GLP-1 receptor agonist medications like semaglutide (Ozempic and Wegovy) have exploded in popularity thanks to their weight loss effects.
While this benefits heart health, blood pressure, mobility and more, weight loss is only one piece of the wellbeing puzzle. Good nutrition and physical activity are still essential for good health.
If you’re using semaglutide as prescribed by your doctor, there are critical eating and exercise habits you need, to avoid side effects like muscle loss and malnutrition.
What are semaglutide medications like Ozempic and Wegovy?
Semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. These copy the action of GLP-1 — a naturally occurring hormone produced in the intestines and the brain, which helps to regulate blood sugar levels and appetite.
Although shifting kilos wasn’t the original intention of semaglutide — it was designed to control blood sugar in type 2 diabetics — it’s been found to help suppress appetite, increase feelings of fullness and slow down digestion, leading to reduced calorie intake.
When combined with lifestyle changes like diet and exercise, these injections can lead to significant weight loss, ranging from 5% to over 20% of body weight, depending on the specific medication and dosage.
Semaglutide also reduces the risk of heart disease and diabetes, and reduces waist circumference, inflammation, blood pressure and blood glucose levels.
As with any medication, semaglutide comes with potential downsides, risks and side effects. Commonly reported side effects include nausea, vomiting, diarrhoea and abdominal pain, with warnings about possible changes to vision, kidney failure and gallbladder issues.
Semaglutide, muscle loss and exercise
“Rapid weight loss is associated with a significant loss of muscle mass,” says Accredited Exercise Physiologist Timothy Douge. This isn’t unique to semaglutide but it is important to consider if you’re taking it.
“While research has shown the use of weight loss injections over a six-month period do not significantly impact muscle function, the loss of muscle mass can be as high as 50% in some muscle groups, which can cause significant issues with metabolism and hormone regulation.”
The extent of muscle loss varies and depends on factors like age (it’s greater in those over 60), overall health status, diet and exercise routine. Age-related loss of muscle mass (known as sarcopenia) can lead to reduced strength and physical function, and an increased risk of injury, falls, bone fractures and higher rates of death.
“To counteract muscle loss associated with rapid weight loss, resistance training is critical,” Douge says.
Resistance training involves making your muscles work against a weight or force, this could be dumbbells, resistance bands or your own body weight, and increases muscle strength. There’s also evidence that other activities like aerobics, yoga and pilates can help strengthen muscles when performed at a certain intensity or frequency. The Australian physical activity and exercise guidelines recommend that adults do muscle strengthening at least twice a week.
“Any changes to a physical activity routine in conjunction with using weight loss injections should be supervised and gradual,” Douge says, as you might not be eating enough to fuel extra exercise.
“Because of the reduced amount of available energy from the injections, a dramatic increase in physical activity can be dangerous and lead to things like hypoglycaemia, dehydration and dizziness.”
Exercising as well as using a weight loss injection will help you lose more weight than just using the medication. Chat with your doctor who can refer you to a qualified exercise physiologist. They can work with you to increase your muscle-strengthening workouts safely and sustainably.
Semaglutide, nutrition and diet
Despite the widespread uptake of semaglutide, there hasn’t been any solid research into nutritional recommendations for patients using the medications.
Semaglutide can significantly suppress your appetite, reducing your food intake, and slow your digestion, affecting nutrient absorption. Side effects like nausea, vomiting and diarrhea can also lead to nutrient loss. This makes eating nutrient-dense foods critical.
“Weight loss injections might help shed the kilos, but if you’re not eating right, they can lead to some nasty side effects — think muscle loss, constipation, nutrient deficiencies, and even dehydration,” says Accredited Practising Dietitian Joel Feren.
Protein needs to be a major focus for preserving lean muscle mass, so incorporate a good source of the stuff in every meal and snack.
“Opting for lean protein sources like beef, veal, lamb and chicken, eggs, dairy products, tofu, and plant-based options such as legumes and beans can ensure the body gets what it needs to maintain strength and functionality during weight loss,” Feren says.
You should be eating .84 grams of protein per kilogram you weigh, which is about 73 grams of protein for the average Australian bloke.
You should also pay close attention to your fibre intake, especially if you’re part of the nearly 90% of Australian men who already don’t eat enough.
“Foods such as whole grains, nuts, seeds, legumes, and a wide variety of fruits and vegetables should form the cornerstone of their meals,” Feren says. “These foods help achieve daily fibre targets, support gut health, reduce the risk of constipation, and promote overall health.”
Chat with your doctor who can refer you to an accredited dietitian. They can work with you to stay on top of your nutritional intake and manage gastrointestinal problems.
