---

SHOW TRANSCRIPT

The goal within the goal is actually to be healthier.

Paint a picture for us.

Why is muscle more important to pay attention to than maybe the number on the scale?

You know, muscle is incredibly valuable to the human body for our metabolic and our functional purposes.

So we don’t want to give it away, we don’t want to lose it.

Welcome to the Strength Changes everything podcast, where we introduce you to the information, latest research, and tools that will enable you to live a strong, healthy life.

On this podcast, we will also answer your questions about strength, health, and wellbeing being.

I’m Amy Hudson.

I own and operate three exercise coach studios.

My co hosts are Brian Sigan, co founder and CEO of The Exercise Coach, and Dr. James Fisher, leading researcher in evidence based strength training.

And now for today’s episode.

Welcome back to the Strength Changes everything podcast.

Today’s episode is going to build upon a previous episode that we recorded this season, season two, episode 12, all about.

GLP1s.

We are recording this episode today because the prevalence and usage of GLP1s has just grown since then.

And we have a lot of people coming to us at the Exercise Coach asking us about our position about this and, you know, how they should think about going on this journey if they’re considering it for themselves.

And we clearly do have a position on it when it comes to muscle and why that’s important.

And so today’s episode is really going to cover, you know, the crucial importance, among other things, of strength training if you are going on a GLP 1 journey and why that’s so important while on the journey.

So, Dr. Fisher, how are you doing today, first of all?

I’m doing very well.

Thank you very much, Amy.

How are you?

I’m doing well.

And it is time to revisit a very hot button topic, just like we did before.

And so, tell us a little bit more about kind of what we hope to have the listener take away from listening to this episode today.

Yeah, absolutely.

So, we’ve had a number of questions come in, as you said, about GLP 1 use, and it’s been a year since we recorded that podcast or around about that.

We’ve checked some of the data, and some of the statistics suggest that actually GLP 1 use has Doubled in the last year.

So, you know, it really is a hot topic.

There’s, in some Cases potentially some stigma attached to it.

So I guess, first of all, we wanted to present our position as the exercise coach on GLP 1 use.

And with that, I’m going to add that we have a complete professional neutrality.

I think that this is a journey between each individual and their physician, and we have zero judgment on that at all.

We certainly recognize the values attached to it, but we also recognize the importance of.

Body composition and strength training.

And that’s really where this podcast is going to take us, kind of why the exercise coach is so beneficial.

As far as maintaining muscle mass and strength, specifically through this kind of weight loss body composition journey.

Okay, great.

So let’s start with the problem, you know, and the concern around use of GLP 1s.

Can you paint a picture for kind of what the concern is?

Yeah.

So, first of all, it’s worth kind of reiterating something we’ve said previously.

GLP1 is glufagon like peptide receptor agonist.

It’s a medication that mimics the natural hormone GLP1 and it was originated to treat diabetes.

It’s now primarily used to treat obesity and it works by stimulating insulin release, reducing glufagon and slowing gastric emptying and basically making people feel full.

So it kind of changes their blood sugar control and enhances weight loss on that way.

And it’s an injectable that’s typically injected under the skin, in the belly, the thigh, or the arm.

I believe there are some oral versions available now, but I’m not sure on the efficacy of those or the prevalence of those.

So it’s kind of worth clarifying that.

First of all, I’m just going to talk about the benefits actually.

People who are overweight or obese are often.

Low in self esteem and self efficacy, they’re low in confidence, they may be high in anxiety, and a gym or a fitness or an exercise environment might be overly daunting for them.

It’s simply Isn’t something that they want to engage in.

They might also experience pain associated with their weight.

So, their capacity to simply go and exercise, which seems like the obvious solution, the very superficial black and white solution to this, really isn’t an option.

It’s simply not the ideal for them.

And hence, GLP 1 use can be a real parfait.

LP1 use can be a real puff that they can use to begin a weight loss journey.

And it can start to create behavioral changes, you know, because it changes satiety and it changes how full people feel.

It can make people eat smaller portions, which often might be a big thing that’s, you know, really important in this journey.

It doesn’t typically change what people put on their plate.

So it doesn’t typically change.

The nutritional content.

So the macronutrient content might remain or even still not be overly healthy.

It might be low in protein, high in carbohydrate, or so forth, but it might still not be high in nutritional value.

So there’s some things that are good and there’s some things that aren’t perfect.

Let’s put it that way.

But the main problem with GLP 1 use is that, well, some of the data suggests between 20 and 40 of the weight loss.

Through GLP 1 use is actually lean tissue, which is typically thought of as muscle mass.

It’s not solely muscle mass, but it’s typically thought of as muscle mass.

So that’s a problem.

You know, muscle is incredibly valuable to the human body for our metabolic and our functional purposes.

So we don’t want to give it away.

We don’t want to lose it.

And we’re going to lose it as we age anyway.

So we want to retain or build as much as we can while we can.

Yes, absolutely.

And we’ve talked about that in plenty of other podcasts as well.

That it’s the most metabolically active tissue in the body and how important it is for our longevity, right?

And so destroying it or speeding up the loss of it in any way isn’t what we want, right?

So, and we’re going to get more into that a little bit.

So, people are using GLP 1s in hopes to basically lose weight and perhaps reduce the number on the scale.

You mentioned some other factors going on, but, you know, paint a picture for us.

Why is muscle mass or why is muscle more important to pay attention to than maybe the number on the scale?

You know, we talked about this before the podcast of the old idea of asking a client the whys of their exercise journey.

And ultimately, when you ask somebody why they might engage in GLP 1 use, a lot of it might be weight loss.

The response might be weight loss.

But if we press a little further and say, well, why are you interested in weight loss?

Most people either perceive or they know that there are health benefits to weight management.

Their goal isn’t per se weight loss, it’s to be healthier and improve maybe their quality of life.

Well, weight loss does not differentiate between fat mass loss and muscle mass loss.

So, if we’re simply looking at the number on the scale, then we’re not differentiating between fat loss, which can be very beneficial, and muscle loss, which is absolutely tragic and can decrease our metabolism, which can promote greater weight loss in the future, but can also.

Decrease functionality and increase sarcopenia and diminish kind of long term health outcomes.

Some of the data around GLP 1 use suggests that around two thirds of the weight loss is regained within a year.

And that’s not just GLP 1 use, that’s any kind of weight management medication compared to behavioral weight management programs.

So the problem is that people engage on this journey of weight loss, but it’s not geared towards kind of behavioral.

It’s geared towards simply losing weight.

And as we said, losing weight is not the goal here.

So the goal really is losing fat, not losing weight.

And in fact, if we start to add in strength training, the goal can be to lose fat and at least retain, if not build, muscle.

And in fact, we’ve talked about a paper previously that mentions something called the fat but fit paradigm.

Just to kind of recap that one of the key points for it was that longevity and lower mortality risk was associated with increased strength, regardless of body composition, regardless of carrying excess fat.

So, from a health perspective, it’s almost a way of saying it’s okay if you’re overweight as long as you’re strong with it.

So, the idea of people being on a GLP 1 journey but not engaging in strength training is always counterintuitive to improving health and reducing.

Mortality risk is probably the best way to look at this.

Yeah.

I mean, basically, to summarize in a nutshell, what you’ve said so far is you know, if we, if your only goal, if the only goal is to be the lowest possible weight, according to the regular scale, you may be neglecting, you know, looking at muscle mass, which may actually make you less healthy in the long term, you know.

And so that’s really not at the end of the day what most people are looking to achieve.

And so it’s important to keep not only my immediate goal in mind, but my long term health in mind when I engage in something like this.

Is that fair?

That’s exactly fair.

And if we think about people who are personally who I associate with kind of extreme weight loss without muscle, I tend to think of older adults who are frail, who have dependence upon other people, who maybe use a walker or are very immobile, who have very low functional capacity.

And that’s effectively the journey that you’re rushing into it you’re not engaging in some kind of exercise to retain muscle and retain metabolic health and retain functional capacity and strength.

Yeah.

So let’s get into that.

I mean, you kind of just teed it up, but what is the most important thing that we can do and why is preserving muscle so important and how can we do that?

Our muscle is absolutely key from a whole organism perspective.

It’s our key kind of metabolic driver.

So, as soon as we’re losing muscle, that’s bad.

Our capacity to add fat is elevated anyway because we simply don’t have the storage capacity for the nutrients that we take in.

We’ve talked historically about how diabetes occurs, that we need storage sites.

For carbohydrates.

And if we don’t empty those storage sites in the form of our muscles, then we don’t create storage capacity.

Well, if we decrease the volume of that storage site, which is effectively what we’re doing if we’re losing muscle, then we’re decreasing the capacity to store that carbohydrate.

So, and really, the whole purpose of this conversation is that strength training is the signal.

This is the appropriate mechanical loading that stimulates muscle protein synthesis, reinforces the body’s need.

To retain lean tissue, to retain muscle mass, even when overall energy intake is reduced.

And the exercise coach does a phenomenal job of having multiple facets to approach this strength increase alongside the GLP1 journey.

So there’s a few things that we typically do at the exercise coach.

So, you know, we measure.

So, many exercise coach locations would use in body assessments.

And in body is a method of measuring body composition that measures just more than the weight on the scales.

So, it will give a body fat percentage, it would have a muscle mass percentage.

And of course, we’ve talked about the idea that what we want is to lose weight, but we want that to be body fat, not lean tissue.

So, the importance of having that kind of measurement is absolutely key.

We want the weight loss to be high quality.

So we want it to be fat loss with the muscle being preserved.

We also want the strength training program to be optimized.

And one of the key things that we’ve talked about previously is the eccentric loading associated with the isokinetic training on the exobotics devices.

Now, that will preferentially recruit type 2 muscle fibers.

Type 2 muscle fibers are the most responsive to growth and to that recruitment.

And they’re the ones that we want to keep and we want to build and we want to retain with age.

So it’s really optimizing that strength training methodology.

The exabotics devices obviously also give feedback to the clients.

They give values in strength index and they give data on maintaining or increasing strength and, of course, use of in body.

Can help see where you are along that journey.

So, the idea of tracking progress is not simply a case of taking a GLP1 and then stepping on the scales to say and saying, Great, I’ve lost weight.

It’s a case of using the processes in place, whether that’s GLP 1 and strength training, and saying, Okay, I’ve lost body fat.

I’ve also increased in strength or I’ve lost weight because I’ve also maintained my strength and my muscle mass, which is obviously key on this journey.

And then the final, the final facet that I think is really important is that workouts are supervised.

So there’s a coach there to have these conversations with.

Many people that I’ve spoken to in the UK who are on their GLP1 journey talk about their self injecting, they talk about it having been prescribed, but they seem like they’re now almost out on an island on this journey.

And that’s kind of worrying.

So it’s the idea that when you train at the exercise coach, you have a coach there taking you through the workout.

So we know that workouts are better.

When you have a coach there, supervised workouts are more productive than unsupervised workouts.

The exercise coach is always wonderful semi private location.

It’s not a typical exercise facility with music and mirrors and lycra and all that kind of stuff.

So it’s a really personal environment.

And the coach is there to kind of talk through these experiences with and talk through and get the coaching in strength training as well.

Awesome.

I’m just going to pop in because there were a few really great things that you just said.

And I just want to make sure that the listeners take it away.

The first one is you just mentioned it in passing, but I think that a lot of people would be uncomfortable to realize and admit that, you know, a weight loss journey without maintaining muscle mass will actually make it easier for your body to store fat in the future.

You know, neglecting your muscle while losing weight is setting you up.

You’re telling your body, hey, just add as much body fat as you want, you know, as soon as I stop this journey.

And so I don’t think anybody would want that.

And that’s a compelling reason first of all, to focus on strength training.

Then, the four points what you just said about what makes our environment so helpful and ideal for people who are on a journey like this is the measurement.

It is so crucial to track your muscle mass.

If you don’t know where your muscle mass is, we don’t want to lose it, right?

We need to maintain it.

We need to watch that so that it doesn’t drop too much and we can maintain that.

The act of strength training itself.

We’ll maintain our strength and hopefully.

You know, the act of strength training itself will maintain our strength and hopefully increase or at least maintain our muscle mass.

But being able to check in on that is huge and try to shoot for body fat loss if that’s our goal, right?

Optimizing the workout and making it personal is ideal if fitness overall and health overall has been sort of a long term struggle or difficulty in the past, you know, and that environment is ideal for that.

The trainer and making it so focused on those eccentrics as well to build strength up and to preserve that and make sure you can see that you’re maintaining that strength while with the reporting is important.

And so those are really, really key factors.

I agree to highlight there.

You talked earlier in the episode too about the fact that a lot of times there isn’t a lot of maybe consideration given to the macronutrients that people are eating.

You know, maybe they don’t even change what they’re choosing to eat as much.

You know, they are just perhaps reducing their portion sizes because they feel full.

But talk about the role of protein.

You know, if somebody is on this journey, talk about the role of protein that they should consider.

You know, yeah, I think this.

Yeah, I think this can be really beneficial for people to hear, even if it’s something that they choose to pass over.

So, at the exercise coach, we don’t take a strong position stand on nutrition.

Obviously, we have the metabolic comeback every quarter.

And the idea with that is that you’re engaging in whole food nutrition rather than refined foods.

But one of the key things that we do often talk about is protein intake.

Now, resistance training is the first thing towards maintaining or increasing muscle mass.

There’s no question about it.

You can’t compensate for not engaging in resistance training.

But if you’re engaging in resistance training and if you’re on a weight loss journey, then having adequate protein intake can help you optimize the adaptations of strength training that you’re already stimulating.

It helps effectively optimize muscle protein synthesis.

And there’s a wealth of research around this.

And if you’re Already diminished in satiety, then so if you’re already feeling full and you’re not interested in eating or you don’t feel very full or you already feel full, excuse me, then oftentimes it’s things that, you know, people might often just reach for a snack or have small food and they might not consider the quality of what they’re actually consuming.

So one of the things that we typically sort of say is actually, if you’re going on this journey, that’s Absolutely fine.

Strength training is key, and protein intake along that way is also going to be beneficial.

Now, it’s very much an add on, it’s not a key part of this.

It’s strength training is the key part of this, but ultimately, if we were supporting somebody through this process, we would say the protein intake is going to help them along that journey.

We almost never can have that body composition discussion without mentioning protein.

When you strength train, your body is looking to add muscle.

Your body is looking to repair those muscles and adapt.

And the building blocks of those adaptations and that muscle growth and maintenance is protein.

And so it is very, very crucial as well.

I think it’s important to recognize that when somebody reduces their calories, and this is anybody who’s on calorie restriction, protein becomes more important not less important.

So, you know, typically people might opt for a certain amount of protein in their diet, whether that’s grams per kilo or grams per pound of body mass.

But actually, if they go on calorie restriction, they should at least maintain that protein consumption and have fat and carbohydrates reduced rather than reduced protein in line with those other macronutrients.

Absolutely.

Yeah.

Yeah.

You don’t want to diminish that.

You want to fight to maintain that.

Absolutely.

How would you describe what you would envision as client success?

You know, if somebody is using a GLP1 and they’re a client at the exercise coach, what does that look like?

Yeah.

So I think the problem with GLP1 use is often success is defined by producing minimum on the scale.

So I’ve gone from this weight to this weight.

That’s what I plan to do.

I plan to lose weight.

And that’s not, that shouldn’t be the goal.

As we said, the goal within the goal is actually to be healthier, whether that’s to be a healthier weight or a healthier body composition or a healthier function or so forth.

And therefore, it’s not simply about weight loss, it’s the quality of that weight loss and it’s the physical capability throughout that process.

Bigger factors along this journey.

So it’s about body composition, it’s about strength, increasing strength, and it’s about increasing function.

So, somebody’s not just interested in producing the number on the scale, they’re genuinely interested in their overall health.

And secondly, I think that engaging in, I mean, aside from all of the other wonderful benefits of resistance training, which we’ve talked about extensively, as far as the acute benefits and the chronic benefits, the long term benefits of resistance training, we know that engaging in a workout over the long term as a behavior change will increase health span, will reduce risk of mortality, you know.

Reduce risk of all cause mortality, and will ultimately be something that helps to maintain a healthy body weight or a healthy body composition rather than just a short term weight reduction, which might be put back on later.

Absolutely.

If you really want to give yourself a A report card, measure it by the fact that you’re keeping up strength training, maintaining a good body composition where you’re doing your very best to preserve the muscle that you have so that you’re healthier in the long term.

Dr. Fisher, what did we not hit today?

What are your final takeaways or what would you like to leave listeners with, especially those who are either on a journey with GLP1s right now or considering?

Well, it’s really exactly what we’ve already said.

It’s simply to say that if the goal is weight loss, the goal within the goal is probably health.

That’s most people’s goals.

It’s health, it’s to have a better quality of life.

And while GLP 1 use can certainly support that in some forms, it’s worrying to think about the muscle loss that might occur alongside it if strength training is not undertaken.

So, if the goal is truly health, then strength training is going to be a key part of that weight management and that body composition journey.

Absolutely.

If you are listening to this today and you’re on a GLP one and you have kind of internalized the fact that, yes, I really do need to add in some strength training, I’m intimidated by big gyms.

I don’t like strength training.

Please visit an exercise coach location.

We are the ideal environment.

We’re going to make it safe.

We’re going to make it super time efficient and effective.

We specialize in working with people who haven’t exercised in years, who don’t like the gym, but who know they need to strength train.

And we can give you what you need in terms of measurement, results, and experience.

And so please visit exercisecoachcom if that is of interest to you.

Dr. Fisher, thank you for breaking this down.

For us today, and this will be an evolving topic, I am sure.

So, but we really, really appreciate it.

We will see you next week on the podcast, and until then, we hope you remember strength changes everything.

Thanks for listening.

If you enjoyed today’s episode, please share it with a friend.

You can submit a question or connect with the show at strengthchangeseverythingcom Join us next week for another episode, and be sure to follow the show on Apple Podcasts, YouTube, or wherever you get your podcasts.

So that you never miss another episode.

Here’s to you and your best health.