Protecting the muscle and metabolism that decide whether the result lasts.
Most patients who come in to talk about weight loss aren’t people who haven’t tried. They’ve dieted, exercised, willpowered their way through it, watched the number come back, and are now asking us what’s actually going on in their body.
For patients on a GLP-1, the question is usually the same one. The weight is coming off. They can see they look different. But they’ve heard about muscle loss, and they want to know what’s happening underneath the scale, and what to do about it before the medication stops working or they come off it.
What most of them haven’t had is a specific, structured resistance training program that’s timed to the medication, supervised by an exercise physiologist, and coordinated with the endocrinologist managing their dose. Most weight loss plans stop at “eat less, move more”. That isn’t the missing piece.
Exercise Physiology is the clinical service that fills that gap. An Accredited Exercise Physiologist (AEP, ESSA) prescribes exercise as part of a treatment plan, working alongside the patient’s endocrinologist and dietitian.
Exercise physiology is useful if you are:
When you lose weight, you lose muscle along with fat. The proportion is significant — body composition studies on GLP-1 medications show that roughly a quarter of the weight lost is lean muscle rather than fat.
This is one of the main reasons people regain weight after stopping a GLP-1 medication. In the STEP 1 trial, participants regained about two-thirds of the weight they had lost within a year of stopping semaglutide. The SURMOUNT-1 study on tirzepatide showed similar body composition outcomes.
Muscle is metabolically active tissue. Your body uses energy to maintain it, even at rest. When you lose muscle during weight loss, your daily energy requirement falls. If your food intake does not adjust to match, the excess is stored as fat.
This is why resistance training matters during weight loss. It is the specific stimulus that preserves lean muscle while the rest of the body composition changes. Cardiovascular exercise supports heart health and recovery, but the resistance work is what protects your metabolism.
An initial assessment covers your medical history, current medications, recent blood tests, prior exercise history, and goals. From there, a program is developed and adjusted as your weight, blood tests, and medications change.
Programs are centred on progressive resistance training — typically two to three supervised sessions per week. Cardiovascular work, mobility work, and recovery are included alongside. Sleep, daily activity, and stress are discussed as part of the program.
Programs are coordinated with the treating endocrinologist. Where eating habits are part of the picture, the dietitian works alongside. Medication changes, blood test changes, and exercise changes are reviewed together.
The first appointment is an assessment, not a workout. It usually takes 45 to 60 minutes. The exercise physiologist takes a full history, including current medications and any recent blood tests, and asks about your goals. From there, a program is written and a follow-up is scheduled.
If you are unsure whether exercise physiology is the right fit, a discovery call with our team can help clarify this before booking an assessment.
Yes. Resistance training before and during treatment protects muscle from the beginning, which is easier than rebuilding it later. If you are already on a GLP-1, it is not too late — starting resistance training now still reduces the proportion of muscle lost.
Body composition changes take weeks to show on the scale. Improvements in strength, energy, and how your body handles blood sugar usually come earlier. The muscle-preservation work is a long-term investment rather than a quick change.
The first assessment is in person. Ongoing sessions can be supervised in person or, depending on your situation, supported remotely. Home-based programs can be effective when appropriately prescribed and progressed.
Exercise physiology is covered by most Australian private health funds under extras cover. It is not covered by Medicare for weight loss specifically, but may be covered for related conditions. Our reception team can help you check your cover.
Endocrine & Wellbeing Clinic
Phone: (02) 9870 3256
Or book online via the link in our bio
Locations: Balmain (inner west Sydney) and Telehealth Australia-wide
Affiliated with: ESSA (Exercise and Sports Science Australia), ANZBMS, Endocrine Society of Australia
This page is not a substitute for individual medical advice. Book a consult for assessment specific to your situation.
All future appointments will be at 100 Elliott Street Balmain 2041
