatide acting as a dual agonist for both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) to enhance weight loss effects. These medications are highly effective, with Wegovy users losing an average of 9.6% of their body weight over 68 weeks compared to 7% for Ozempic. However, rapid weight loss, whether through these drugs or other means, can lead to unintended consequences, including the loss of fat-free mass.

The Risk of Fat-Free Mass Loss with Weight Loss Drugs

Fat-free mass includes muscle, organs, bones, and connective tissues, with skeletal muscle making up about 50% of this component. While GLP-1 agonists primarily target fat loss, studies show they can also cause significant muscle loss. For instance, in the STEP-1 trial for semaglutide, participants lost 17.3 kg of body weight, but approximately 13.9% of this was lean muscle mass, equivalent to 6.9 kg (15 lbs). Another study reported that semaglutide users lost 3.61% of their lean mass compared to 0.11% in the placebo group, with muscle loss proportional to the degree of weight loss. This muscle loss is concerning because it can lead to sarcopenia—a condition characterized by reduced muscle mass, strength, and function, typically associated with aging but exacerbated by rapid weight loss.

Muscle loss has several negative implications:

Reduced Metabolic Rate: Muscle tissue burns more calories at rest than fat, so losing muscle lowers the basal metabolic rate, making weight maintenance harder.
Decreased Strength and Mobility: Muscle loss can impair daily activities, such as climbing stairs or lifting objects, reducing quality of life.
Increased Health Risks: Low muscle mass is linked to higher risks of chronic diseases, frailty, and poorer cardiovascular outcomes, particularly in older adults or those with obesity-related conditions like type 2 diabetes.

The rapid weight loss induced by GLP-1 agonists, combined with reduced calorie intake, can trigger an “inappropriate starvation response,” where the body breaks down muscle for energy instead of fat, especially if protein intake and physical activity are inadequate. This underscores the need for proactive strategies to preserve muscle mass, which is where resistance training and proper nutrition come into play.

Why Resistance Training is Crucial

Resistance training, also known as strength training, involves exercises that work muscles against an external force, such as weights, resistance bands, or body weight. At Sussex Performance Centre, we emphasize resistance training as a critical component of any weight loss program, particularly for clients using medications like Ozempic. Here’s why it’s essential for preventing fat-free mass loss:

Preserves and Builds Muscle Mass: Resistance training stimulates muscle protein synthesis, counteracting the muscle breakdown that occurs during rapid weight loss. Studies show that resistance training can significantly reduce lean mass loss in individuals with obesity, even during calorie restriction. For example, exercises like squats, push-ups, and bicep curls help maintain muscle size and strength.

Boosts Metabolism: Muscle tissue is metabolically active, requiring more energy to maintain than fat. By preserving or increasing muscle mass, resistance training helps sustain a higher metabolic rate, facilitating long-term weight management.

Improves Functional Health: Regular strength training enhances mobility, balance, and physical function, reducing the risk of sarcopenia and improving quality of life. This is particularly important for older adults or those with lower baseline muscle mass, such as women.

Complements Aerobic Exercise: While aerobic activities like walking or jogging support cardiovascular health, resistance training specifically targets muscle preservation. Combining both, as recommended by experts, maximizes health benefits.

Mitigates Medication Side Effects: GLP-1 agonists can lead to a slowed metabolic rate due to muscle loss, but resistance training helps counteract this by promoting muscle growth and increasing calorie burn.

At Sussex Performance Centre, our trainers design personalized resistance training programs tailored to each client’s needs, fitness level, and health goals. Whether you’re new to exercise or an experienced athlete, we provide guidance on exercises like weightlifting, bodyweight circuits, and resistance band workouts to ensure you maintain muscle mass while losing fat.

The Role of Nutrition in Muscle Preservation

Resistance training is most effective when paired with adequate nutrition, particularly protein intake. Protein provides the amino acids needed for muscle repair and growth, and insufficient intake during weight loss can exacerbate muscle loss. The Institute of Medicine recommends 0.8 g of protein per kg of body weight daily for healthy adults, but higher amounts (1.2–2.0 g/kg) are often suggested for those over 65 or undergoing rapid weight loss. For example, a 200-lb (91-kg) individual should aim for 160–200 grams of protein daily to support muscle maintenance while on Ozempic.

High-protein foods include:

Lean meats (chicken, fish)
Eggs
Low-fat dairy (Greek yogurt, cottage cheese)
Tofu, beans, and legumes

At Sussex Performance Centre, we collaborate with registered dieticians to create meal plans that optimize protein intake and ensure adequate vitamins and minerals, such as those needed for muscle-building. Our holistic approach ensures clients receive comprehensive support to complement their training and medication use.

How Sussex Performance Centre Supports Your Journey

Located in the heart of Sussex, our performance centre is equipped with strength training equipment, functional fitness areas, and spaces for personalized coaching. Our team of certified trainers and health professionals works closely with clients using weight loss medications to:

Develop Tailored Exercise Plans: We create resistance training programs that fit your schedule and fitness level, incorporating 2–3 sessions per week to target all major muscle groups.
Provide Nutritional Guidance: Our partnerships with dieticians help clients meet protein and nutrient needs to support muscle preservation.
Foster a Supportive Community: Our group classes and one-on-one coaching create an encouraging environment to stay motivated and accountable.

For clients on Ozempic or similar medications, we emphasize starting resistance training early in the weight loss process to minimize muscle loss from the outset. Our trainers also educate clients on the importance of lifestyle adjustments to manage side effects like nausea or fatigue, which can impact exercise adherence.

Addressing Concerns and Looking Ahead

While Ozempic and other GLP-1 agonists offer significant benefits, their long-term effects on muscle mass and overall health are still being studied. A recent University of Alberta study raised concerns about potential cardiac muscle loss in mice and human cells treated with semaglutide, highlighting the need for further research. Additionally, stopping these medications often leads to weight regain, primarily as fat, which can further reduce muscle mass if not managed properly. This reinforces the importance of sustainable lifestyle changes, including resistance training, to maintain health benefits post-treatment.

Pharmaceutical companies are exploring combination therapies, such as bimagrumab, which may preserve or even increase muscle mass while promoting fat loss. Until these are widely available, resistance training remains the most effective, accessible strategy to combat muscle loss.

Conclusion

Weight loss medications like Ozempic have revolutionized obesity management, but their potential to cause fat-free mass loss requires proactive measures to protect muscle health. At Sussex Performance Centre, we empower our clients to achieve their weight loss goals while preserving muscle mass through personalized resistance training, nutritional guidance, and comprehensive support. By integrating these evidence-based strategies, we help clients not only lose fat but also maintain strength, mobility, and long-term health.

References

Drugs.com. (2025). Does Ozempic cause muscle loss and how to prevent it?
Healthline. (2023). Ozempic May Make Your Muscles and Bones Weaker.
University of Alberta. (2024). Weight-loss drug found to shrink heart muscle in mice, human cells.
The New York Times. (2024). The Race Is On to Stop Ozempic Muscle Loss.
ISSA. (2024). How to Prevent Muscle Loss While Taking Weight Loss Drugs.
The Atlantic. (2024). Ozempic Makes You Lose More Than Fat.
Sydney Morning Herald. (2023). Ozempic in Australia: Weight loss may come at a price.
Drugs.com. (2025). How does Ozempic work for weight loss?
Ro. (2024). Does Ozempic Cause Muscle Loss? 4 Healthy Weight Loss Tips.
Hone Health. (2024). Does Ozempic Cause Muscle Loss?
Bulldog Online Yoga. (2023). How Do I Maintain Muscle Mass While on Ozempic, Wegovy, Zepbound, or Mounjaro?
Diabetes UK. (2025). What is Ozempic and how does it work?