This blog is written in partnership with Dr. Sarah Stombaugh, Obesity Medicine Physician and Founder of Sarah Stombaugh, MD – Personalized Weight Loss.
Struggling to start a regular workout routine or difficulty maintaining results? You might have looked into medications such as Ozempic or Wegovy. These GLP-1s are a class of FDA-approved drugs that mimic a natural hormone to help control blood sugar, appetite, and digestion. These medications are oftentimes utilized to combat type 2 diabetes, as well as obesity. We connected with Dr. Sara Stombaugh, owner and founder of Sarah Stombaugh, MD Personalized Weight Loss, who dives into the path of starting and sustaining your fitness routine on GLP-1 medications.
What should people know about starting or sustaining an fitness routine while taking GLP-1 medications like Ozempic or Wegovy?
Exercise plays an important role during the weight loss journey, especially in terms of building and maintaining muscle mass. I encourage people to start where they are and build from there. There are certain considerations, like making sure to get plenty of hydration and emphasizing protein, which can be more challenging while using GLP-1 medications.
Can lifestyle choices like diet and hydration help manage some of the common side effects of GLP-1 medications?
Lifestyle choices are an important part of managing common side effects of GLP-1 medications. The most common side effects are gastrointestinal, such as nausea, constipation, or diarrhea. To manage nausea, I encourage my patients to stay well-hydrated with a sugar-free electrolyte beverage and to emphasize protein. We often encourage patients to consume what we call “protein liquids” like protein shakes, protein waters, or broths. These are often easier to get down when one is feeling nauseated. Certain vitamins and supplements, like vitamin B6, ginger, and peppermint, can also be helpful in reducing nausea. To manage bowel changes, I recommend using a fiber supplement like psyllium husk. Fiber should be taken with plenty of water and can be helpful for managing both diarrhea and constipation. Adequate hydration and regular physical movement are also important to support healthy bowel habits.
What advice do you give to patients who experience a weight loss plateau while on a GLP-1 medication?
Plateaus during the weight loss journey are common, and sometimes they are actually a good thing! First, we need to decide if someone is actually in a plateau. While there are different definitions, I will define a plateau as no weight loss over a month or longer. However, plateaus may be a sign of body recomposition. So even though the number on the scale is the same, the body has actually gained muscle and lost fat. When someone is in a plateau, it can be helpful to do a body composition scan or to look for non-scale victories, such as changes in waist circumference or clothing size.
However, true plateaus do happen as well, and they are great opportunities to re-evaluate the plan. Plateaus may be a sign that one needs to make an adjustment to their nutrition plan, exercise plan, and/or to adjust their medication dose.
How can individuals on GLP-1s protect muscle mass while losing weight, and what role does strength training play?
While we often speak of weight loss, what we really desire is for our bodies to preferentially lose fat mass and to minimize muscle mass. It is important to note that some decrease in muscle mass can happen during the weight loss journey, whether someone is utilizing medications like GLP-1’s or not. However, there are important steps you can take in order to reduce muscle mass loss during the weight loss journey. The most important things are regular movement, particularly resistance training, and adequate protein intake. Protein needs will vary significantly from one individual to another, so it is important to have a conversation with whoever prescribes your GLP-1 medication or with a registered dietician, so you understand the protein needs for your own body.
What habits or programs do you recommend for people coming off GLP-1s to maintain their weight loss and overall health?
It’s important to note that GLP-1 medications are designed for long-term use. While there are people who may use them temporarily, it’s important to understand why they were prescribed for you and what role they are playing before deciding to stop your medication. Before stopping any medication, you should always speak with the prescribing provider. When a person does desire to stop the medication, it is ideal if they can wean off of it, rather than stop abruptly.
Emphasis on nutrition, which includes lots of whole foods, particularly those that contain protein, fiber, and healthy fats, will be most supportive of long-term metabolic health and weight maintenance. Regular exercise, both cardiovascular exercises and resistance training, plays an important role in weight maintenance as well.
About Dr. Stombaugh
Dr. Sarah Stombaugh is a family medicine physician and diplomate of the American Board of Obesity Medicine. Graduating from Creighton University Medical School and completing her family medicine residency at the University of Chicago, Dr. Stombaugh practiced outpatient primary care in Evanston, Illinois, before moving to Charlottesville, Virginia, with her family.
Upon moving to Charlottesville, Dr. Stombaugh opened a private practice weight loss clinic, in which she sees patients at her downtown Charlottesville office and by telemedicine throughout the states of Virginia and Illinois.
In addition to her clinical work, Dr. Stombaugh is the host of the “Conquer Your Weight” podcast. Through this platform, she shares valuable insights, expert opinions, and practical advice on weight management, contributing to the well-being of a broader audience. Dr. Stombaugh believes in empowering both individuals and the medical community in order to promote an evidence-based approach to the treatment of obesity.
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We designed a 3-month program specifically for individuals who are currently taking or considering obesity management medications (GLP-1s, GIPs, etc). Participants work with our specialty trainers to ensure a personalized exercise and nutrition/health coaching plan. The program includes 1-on-1 meetings, support group-type interactions, monthly educational seminars, and more. Learn more and connect with our trained professionals to see if this program is right for you.
