The short answer
Ozempic and exercise aren’t competitors. GLP-1 medicines are a medical treatment your GP decides on; exercise is a habit you build. If you used to train and work has wrecked your routine, your problem may be structure, not biology. Either way, strength training is the best tool for keeping muscle while you lose weight.
Why everyone is talking about GLP-1s
GLP-1 receptor agonists (the class of medicines that includes semaglutide) have moved from diabetes clinics into everyday conversation. In the 2025 NSW Population Health Survey, around 8% of NSW adults aged 16 and over reported current GLP-1 use. Among men it was 6.5%, and in the 45-54 age group it was 11.9% (NSW Health, GLP-1 receptor agonist use, NSW, 2025, preliminary results). Of people using them, 54% said their main reason was weight loss and 42% said type 2 diabetes.
These are preliminary, self-reported figures from one state, and NSW Health notes wide confidence intervals for some age groups. But the direction is clear: plenty of men in their 40s and 50s are either using these medicines or wondering if they should.
First, what this article is not
This isn’t medical advice, and it isn’t a judgement on anyone using GLP-1 medicines. For many people they’re an appropriate, prescribed treatment. Whether you should use one is a decision for you and your GP, based on your health history.
This article is about a different question, one only you can answer.
Drug case or structure case? A simple self-check
Ask yourself these five questions honestly:
- Did you used to train consistently? If you were fit in your 20s or 30s, you know how to do the work.
- When did the waist start creeping? If it lines up with a promotion, a new role or more travel, that’s a clue.
- Do you eat well when your week is predictable? If the wheels only fall off during busy periods, the issue is systems, not willpower.
- Have you ever followed a structured plan with a coach? If not, you haven’t tested the structure option yet.
- Has your GP raised a specific medical concern? If so, start with that conversation.
If you answered "yes" to the first three and "no" to the fourth, you may be what we call a structure case: someone whose results disappeared when the structure did. That’s not a character flaw. It’s a design problem, and design problems can be fixed.
Why muscle is the real issue
Whichever path you take, the conversation should include muscle, not just the number on the scale.
When people lose weight by any method, some of that weight is lean mass. A 2025 systematic review and meta-analysis in Obesity Reviews pooled 38 publications and 1,735 participants to look at how GLP-1 receptor agonists affect measures of muscle mass (Anyiam et al., 2025). Key findings:
- In people without type 2 diabetes, measures of muscle mass fell by an average of 1.41 kg, alongside 6.02 kg of fat mass.
- In people with type 2 diabetes, the reduction in muscle-mass measures (0.74 kg) was not statistically significant, while fat mass fell by 3.18 kg.
- In both groups, the loss of muscle-mass measures made up less than 20% of total weight lost.
The authors note that more detailed research on functional skeletal muscle is still needed. The practical takeaway for a man over 40 is simple: muscle is worth protecting, and you protect it by using it.
What the research says about strength training and weight loss
Strength training is the most consistently supported way to hold on to muscle while losing fat.
- A meta-analysis of six randomised controlled trials in older adults with obesity found resistance training three times a week during calorie restriction prevented about 93.5% of the lean mass loss caused by dieting alone, with similar fat loss (Sardeli et al., Nutrients, 2018).
- Protein supports the process. A meta-analysis of 49 trials found muscle gains from resistance training plateaued at about 1.6 g of protein per kg of body weight per day (Morton et al., BJSM, 2018).
That’s why our position is the same for everyone: lift, eat enough protein, and track your waist and strength, not just your weight.
Ozempic vs exercise: a side-by-side view
|
GLP-1 medicine |
Structured strength and nutrition program |
|
|---|---|---|
|
Who decides |
You and your GP |
You, with a coach |
|
What it targets |
Appetite and blood glucose (medical treatment) |
Muscle, strength, habits, routine |
|
Effect on muscle |
Some loss of muscle-mass measures reported in research |
Resistance training helps preserve muscle |
|
Skills you keep |
Depends on the habits built alongside it |
Training and eating systems you can run for life |
|
Can they be combined? |
A question for your GP |
Australian guidelines recommend strength work at least 2 days a week for adults |
Why structure beats motivation for executives
Executives don’t lack discipline. They lack spare decision-making capacity. When every session needs planning and every meal needs choosing, training is the first thing to go in a big week.
Structure solves that by deciding in advance:
- What you’ll do: sessions written for 12 weeks, ready in an app.
- When you’ll do it: four short sessions, booked like meetings.
- What you’ll eat: default meals and a "work dinner" rule.
- Who’s checking: a weekly check-in with a coach who adjusts the plan.
Australian data shows how hard it is to keep strength training going through mid-life. In 2022, just 21.0% of Australians aged 45-54 did strength or toning exercise on two or more days a week (ABS, Physical activity, 2022). The guideline is at least two days a week (Department of Health: recommendations for adults).
What to do this week
- Measure your waist at the navel, relaxed, first thing in the morning. Write it down.
- Book four 40-minute blocks in your calendar for strength training.
- Pick a default breakfast and lunch with a solid serve of protein.
- Book a GP check-up if you haven’t had one recently, especially before starting a new program.
- Decide whether you’ll go it alone or get a coach to make the training decisions for you.
FAQ
Is Ozempic better than exercise for weight loss?
They do different jobs. GLP-1 medicines are a medical treatment that you and your GP decide on. Exercise, especially strength training, builds and preserves muscle and fitness. Australia’s physical activity guidelines recommend muscle-strengthening activity on at least two days a week for adults aged 18-64.
Do GLP-1 medicines cause muscle loss?
A 2025 meta-analysis found people without type 2 diabetes lost an average of 1.41 kg in measures of muscle mass alongside 6.02 kg of fat while using GLP-1 receptor agonists. The authors say more research on functional muscle is needed. Ask your GP about your own situation.
How do you prevent muscle loss while losing weight?
The best-supported approach is regular resistance training plus adequate protein. A meta-analysis found strength training during calorie restriction prevented about 93.5% of diet-induced lean mass loss in older adults with obesity.
How do I know if I need Ozempic?
Only your GP can answer that. A useful question to bring to the appointment is whether your weight gain is mainly medical, or whether it followed a change in routine, such as a bigger job or more travel.
What is a "structure case"?
It’s our term for someone who knows how to train and eat well but lost their results when work removed the structure. The fix is a plan, a schedule and accountability, not more willpower.
Want the structure done for you?
Executives make enough decisions. In 12 weeks, StrongCEO makes your training and nutrition decisions for you: four short sessions a week in the Everfit app, nutrition defaults, and weekly check-ins.
Free download: 14-Day Executive Reset. Start here before committing to a program.
Get the free 14-Day Executive Reset →
Ready for the full program? See StrongCEO →
This article is general information only and is not medical advice. Talk to your GP about weight-loss medicines, and before starting a new exercise program.
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About the author
David Stanton, Founder and Head Coach, Stronghold Coaching (Brisbane, Queensland)
- Qualifications: Exercise scientist and clinical exercise physiologist
- Experience: Ran Stronghold Gym in Underwood, Brisbane for over a decade; competitive strength athlete
- Specialties: Strength coaching for busy professionals, dads and lifters
- More: About David