Semaglutide & Strength Training Guide: Maximizing Muscle Retention

Strength training is crucial for those taking semaglutide (brand names: Wegovy®, Ozempic®) to help preserve muscle mass, improve bone density, and promote longevity. However, these medications typically put you in a calorie deficit and may lower your blood sugar levels, both of which can lead to fatigue, joint discomfort, and digestive issues. That’s not exactly a recipe for motivation.

In this guide, we’ll walk you through how to lift smart while on semaglutide. You’ll learn how to maintain muscle as you lose weight, navigate common side effects, and choose between a three- or five-day workout program designed to meet you where you are.

Why Strength Training Matters on Semaglutide

People taking GLP-1 receptor agonists, such as Ozempic® or Wegovy®, face a potential 40 to 60 percent loss in lean mass. (For clarity, “lean mass” isn’t just muscle. It also includes organs, bones, fluids, and even water stored in fat tissue.) Resistance training remains one of the most effective ways to build and preserve muscle, maintain bone density, and boost your resting metabolic rate.

In other words, if you’re using medications like Ozempic® or Wegovy®, strength training isn’t just helpful—it’s essential. The best strength training for semaglutide users focuses on preserving lean mass and boosting functional strength.

Muscle Preservation vs. Fat Loss

When people say they want to “lose weight,” they almost always mean fat loss, not muscle or water weight.

Your body primarily draws fuel from two sources: stored carbohydrates and stored fat. Carbs are your short-term energy supply during workouts like lifting or running. Fat serves as your long-term energy reserve. When you're in a calorie deficit (burning more than you eat), your body taps into fat stores to make up the difference.

There’s some anxiety about losing muscle while cutting, but your body doesn’t break down muscle tissue unless it has to. Muscle plays a key role in joint movement and overall function, so your system tries to hang onto it. However, if you’re in a steep calorie deficit (think: 500+ calories per day) and you’re not challenging your muscles, you increase your risk of losing mass.

There are two keys to preserving muscle while shedding fat:

Prioritize Protein

Protein provides the amino acids, building blocks, your body needs to maintain muscle. It also slightly increases your calorie burn. That’s because protein takes more energy to digest; about 20 to 30% of its calories go toward digestion, compared to just 5 to 10% for carbs and 0 to 3% for fat.

Replacing some of your daily calories with protein helps preserve lean mass and improves fat-loss efficiency.

Resistance Train Consistently

Strength training sends a clear signal: "This muscle is in use—don’t get rid of it." When you lift weights (or do bodyweight resistance work), your muscles adapt by getting stronger. This stimulus protects your existing muscle during weight loss.

Can you build muscle while on semaglutide? It’s tough. Muscle growth typically requires a calorie surplus. That said, beginners and people eating at maintenance may still gain some muscle with the right plan.

More muscle also means a slightly higher calorie burn at rest. One pound of muscle burns about six calories per day versus two calories for fat, according to a 2010 comparative study. Swap 10 pounds of fat for muscle, and you’re burning roughly 40 extra calories daily—15,000 per year, or about four pounds of fat. That’s small, but meaningful.

How to Lift Weights on Ozempic Without Muscle Loss

Any strength training is better than none, but if your goal is to maintain muscle, some structure helps.

Frequency & Duration

A position paper (an academic essay that argues a specific stance or opinion supported by evidence) published in the International Journal of Strength and Conditioning recommends around 10 sets per muscle group per week for muscle growth. Beginners can see results with fewer sets. One study found that even one hard set, performed two to three times per week, can improve strength.

How many total sets you hit per week is more important than how many days you train. Whether you split your workouts into two, three, or five days, aim to hit each major muscle group—your chest, back, shoulders, biceps, triceps, and leg muscles—at least once. Of course, the more sessions you have in a week, the more total volume you can accumulate. If you opt for two to three weekly workouts, you’ll need to prioritize specific muscles over others with more sets.

Progressive Overload Strategies

The best exercises to pair with GLP-1 agonists are compound lifts, which involve multiple muscles—think squats, rows, and presses—that allow for gradual progression. Lifting weights stresses your muscles just enough to trigger growth and strength gains. But over time, your body adapts. To keep progressing, you need to increase the challenge—a principle called progressive overload.

Here are two simple ways to do that:

1. Do More Reps 

The program below includes rep ranges for each movement to guide your effort. On your first set, choose a weight that brings you within 1 to 2 reps of failure. You’ll likely do fewer reps on subsequent sets.

Example:

• Set 1: 40-pound dumbbells × 14 reps
• Set 2: 40 pounds × 12 reps
• Set 3: 40 pounds × 10 reps

The goal is to increase the number of reps you can do for each of your sets until you’re performing the top number of reps in the prescribed rep range for all your sets. Then, you’ll…

Lift Heavier Weights

A good rule of thumb is to:

• Add 5 pounds to upper-body lifts (bench press, rows, shoulder press)
• Add 10 pounds to lower-body lifts (squats, deadlifts, lunges)

You don’t need to go heavier every session. But if your reps feel strong, it’s a sign you’re ready. If your last few workouts with the same weight felt too easy, your muscles have adapted, and it’s time to raise the bar.

Nutrition for Muscle Support

Lifting weights is only half the equation. If you’re not eating enough (or eating the proper nutrients), your body won’t have what it needs to hold onto muscle. Let’s break down the basics of protein, smart supplementation, and how to eat to support your goals on GLP-1 meds.

How Much Protein Do You Need and When?

It’s vital to increase your protein intake for lifting on Ozempic® and while taking any other GLP-1. Without enough, your body may start breaking down muscle for energy.

The International Society of Sports Nutrition recommends that active adults consume between 1.4 and 2.0 grams of protein per kilogram of body weight. To find your minimum target, use pounds: divide your body weight by 2.2 to get kilograms, and then multiply by 1.4.

Example:

• A 180-pound person weighs 82 kilograms.
• 82 × 1.4 = 115 grams (minimum target)
• Aim for 115 to 165 grams of protein per day.

Start at the lower end and bump up by 10–20 grams if you’re still hungry, fatigued, or slow to recover.

What About Protein Timing?

As long as you hit your daily protein target—and resistance train—you’ll preserve (and potentially build) muscle.

However, to optimize muscle retention, a 2018 review by exercise scientist Brad Schoenfeld, PhD, and nutrition expert Alan Aragon recommends spreading protein across four meals per day. Think of it like drip-feeding your muscles fuel throughout the day, rather than dumping it all at once. Eating fewer meals spread throughout the day may help you feel more satiated, too.

Key Nutrients (Creatine, Electrolytes)

• Creatine is the most scientifically backed supplement on the market. It’s a compound that plays a key role in creating ATP (adenosine triphosphate), the primary energy currency your muscles use to contract during high-effort movements. A 2003 review found that lifters who supplemented with creatine experienced an average strength increase of 8% compared to the placebo group. (Current evidence suggests no negative creatine and semaglutide interactions, but you should always speak with your doctor before starting a new supplement.)
• Electrolytes—like sodium, potassium, and magnesium—are essential for fluid balance, nerve function, and muscle contractions. Semaglutide can cause side effects like nausea, vomiting, or diarrhea, which may dehydrate you and deplete these critical minerals. If you’re dealing with GI symptoms or training intensely, consider using an electrolyte powder (after clearing it with your healthcare provider).

Managing Semaglutide Side Effects During Workouts

Semaglutide is a medication that helps regulate your blood sugar levels and appetite by mimicking a naturally occurring hormone in your body (glucagon-like peptide-1 or GLP-1 if you’re interested). When on it, you’ll find it easier to eat less and feel fuller for longer. And while Semaglutide was found to be safe and effective compared to other GLP-1 medications, it does present some side effects and therefore considerations for users who want to strength train.

Fatigue & Energy Levels

It’s not unusual to feel more tired than usual while taking semaglutide. You are, after all, eating less, and the drug lowers your blood sugar. Here are two strategies to help combat feelings of fatigue

1. Time your meals around workouts. If safe, include some carb-rich foods before training to fuel your body quickly. Work with your doctor or a Registered Dietitian to build a plan for your blood sugar response.
2. Ease into each session. Use your warm-up sets to check in with how your body feels. If you get lightheaded, dizzy, or short of breath, pause, hydrate, and reassess. If symptoms persist, consult your doctor.

Joint Pain

While there’s no confirmed link between semaglutide and joint pain, some users report muscle and joint discomfort while taking the medication. If that’s you, try the following strategies to reduce strain:

• Opt for machines over free weights. Machines offer more stability and generally place less stress on the joints.
• Increase your reps. Heavier weights (used for low reps) put more pressure on joints. Instead, lower the weight and aim for a higher rep range (anywhere from 5 to 30 reps is effective as long as you’re pushing close to failure).
• Avoid explosive movements. Exercises like box jumps and medicine ball throws are considered high-impact. While these movements are good for increasing your bone density, they may irritate your joints if you’re already experiencing pain.

Digestive Issues

Nausea and diarrhea are reported side effects of semaglutide that can lead to dehydration. If your stomach’s off, consider moving your workout to later in the day or rescheduling altogether. No workout is worth pushing through GI distress.

Also, stay hydrated. Proper fluid balance is crucial for both digestion and performance. (See the “Hydrate Well” section under “Recovery Tips” for more information.)

4-Week Workout

This program is built around a three-day training split with the option to add a fourth and fifth day. The base plan gives you enough weekly volume (total sets and reps) to maintain and even build muscle, especially if you're new to lifting. More experienced lifters can use the optional days to hit each muscle group twice weekly. Each workout includes:

• Regressions for beginners or low-energy days
• Progressions for advanced users
• Full-body focus to maximize efficiency and total volume

Stick with the regressions if you’re new to the gym or returning after a long break. If possible, work with a trainer or knowledgeable friend to fine-tune your form.

How to Track Your Progress

Tracking your results can help you stay motivated, adjust your plan, and spot trends early. Here are three simple ways to monitor progress:

• Weigh Yourself: Step on the scale once a week, first thing in the morning before eating. Log your weight to watch trends over time, not day-to-day fluctuations.
• Measure Your Limbs: The National Academy of Sports Medicine (NASM) recommends measuring your neck, chest, waist, hips, thighs, calves, and biceps. That’s a lot, so if you're short on time, just track your waist circumference (The Heart Foundation reports increased health risks when waist measurements exceed 37" for men and 31.5" for women.)
• Take Pictures: If you look leaner, you probably are. Take photos once every 2 to 4 weeks in good lighting. Stand relaxed and capture three angles: front, side, and back.

Recovery Tips

• Schedule Rest Days Properly: Ideally, you want to rest at least 24 hours between sessions and even more in some cases. If you’re following the three-day split, your workout days could be Monday, Wednesday, and Friday or Tuesday, Friday, and Sunday.
• Hydrate Well: NASM suggests that men drink 16 cups (128 ounces) of water per day and women drink 12 cups (or 96 ounces). They also suggest replacing the fluid you lose during a workout by 125%. For example, if you sweat off 16 ounces in a single workout, you should drink 20 ounces of water following a training session.

Day 1: Legs

Exercise	Sets	Reps	Rest	Regression	Progression
Goblet Squat	3	6-10	90 Seconds	TRX Bodyweight Squat	Barbell Front Squat
Dumbbell Split Squat	3	8-12 (each leg)	30 seconds (between legs)	Supported Split Squat	Walking Lunge
Dumbbell Romanian Deadlift	3	8-12	90 Seconds	Dowel Rod Romanian Deadlift	Barbell Romanian Deadlift
Leg Extension + Seated Leg Curl	3	10-15	90 seconds after both movements	N/A	N/A
Seated Calf Raise	2	10-15 (hold the bottom of each rep for 5 seconds	60 Seconds	Bodyweight Calf Raise	N/A

Day 2: Push

Exercise	Sets	Reps	Rest	Regression	Progression
Dumbbell Bench Press	3	6-10	90 Seconds	Seated Machine Chest Press	Barbell Bench Press
Seated Dumbbell Shoulder Press	3	6-10	90 Seconds	Seated Machine Shoulder Press	Dumbbell Z-Press
Push-Up	3	Failture	60 Seconds	Incline Push-Up	Deficit Push-Up
Cable Triceps Pushdown	3	10-15	60 Seconds	N/A	N/A
Seated Dumbbell Lateral Raise	2	10-15	60 Seconds	N/A	N/A

Day 3: Pull

Exercise	Sets	Reps	Rest	Regression	Progression
Trap-Bar Deadlift	3	6-10	90 Seconds	Kettlebell Deadlift	Barbell Deadlift
Assisted Pull-Up	3	6-10	90 Seconds	Lat Pulldown	Pull-Up
Seated Cable Row	3	Failture	60 Seconds	N/A	N/A
Cable Face Pull	3	10-15	60 Seconds	N/A	N/A
Incline Dumbbell Curl	2	10-15	60 Seconds	N/A	N/A

Day 4: Upper (Optional)

Exercise	Sets	Reps	Rest	Regression	Progression
Incline Smith Machine Bench Press	3	6-10	90 Seconds	Dumbbell Bench Press	N/A
Dumbbell Upright Row	3	10-15	90 Seconds	Resistance Band Upright Row	Cable Upright Row
Neutral-Grip Assisted Pull-Up	3	Failure	60 Seconds	Neutral-Grip Lat Pulldown	Neutral-Grip Pull-Up
Overhead Triceps Cable Extension	3	10-15	60 Seconds	N/A	N/A
Standing Dumbbell Curl	3	10-15	60 Seconds	N/A	N/A

Day 5: Lower (Optional)

Exercise	Sets	Reps	Rest	Regression	Progression
Leg Press	3	6-10	90 Seconds	Single-Leg Leg Press	Hack Squat
Seated Leg Curl	3	6-10	60 Seconds	N/A	N/A
Leg Extension	3	Failure	60 Seconds	N/A	Sissy Squat
Standing Calf Raise	3	12-15	60 Seconds	Bodyweight Calf Raise	N/A