You're Losing More Than Just Fat on Your GLP-1

On a GLP-1, a big chunk of the weight you lose can come from muscle instead of fat, and for women over 40 on Ozempic or Wegovy, that's the one kind of loss you don't want, especially in perimenopause.

If you're on a GLP-1, thinking about starting one, or already off it, this episode is for you. Half the women in my life are on these drugs right now, and I'm not anti-medication at all. But for women in their 40s and 50s, what's happening underneath that weight loss matters just as much as the number you see on the scale, and it changes what you do while the medication is doing its job.

I'll walk you through what's going on in your body on a GLP-1, the three things I'd prioritize if I were you, in order, and the one part of coming off the medication that most women skip and end up regretting. I'm a double-certified nutrition and fitness coach who lost 20 pounds in my mid-to-late 30s and kept it off for 10 years through perimenopause, and my whole focus is on making sure the weight you lose is fat and that it stays gone after the injections stop.

Resources Mentioned:

👉🏻 Grab The FREE Fat Loss Formula Workbook HERE to calculate your exact calorie deficit and maintenance numbers

💪🏼 The Strong Core Method: a 4-week, step-by-step core program for women over 40 that includes 12 guided workouts, video demos, and a simple plan to help you build a stronger, more defined midsection in just 20 minutes, 3 times per week.

🎯 Take the FREE ‘What’s My Metabolism Type’ Quiz that identifies your unique metabolism type and get empowered with a personalized plan to manage your weight confidently.

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🎧 Listen Next: The Fastest Path to Fat Loss and Fitness in Your 40s and 50s

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👋🏻 ABOUT ME:
 I'm Andrea, a NASM-certified nutrition and fitness coach and founder of Behind the Body. For years, I tried every diet imaginable, avoided weights, and stuck to cardio, all in pursuit of being skinny. None of it worked. At 40, I overhauled my approach and started lifting 3–4 times a week. Now at 45, I have the strong, toned body I spent decades chasing, and I've maintained it for 10 years using the same simple approach. I help women over 40 simplify their approach, build real strength, and get results that actually last. Every week, I cover the science, the strategy, and the honest truth about fat loss and maintenance for women over 40.


MEDICAL DISCLAIMER: This podcast is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your diet, exercise, or health routine. Results vary. Andrea is a NASM-certified nutrition and fitness coach, not a doctor or registered dietitian.

Transcript

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A quick note before we start today's episode. If you like this podcast, consider subscribing and even sharing it with a friend who you think might like it as well. I'm trying to grow our reach and meet more women in their 40s and 50s who are interested in improving their bodies and their health at this phase of life. And if you have any suggestions on topics you want me to cover in the future, or you just want to pop in and say hi, click that link that says send us fan mail at the top of the description, and I will get your message directly and reply. Thank you so much in advance. It means the world to me. And now let's dive into today's episode. Welcome to Behind the Body. I'm Andrea, certified nutrition and fitness coach. In my 30s, I lost 20 pounds and I've maintained it well through my 40s. Every week here, we talk about what's really happening with perimenopause and weight gain, what to do about it, and the brutal but beautiful truth about this stage of life. Whether you're just starting or tired of starting over, you are in the right place, and I'm so happy you're here. Let's dive in. I want to talk about GLP1s today. And I know that seems like an old topic. GLP1s have been out forever now, and it seems like everybody is using it. I mean, probably half of the women in my life are using it. Even the ones who don't need to lose weight, but who want to get rid of the food noise or who want to maintain being thin. I mean, it is so prevalent that it is just, I feel like popping Tylenol now. It is incredibly common that people use GLP1 drugs. And while this does seem like old news, right? We know that a lot of people use it. There has been a prevalence of famous people on TV, most notably recently Demi Moore, who showed up at the Metgala or somewhere super rail thin. I mean clavicle, bones sticking out everywhere. And while I'm not saying she's necessarily on a GLP one, seeing women like her on TV, combined with something that I recently heard, my husband sent me an article, which I don't think is that new. It's not old, but I don't think it's like recent as of the last month. But there was a statistic that came out of studies done on semiglutide, which is the drug in Ozempic and Weigovi, that shows that up to 40% of the weight that people lose from semiglutides can come from lean mass, which is mostly muscle. And this blows my mind. For us women at our age in our 40s and 50s, we can absolutely not afford to lose muscle. And so when I hear that statistic from these studies and I see women like Demi Moore, and to be honest with you, women in my life too, who have lost a substantial amount of weight. I mean, their main goal is to be as skinny as possible. It breaks my heart and it concerns me for the state of their future. And I know that seems dramatic, but I'm talking to you like I would talk to my best friend or my sister. Like it is unacceptable to put yourself in a position at this age, at this phase of our life, to be, I'm gonna just say this directly. I don't want to hurt any feelings, but to be reckless, where your main and only goal is to be thin and not give a care about any of the health implications that come with that. Not to mention, and this is a personal opinion, but I'm just gonna say it here, right? Because you're we're best friends and related sisters. But most of these women who are getting so super thin don't even look great, in my opinion. They don't look their best. And to me, looking great means looking healthy and vibrant and strong and fit. And I don't mean you have to have the same amount of muscle as I do. But if you're looking like you're a walking corpse, to me, that just is not the epitome of health or attractiveness. And while attractiveness is not the only thing, it is absolutely not the main thing. It is really a marker, I think, of your health when it comes to certain aspects like your skin, your bones showing through, your overall body composition. Okay, but I'm going on a little bit of a tangent because this isn't about people who are on the drugs. I completely support GLP ones. Maybe you're currently using one, or maybe you've used one in the past or you're considering it in the future as a way to lose weight. That's great. I'm not anti-medication at all. I believe there is a very valuable place for it in our society, in women's lives, and in weight loss and health efforts. But I do want to paint the full picture of not just what you stand to gain by using it, but what you stand to lose if you're not careful or intentional. Because while these meds can genuinely help with weight loss and they can help with diabetes and overall health, they've been proven to do that. They also fall short for us women over 40. So we need to understand what to do alongside them so that the weight you lose is only fat and that that fat doesn't come back. And the biggest piece of all of this is what happens when you stop the injections, because most women are not going to be on them forever. You do stop eventually. And whether or not the weight stays off comes down to what you did while you were on it and the habits that you implemented and set in place. And for those of you who don't know, I'm a double certified nutrition and fitness coach. I read a lot of the literature and the studies. My husband is also a physician, not in the weight loss arena, but he's also well read on this. And so we discuss this type of information and studies all the time. And because I'm a certified nutrition and fitness coach, because I've lost a good amount of weight and kept it off now for 10 years through perimenopause, my number one priority for myself and for my clients and in my business at behind the body is not only that we lose the weight, but that those fat loss results hold up after the injections stop. We all know that the only thing these medications do is control your appetite. They don't build your body. Those are two completely different jobs, and only one of them is yours to keep. Okay, so let's start with what's happening in your body. Now, I don't need to go into the science and the background of GLP ones. I'm pretty sure that we all know how they work. I'll just cover it high level. GLP ones copy a hormone that your gut makes after you eat that tells your brain that you're full. So that makes your appetite drop, and then you eat less without feeling like you're starving. That causes your appetite to drop. So you eat less without feeling like you're starving, and then the weight comes off. And that weight loss can be significant. Now, naturally, you lose a little bit of muscle every time you lose weight. That's normal. It can happen with GLP1s, or it can even happen just in a regular calorie deficit. The issue with these drugs is the amount of muscle loss. When the weight comes off this fast and your appetite is so low, your body starts offloading muscle, not just fat. And that's where that 40% number comes from. Here's why it hits you so much harder than it would for somebody in their 30s or 20s. After 40, you're already losing muscle slowly thanks to the hormone shifts and perimenopause. After the age of our mid-30s, per decade, we start to lose three to eight percent of our total muscle mass due to sarcopenia, which is age-related muscle loss. This is biological. We can't change it. Well, we can change it through certain habits and activities and actions, but this is biological, right? We have to combat this in order not to lose that muscle. Okay, so this additional muscle loss from the GLP ones lands on a woman whose body is already working to hold on to the muscle that she's got. So sure, the scale goes down and you're smaller. And because of that, you're so happy that the weight finally came off. I can relate to that. When you've been fighting your weight year after year, decade after decade, and there is this drug that you can take that has a high safety profile and that can make you finally lose significant weight and you see that scale come down. That seems like the ultimate win. That seems like you have finally cracked the code and your endorphins start going and you so excited to fit better in your clothes or to buy smaller clothes. Like I understand that whole psychological situation that goes with weight loss. After all, I'm a woman who's been struggling with weight loss my entire life, been dieting my entire life. And so I understand that dopamine hit of finally losing the weight. But because of all that muscle loss, underneath that fat loss, you're softer, maybe flabbier, and definitely a little weaker than you were before you started. This is why, after weight loss, that your skin may seem a little saggy, or your clothes, even if they're smaller now, are a little baggy and they're not filled in where you want them to be. Because ultimately, muscle is what holds your shape. It's what creates shape in your body. It keeps you strong and it keeps your metabolism from dropping through the floor because muscle takes more energy to carry around. So that helps your metabolism to keep firing pretty strong because it's burning calories while it's carrying your muscle around. So you lose too much of it. And you've not only made yourself smaller, weaker, more fragile, but you've now also tanked your metabolism. And now your ability to keep the weight off after you're done with the injections is so much harder because once your metabolism tanks, you're burning significantly fewer calories. And you need to take time now to rebuild and restore your metabolism. And honestly, this is the part that gets me the most. Again, I have no problem with using weight loss drugs to help lose weight at all. My problem is that we hand it over to women over 40 and give her zero instructions or direction on how to protect her muscles and the importance of protecting her muscles while she's losing weight. And there are such terrible long-term implications of losing so much muscle because after 40, not only is it just hard enough to hang on to existing muscle without extreme dieting, but it's also hard to build new muscle at this age. So if you're on a GLP1, if you're thinking about it, or if you already came off and you're not really sure what to prioritize, I'm gonna tell you what I think is the most important in order of priority, as I would tell my sister or my best friend. First and foremost, you need to prioritize protein. Protein is the one macronutrient, the one food that protects your muscle while the medication is doing its job. And it's the priority almost everyone underestimates. Now, I know in our culture, we hear about high protein this, high protein that. If I get to choose whatever I eat, you know, let's say I'm my husband, for example, who doesn't ever care what he puts in his mouth and just eats whatever he wants, I would probably opt for carbs first and then maybe some fats and then probably protein last. I'm not alone in that, I'm sure. And our culture is also set up that way. So in general, we are likely not prioritizing protein in our life. But in general, without using a GLP one or in a weight loss program, that might not have as detrimental effects as it does if we are using GLP ones and trying to lose weight. And if it's hard to get protein on a normal day, it's even harder when you're on a GLP one because your appetite is gone and you have to probably force yourself to eat much of the time. And protein just feels heavy now that nothing really sounds good. So most women on these medications end up eating almost none of it. That is exactly how a little muscle loss can turn into a lot. And here's what I recommend. If you follow me, I always say aim for 0.7 to one gram of protein per pound of your goal body weight every single day. Now, if you're on a GLP one, I would aim for the higher range of that. I would aim for 1%. Now, of course, this is my advice without seeing your lab work and you want to make sure that you do get blood work done and make sure that your doctor is approving this, right? I'm not a medical professional, but I am saying as a certified nutrition and fitness coach, aim for one gram per pound of your goal body weight every single day. That means if your goal weight is 150 pounds, aim for 150 grams of protein per day. Now, that seems like a ton. And I hate to be the bearer of bad news, but that is a lot of protein. It is a lot of protein. That does not come easy for somebody who's not on GLP1. And you throw in a lack of appetite with that, that is gonna be challenging to do. But it's not impossible. It's going to take intention. And what I recommend is using what I call the protein anchor. Protein goes on your plate first at every single meal before anything else fills up around it. Chicken, fish, eggs, Greek yogurt, cottage cheese, like pick one, that doesn't matter. But if you truly want your body to look its best after all the weight is off, you need to prioritize protein. That is the number one on this list. If you want your exact protein number plus your maintenance calories and your calorie deficit numbers, I have a free fat loss formula workbook that's in the description and it walks you step by step through the math on your specific body in about five minutes. And you can use it now while you're on a GLP one or after you're off, which will be really helpful for that. Okay, number two of what to prioritize. And I say this with love, especially for those who do not incorporate this already, but you need a strength train. And I understand when I say that, this is falling on the ears of women who may have never worked out in their life, who have no intention of ever stepping into a gym or ever lifting a weight. I understand that feeling. And I'm talking to you like I'm talking to my sister, who is my absolute best friend. My sister was on a significant weight loss journey over the last few years. She lost 150 pounds and she will not pick up a weight. She will not pick up a weight. And she is nine years older than me, so she's 54. And I cannot get that woman to work out to save her life. So I am talking to you like I would talk to her. You need to strength train. This is absolutely non-negotiable. You work so hard to lose all of this weight. You take your GLP one, you inject that on a weekly basis, you achieve your goal weight. And what you're left with is a shell that is soft with no muscle. Even if you're prioritizing protein, you are doing yourself a massive benefit, but few things will change your body composition like strength training will. And you don't even need to become a gym goer or a worker outer or a weightlifter or a bodybuilder. I mean, pick up some heavy dumbbells two or three times a week for about 30 minutes. And that is enough to substantially make a huge difference to your body composition. Because the medication, the GLP1, that creates the calorie gap. But lifting weights is what protects your muscle inside that gap. If you're losing weight and not strength training, you're losing the kind of weight that you'll wish you'd kept. If you've never picked up a weight in your life, this is a single most important thing that you can add. I have a program out called the Strong Core Method. It is a four-week program, three workouts per week, all levels, beginner, intermediate, advanced, that outlines a complete strength training program for you for your core. Now I realize this is only the core, but it is a great place to start. There's video tutorials for every exercise. So you don't have to wonder or guess or research. It is laid out for you so simply. If that sounds interesting to you at all, the link is in the description. You can check that out and see if that's a good fit for you. Okay, let's move on to number three of what you need to prioritize. And in my experience, I feel like this is what many women skip is how you come off the GLP one. If you're thinking about stopping, or if your doctor is bringing it up, this is the conversation that matters the most. Going straight from no appetite back to a normal one with no plan in place is how the weight piles back even faster than it left. The smarter way is to do it gradually. You build up your protein and your strength while you're still on the GLP one. So that by the time that your appetite comes back, your habits and your muscle and your metabolism are ready for it. Because I don't know about you, but the thought of injecting myself, you know, every week for the foreseeable future doesn't sound enticing. Also, I don't know if it's necessarily healthy or recommended. So eventually you want to come off of the drug, save a little bit of money, and maintain your weight on your own. And if you're set up with a high protein diet and you're set up with a strength training plan that's 30 minutes three times a week, you have set yourself up for the greatest success post-GLP one. And if you download my free fat loss formula workbook, that's gonna tell you exactly how many calories that you need a day to maintain your current weight. And if you need to again in the future without the use of GLP1, it's going to tell you how many calories you need to be in a safe deficit to lose weight. This way, you don't have to be so worried about the repercussions of coming off a GLP one. You don't have to wonder what you need to do to maintain your weight loss. I know all of the effort, all of the courage that it took, all of the sacrifice with a GLP one or otherwise that it takes or that it took to lose weight. I don't want you to gain that back. I want you to stay proud of yourself and feel good about yourself. I want you to set yourself up for the most success in your future because surprisingly, the weight loss part is the smallest part of the puzzle. The biggest part of that puzzle is how you maintain it. This is a skill we can learn and start to implement right from the beginning so we can increase our chances of keeping that weight off. So here's what I want you to walk away with. These medications can make you smaller, they can make you skinnier, but they cannot build the body that you want to keep and they cannot keep it for you. That part will always be your job. The medication just buys you time to do it well. Before you go, if you've been on a GLP one or you're thinking about starting one, the next logical step is figuring out the state that your metabolism is in because that changes how much protein and training that you need to protect your muscle. I have a free metabolism type quiz that tells you it takes about two minutes and you'll know the exact thing that's holding back your results and what to work on first for your specific body. That could make the difference between a month of spinning your wheels and a month that helps you make progress. You'll find the link down below in the description. And if this was helpful, follow the show so that the next one lands in your library automatically. And I would love if you could leave a quick rating if you've got 10 extra seconds. It's the single biggest thing that helps women like us find this podcast. And if you want more things on all health, fitness, nutrition, and lifestyle for us women over 40, come and join the behind the body community. Every week, I'll send you something to help you keep making progress. You can sign up for free at behind the body.com forward slash newsletter. Thank you so much for joining me, my friend, and I can't wait to chat with you next week.