When the Pounds Fall Off – GLP-1 Medications, Physical Therapy and Maintaining Health

The 2020s saw the introduction of GLP-1 weight loss medications brought to consumers. Presented slowly at first, and at a high price, the drugs in both injection and pill form are now frequently prescribed, more affordable and readily available through medical and online sources.

For people who have struggled with being overweight or battled conditions related to excess weight, GLP-1 medications have opened the door to weight loss reality. Not just reality, but larger loss numbers, seen in shorter periods of time.

If you are starting a weight loss journey with GLP-1s or are already seeing results from GLP-1 medication use, adding physical therapy can be a huge step in transforming lost pounds into a healthy body.

The impact of weight on the body

Let’s look at what carrying excess weight does to the human body.

In addition to generally having an increased risk of chronic conditions like heart disease, type 2 diabetes and certain cancers, individuals who register higher on the body mass index (BMI) scale can experience added strain on the musculoskeletal system, resulting in:

• Joint pain – Excess weight puts extra pressure on weight-bearing joints like the knees and hips, which can accelerate cartilage breakdown and lead to osteoarthritis.
• Increased injury risk – Carrying extra weight makes you more prone to fractures, strains and sprains because of higher fall risk.
• Reduced mobility – Added pressure and potential pain can lead to a reduced range of motion and difficulty with daily activities.
• Muscle and tissue inflammation – Added weight can mean added inflammation throughout the body, limiting flexibility and range of motion. 

Good news, bad news – pros and cons of rapid weight loss

The upside.

For many, GLP-1 medications have made possible what those who have battled weight felt was impossible — giving them a jump start on a journey to health. That means people all around the country are seeing improvements in metabolic health, or the body's ability to efficiently process and use energy from food, maintain stable blood sugar and cholesterol and regulate blood pressure.

The ripple down effect of the body working more effectively equals a reduction in inflammation, less stress from body mass on joints, improved mobility and overall feeling more energized to take on activities.

The downside.

When you are losing “weight,” it’s not just fat loss. Included is muscle loss (medically known as muscular atrophy), with some studies suggesting that 15-40% of the weight loss with GLP-1s being muscle itself.

Muscular atrophy, left unchecked, can make doing everyday tasks, like going up and down stairs, getting up from a chair without assistance, carrying groceries or walking for long periods challenging. Rapid or extreme weight loss is also more likely to cause bone loss, increasing risk of fall or issues with balance and potential for fracture.

Physical therapy transforms weight loss into bodies built for healthy aging

Weight loss is about more than just looking good and improving metabolic numbers. Exercise is essential. Just doing normal activity is not enough. The body needs to have stress on it to reach its potential, so fitness becomes a vital component.

Physical therapists operate at a crucial intersection between medicine and fitness for GLP-1 patients. Using evidence-informed techniques and exercises to safely progress physical function, with education along the way, they create a lifelong healthy relationship with the body.

Transformation begins with a thorough evaluation of strength, pain, mobility and any physical barriers such as medical conditions, joint stress, muscle imbalances or fear of movement. From there an individualized, exercise-based program is designed and customized around personal goals and life activities that matter most. Long-term success happens best when you are motivated to continue progress toward healthy habits.

Physical therapy looks at building the body back piece by piece during and after weight loss. Each area of focus brings a different dimension to health.

Your therapist restores function and counteracts rapid weight loss side effects by:

• Protecting bone density – The areas in our body that are most likely to fracture are the spine, hips, pelvis and wrist. Knowing rapid weight loss can strip bones of their mineral strength, therapists use resistance training to strengthen legs and arms, posture exercises to tighten up the core and mid-back and balance exercises to decrease risk of falling. Also vital are impact exercises like controlled jumping or stomping that put pressure on the bones in a healthy manner – safe stress equals gains in bone strength.
• Preserving muscle mass – Similar to bone strength, maintaining strong muscle mass while losing fat serves you in the long run. Fortifying your diet with protein rich foods and strengthening various muscle groups through resistance training and weight bearing exercises creates a mechanical stimulus to build muscle.
• Enhancing functional capacity – For rapid weight loss, the right level of aerobic exercise positively impacts cardiovascular health, increases energy levels and builds endurance. The ideal plan is careful about finding the proper balance of cardio-related exercise with resistance training to make sure muscle loss is kept to a minimum.
• Reducing injury risk – The rate of progress matters. Therapists know the proper pace at which to advance through strengthening. This prevents taxing the body too hard, too fast, for better results.
• Improving balance and posture – Strong balance comes down to a coordinated response of full strength along with proper hip and toe alignment and centering of body weight giving feet the ability to grab and feel the ground. Your therapist addresses these areas with strengthening and stretching exercises, manual therapy and ergonomic advice.
• Supporting long-term habits – A large part of maintaining weight loss is creating new habits. Habits are formed by routine practice. Therapists assist with habit building by addressing proper nutrition and implementing a home exercise program that can be done as part of a daily or weekly schedule to continue progress between visits or after discharge from physical therapy.

Partnering for health

Having a team of professionals on your side gives you power in your pursuit of life after weight loss.

Physical therapists work with a variety of health care providers to make sure you’re on track with your goals. They can tap you into resources like dietitians or nutritionists to ensure you are fueling the body in the proper ways to maintain strength and endurance. They openly communicate your progress with your physician or health specialists to meet your specific health goals.

Choosing physical therapy as part of your GLP-1 plan is a commitment to taking your body to the next level. Through a care plan customized just for you, physical therapy completes the loop by giving you the tools you need to continue weight loss success.