Can You Build Muscle While Taking Ozempic?

As Ozempic and other GLP-1 medications continue to reshape the weight-loss landscape, a few questions are emerging among clinicians, researchers, and patients alike. Such as, can you build muscles during this rapid weight loss perieod? and what happens to muscle during rapid weight loss?

The concern stems from evidence showing that semaglutide, the active ingredient in Ozempic, can lead to reductions in lean mass alongside significant fat loss. Because lean mass is often used as a proxy for muscle mass, the findings have fueled concerns that people taking GLP-1 medications may be sacrificing strength and long-term physical function in pursuit of weight loss.

However, new research published in Cell Metabolism suggests the issue may not be as straightforward as previously thought. Researchers at the University of Utah found that while semaglutide-induced weight loss reduced lean mass in mice by approximately 10%, much of that reduction did not come from skeletal muscle. Instead, other tissues, including the liver, accounted for a substantial proportion of the loss.

Some muscles shrank modestly, by roughly 6% on average, while others maintained their size. "Loss of mass in metabolically active organs, such as the liver, is expected as part of healthy weight loss," says Ran Hee Choi, PhD, research instructor in nutrition and integrative physiology at University of Utah Health.

Researchers also noted that some muscle loss may simply reflect a return to baseline. People often gain both fat and muscle as body weight increases because carrying more weight requires more muscular effort. As fat mass decreases, some of that additional muscle may no longer be necessary.

Why Muscle Loss Has Become a Concern

When people lose weight, they don't lose fat alone. Weight loss typically includes a combination of fat mass and lean mass, which includes muscle, organs, connective tissue, and water.

Research has shown that people taking semaglutide can lose a significant amount of lean mass alongside fat loss. In the STEP-1 clinical trial, participants lost an average of 15.3 kilograms (33.7 pounds), with approximately 6.9 kilograms (15.2 pounds) coming from lean tissue.

This finding sparked concerns that Ozempic may cause substantial muscle loss. However, experts caution that lean mass and muscle mass are not the same thing. "Loss of lean mass is often assumed to mean loss of muscle," says Katsu Funai, PhD, associate professor of nutrition and integrative physiology at the University of Utah. "But the relationship may be more complex than many people realize."

The mouse study found that muscle strength sometimes declined even when muscle size remained relatively unchanged. Researchers discovered that certain muscles produced less force after semaglutide treatment despite maintaining their overall mass. This suggests that muscle function and muscle size may not always move in parallel.

While these findings have not yet been confirmed in humans, they highlight an important gap in current research. "There remains a significant need for validation in humans, especially concerning muscle strength," says Takuya Karasawa, PhD, postdoctoral researcher and co-author of the study.

For older adults, this question may be particularly important. Age-related muscle loss, known as sarcopenia, already increases the risk of falls, disability, and reduced mobility. Making the loss of physical function a strong predictor of not just quality of life but longevity.

Why Maintaining Muscles Matters

Experts note that muscles serve as a reserve of amino acids that the body relies on during periods of illness, injury, and stress. Muscle tissues are also metabolically active, meaning they burn calories even at rest. Maintaining muscle mass may help support long-term weight maintenance after significant weight loss. Muscles do far more than help you look toned, skeletal muscles play a critical role in:

• Regulating blood sugar levels

• Supporting metabolism

• Maintaining strength and mobility

• Protecting bone health

• Reducing fall risk

• Supporting healthy aging

Can You Build Muscle While Taking Ozempic?

Experts say it is possible, but the answer may depend on where you are in your weight-loss journey.

During active weight loss, the primary goal is often preserving muscle while reducing body fat. Building large amounts of muscle while simultaneously losing significant weight can be challenging because muscle growth typically requires adequate calories and energy availability.

That said, gaining muscle while losing fat is not impossible. Studies in weight-loss populations have shown that many patients focus first on fat loss while maintaining muscle. Once they reach a maintenance phase, muscle-building efforts often become more successful.

In other words, preserving muscle during weight loss and building more muscle afterward may be the most realistic strategy for many people.

How To Maintain And Potentially Build Muscle While Taking Ozempic

While researchers continue to investigate how semaglutide affects muscle mass and strength, experts agree that muscle preservation should be a priority for anyone experiencing significant weight loss on GLP-1 medications. Here are 7 ways to build muscles while taking ozempic:

1. Prioritize Resistance Training

Strength training remains one of the most effective tools for preserving muscle during weight loss. Research has consistently shown that resistance exercise helps maintain lean tissue and improve muscle strength when combined with a calorie deficit.

Experts generally recommend incorporating resistance training two to three times per week, focusing on major muscle groups through exercises such as squats, lunges, presses, rows, and deadlifts.

For individuals new to strength training, building a consistent routine may be more important than lifting heavy weights immediately.

2. Increase Protein Intake

Protein plays a critical role in muscle repair and growth. According to experts increasing protein intake from the typical 15% of daily calories to closer to 30% may help preserve muscle during weight loss.

Many nutrition experts recommend aiming for 20 to 30 grams of protein per meal from sources such as lean meats, fish, eggs, dairy products, legumes, tofu, and other high-quality protein options.

3. Avoid Undereating

One of Ozempic's primary effects is appetite suppression, which can make it difficult for some people to consume enough calories and nutrients to support muscle maintenance.

Experts caution that inadequate nutrition may contribute to fatigue, reduced exercise performance, and greater losses of lean tissue. Prioritizing nutrient-dense foods and maintaining regular meal patterns can help support both weight-loss goals and muscle health.

4. Monitor Body Composition, Not Just Weight

The number on the scale does not reveal whether weight loss is coming primarily from fat, muscle, or other lean tissues.

Some obesity specialists recommend tracking body composition through methods such as DEXA scans, body composition analyses, or other clinical assessments. Monitoring changes in strength, energy levels, and physical performance can also provide valuable insight into whether muscle is being preserved.

5. Stay Physically Active

Beyond structured workouts, regular movement plays an important role in maintaining muscle function. Activities such as walking, cycling, pilates, and stretching can support mobility, balance, and overall physical health while complementing resistance training.

6. Sufficient Rest and Recovery

Recovery is a critical component of muscle development. While exercise stimulates muscle growth, the repair process largely occurs during periods of rest and sleep. Experts recommend getting 7 to 9 hours of quality sleep per night and incorporating recovery days into your training routine.

7. Work With A Healthcare Professional

Experts emphasize that Ozempic should not be viewed as a standalone weight-loss solution. Physicians, dietitians, and exercise professionals can help patients adjust nutrition, training, and medication strategies to minimize muscle loss and support long-term health outcomes.

The Bottom Line

As researchers continue to explore the relationship between GLP-1 medications and muscle health, weight loss alone should not be the only measure of success. Preserving strength and physical function is equally important.

As the next generation of obesity medications enters the market, researchers say evaluating physical function, not simply changes in body weight or lean mass may become increasingly important in understanding the true health impact of these treatments.