In short
To keep your muscle on Ozempic, Wegovy or Mounjaro, aim for 2 to 3 short strength sessions a week that work the major muscle groups, as the Canadian 24-Hour Movement Guidelines recommend. This 4-week plan uses a chair, a wall and a resistance band, takes 20 to 30 minutes and progresses gently. If you have a heart or joint condition or feel dizzy, get the green light from your doctor or a physiotherapist first.
When the weight comes off quickly, it is tempting to rely on walking alone. Walking is valuable, but it is not enough to protect muscle mass. Muscle is kept when it is asked to work. The good news: that work can be gentle, short and done in your living room.
In this article
Why strength training comes first
In older adults on calorie restriction, a 2018 meta-analysis found that resistance training prevented 93.5% of the lean mass loss caused by dieting. It was not a GLP-1 study, but the principle is the same: muscle that is used is muscle that is kept. To understand how much muscle you can lose on treatment, read our article on muscle loss on Ozempic.
The Canadian 24-Hour Movement Guidelines for adults aged 18 to 64 recommend:
| Recommendation | Target |
|---|---|
| Moderate-to-vigorous physical activity | At least 150 minutes per week |
| Muscle-strengthening activities using major muscle groups | At least twice a week |
| Light physical activity, including standing | Several hours a day |
| Sedentary time | 8 hours or less a day, with no more than 3 hours of recreational screen time |
| Sleep | 7 to 9 hours of good-quality sleep |
The guidelines for adults 65 and older add activities that challenge balance.
Before you start
Talk to your doctor, pharmacist or a physiotherapist if you have heart disease, significant joint pain or osteoporosis, have had falls, or have felt dizzy since starting treatment. On a GLP-1 you eat less: avoid training on a completely empty stomach and drink water.
The 6 exercises
Do each movement slowly, breathing out during the effort. The effort should be noticeable, but you should still be able to talk. A simple scale: out of 10, aim for 5 to 7.
1. Chair sit-to-stand
Sit at the edge of a sturdy chair, feet flat and hip-width apart. Stand up without using your hands if you can, then sit back down slowly over three seconds. This is the most useful exercise on the list: it is a movement you make dozens of times a day.
2. Wall push-ups
Stand facing a wall, hands at shoulder height, and step back. Bend your elbows to bring your chest toward the wall, then push away. The farther your feet are from the wall, the harder it gets.
3. Band rows
Anchor a resistance band in a closed door handle (or loop it around a post). Pull your elbows back, squeezing your shoulder blades together. No band? A bag with two cans works for a bent-over row, one hand resting on a chair.
4. Glute bridge on the floor or bed
Lie on your back, knees bent, feet flat. Lift your hips by squeezing your glutes, hold for two seconds, lower. Great for the lower back and hips.
5. Heel raises
Standing with one hand on the back of a chair, rise onto your toes, then lower slowly. Calf muscles help circulation and balance.
6. Single-leg balance
Next to a counter, lift one foot a few centimetres and hold for up to 30 seconds, then switch. This one matters especially after 60.
The week-by-week plan
| Week | Sessions | Sets per exercise | Reps | Rest between sets |
|---|---|---|---|---|
| 1 | 2 | 1 | 8 to 10 | 60 to 90 s |
| 2 | 2 or 3 | 2 | 8 to 10 | 60 to 90 s |
| 3 | 3 | 2 | 10 to 12 | 60 s |
| 4 | 3 | 2 or 3 | 10 to 12, slower tempo | 60 s |
For balance, use time instead of reps (10 seconds in week one, up to 30 seconds in week four). Leave at least one rest day between strength sessions. On the other days, walk.
How to progress after week 4
- Slow down the lowering phase (4 seconds instead of 3)
- Add light weight: a backpack with books, water bottles
- Switch to a stronger band
- Do sit-to-stands from a lower chair
- Join an adult strength class at your community centre
What about walking?
A meta-analysis of 15 cohorts published in The Lancet Public Health in 2022 found that mortality risk dropped up to about 6,000 to 8,000 steps a day for adults 60 and older, and 8,000 to 10,000 steps for those under 60, before levelling off. You do not need to hit 10,000 steps right away: add 1,000 steps a day each week, for example with a short walk after meals, which can also help digestion.
Warning signs that mean stop
Stop and get help if you feel
- Chest pain, unusual shortness of breath or palpitations
- Dizziness or feeling faint
- Sharp joint pain that does not go away with rest
- Cold sweats, shakiness or marked weakness (especially if you also take a diabetes medication)
For chest pain or signs of a stroke, call 911. For non-urgent questions, the 811 nurse line (in most provinces) or your pharmacist can guide you.
Pair it with your nutrition
Training sends the signal; protein provides the building blocks. A meta-analysis in postmenopausal women found that whey protein only helped lean mass when combined with resistance training: the two go together. Our guide to protein on Ozempic helps you reach your target. If you are over 40, see also menopause and muscle loss.
Talk to a health professional
This plan is general. A physiotherapist or kinesiologist can adapt it to your condition, pain and goals.
Frequently asked questions
Can I do strength training while on Ozempic?
Yes, and it is recommended to limit muscle loss, unless there is a medical reason not to. Start gently, eat before your session and stay hydrated, since a reduced appetite can cause fatigue.
How long before I see results?
Strength often improves within a few weeks, partly because your nervous system learns the movement. Muscle mass changes more slowly. Track simple markers, like how many sit-to-stands you can do in 30 seconds.
Do I need a gym?
No. A chair, a wall and a band are enough to start. A gym or class becomes useful once these exercises feel too easy.
What should I do on nausea days?
Do a shorter session or swap it for a slow walk. Do not push yourself if you have vomited or feel dizzy. See our article on Ozempic nausea.
Is it safe after 65?
Canadian guidelines recommend strength training at every age, along with balance exercises. Have the plan checked by a professional if you have health problems or a history of falls.
Sources
- CSEP. Canadian 24-Hour Movement Guidelines for Adults aged 18–64
- CSEP. Canadian 24-Hour Movement Guidelines for Adults aged 65 and older
- Sardeli AV et al. Resistance training prevents muscle loss induced by caloric restriction. Nutrients, 2018 (PubMed)
- Paluch AE et al. Daily steps and all-cause mortality: meta-analysis of 15 cohorts. Lancet Public Health, 2022 (PubMed)
- Kuo YY et al. Whey protein supplementation in postmenopausal women. Nutrients, 2022 (PubMed)
- Mozaffarian D et al. Nutritional priorities to support GLP-1 therapy. Am J Clin Nutr, 2025 (PMC)
This article is for information only and does not replace advice from a health professional. Talk to your doctor, pharmacist or a registered dietitian before changing your treatment, diet or exercise.
