I’ve been asked about my thoughts quite a lot recently, so here are my two cents on the new craze for GLP-1s/semaglutide/tirzepatide.*

Well, that’s the thing, weight loss jabs are not that new, but have blown up in popularity over the year or so.

Ozempic and Wegovy are GLP-1 agonists and contain a synthetic chemical which mimics the hormone glucagon: glucagon-like peptide 1 (i.e. GLP-1). Mounjaro is a dual agonist, which means it mimics another hormone as well as GLP-1, which is GIP (glucose-dependent insulinotropic polypeptide).

These cost about £180-£220 for one treatment course here in the UK.

There is no doubt that tirzepatide/semaglutide works and I believe it is a powerful tool that can be used to help people shift large amounts of weight.

How they work

The reality? Mounjaro, Ozempic and Wegovy essentially put users into a significant calorie deficit – they eat much less food (due to decreased appetite, slower digestion, more satisfaction after eating and better insulin regulation) and drop weight fast as a result. The powerful impact comes also from the reported drugs’ impact on our desire for food. I’ve listened to copious accounts of people who have taken the drug, as well as spoken to people personally who’ve taken it, and they all report the idea of ‘food noise’ (or other ‘addiction’ noises) quietening. Finally they’re not thinking about food in some capacity all day; they’re finding they’re more akin to that friend we have who says they’ve simply ‘forgotten’ to eat breakfast and lunch.

The drug has notable potential for those struggling with addictions/bad habits, food of course being one of them. Habits which tend to be linked to coping with stress and seeking dopamine rushes, such as alcohol and substance abuse, gambling and online shopping. Ozempic/Mounjaro/Wegovy interact with a region of the brain called the mesolimbic system, which overlaps with the brain processes that dictate addictive behaviours.

It’s important to note that there are of course downsides – no medication is without its side effects and a lot of people are taking the drug in a nonsensical way. Micro-dosing (according to your body’s metrics) is the best way to take the agonists, but most people take a one-size-fits-all dose (fault of the drug companies) which does not fit all, as we are not all the same. Visible side effects commonly found by people who take too much include: nausea/being sick, abdominal pain, fatigue, constipation and diarrhoea, and side effects around internal health include: severe hypoglycaemia (low blood sugar) and hyperglycaemia (high blood sugar) and vision issues. Visually, people develop wrinkles, sunken eyes, a gaunt look, thinner lips and sagging skin.

Absolute non-negotiables to stay healthy while taking GLP-1 agonists

If you decide to take the drug, there are some things you cannot compromise on while you’re doing so:

Strength training. Being on a GLP-1 agonist means you drop weight fast, but about 40% of the weight lost will be muscle mass if the body is left to its own devices (muscle is a tissue that requires a lot of calories to maintain – it’s ‘expensive’ – so the body will try to get rid of it first). This is incredibly detrimental as having muscle mass and strength has been shown in copious studies to categorically be the most important thing for longevity, health and successful aging. Muscle IS medicine. You absolutely have to be lifting heavy, to retain your muscle mass and prevent osteoporosis as much as possible. You won’t build muscle as your calories will be too low – the strength training is about preservation.
Some people report a general apathy feeling towards lots of things when on the drug (linking to the muting of desire I mentioned earlier), which can make motivation to workout hard. But remember, in this case it’s not about waiting for motivation, it’s about dedication!

A High protein diet. That’s hitting 2g per kg body weight every single day. Sadly, we don’t store protein, so it’s not a case of averaging over the week.

Without heavy, regular strength training and a high protein diet, you will end up as what’s known as ‘skinny fat’ – i.e. slim, but having very little muscle mass/’tone’. This leaves you metabolically busted and does your future self a massive disservice. Having less muscle comes with it’s own health problems – you’ll become frail, deteriorate quicker and become significantly weaker, meaning your quality of life will decrease as you’ll be less physically able. Using the drug without these measures means you’ll come out the other side in a worse position than when you started, which sets you up to be yo-yoing on and off the drug for years/the rest of your life and having to eat even less as time goes on.

Work on your attitude to food. GLP-1 agonists can be very powerful at helping alter behaviours to food while the drug is taken. However, this is the time you also need to work hard on figuring out the root causes of your poor relationship with food. Ideally, do therapy at the same time. Obesity is interlinked with mental health – there are often deep-rooted reasons why people overeat. This links to point 2! Don’t let GLP-1s be a temporary relief/plaster.

Eat well when you do eat. Yes, you could just eat one share bar of Dairy Milk for your days’ food and feel full, but you’ll feel terrible and you’re not fixing the deeper issue of how and why your eating habits got you to the point of being overweight. If you’re eating barely anything, micronutrients have to be one of the top priorities. This ties in with point 2.

My thoughts

When taking the drug I think it’s vital to make use the mental clarity you’ll have for improvement of future you (who isn’t on the drug). If you don’t, I believe you’re setting yourself up for failure and reliance on the drug. It’s the same if using it for addictions – without addressing WHY you get urges to drink and compulsively online shop etc., these desires will only come right back once the drug has worn off. Boots appears to be offering programmes and coaching alongside the drug, which is a great step.

Overall, I am still learning a lot about GLP-1s, but I can safely say that I don’t think they’re ‘cheating’. They’ve got extremely powerful uses for those in real, immediate need (obese patients who’s high body fat puts them at serious health risks). But, you can’t deny that having a drug dictate your weight loss means you’ve not gone through the emotionally difficult journey, self-education, lessons learned and hardship that ‘normal’ fat loss entails. These drugs reiterate that it’s the PROCESS which people are desperate to skip, but that’s the part which ensures you’ll keep the weight off sustainably in the future. It’s why studies show those who fad diet come back with much more body fat than they did before – it’s because they have not learned about nutrition and the science of how we lose fat… how can you maintain something you don’t understand? Without education on top of the GLP-1s, you’re throwing money at a problem that is likely to keep coming back.

*I must clarify, I am not a doctor or trained to give out medical advice. This article is about my opinions of the drugs and courses of action that must be taken alongside taking the drug, based on the research I have done.

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One of my wonderful clients is a really good example of that; I’ll call her A.

A is extremely busy, working a stressful senior level job in central London, only working from home once or twice a week. She travels a fair amount for work and she is a mum of a young child. All of this is what led her to contact me… she already weightlifts and loves it, but with strictly one hour for lunch, she barely finds the time to fit it in. If she does, by the time she discounts travel time there and back, plus time to eat and shower, she only has about 25 minutes to actually train. She told me she runs around like a ‘headless chicken’ and clock watches to move onto the next set quickly.

Of course, this experience wasn’t helping her stay consistent as the gym was proving a stressful affair. To top it off? Her gym is incredibly busy, so often she just used what equipment she could and stuck to what movements she knew and enjoyed. She lacked proper guidance and routine.

Fundamentally, she knew she needed advanced programming to stimulate progressive overload, accountability and the convenience I provide by bringing the gym to her. That’s why she signed up with Fitness by Georgia.

She was keen to try and get back to the weights she was lifting pre-baby, which she felt was ambitious but she wanted to give these a go. I thought this was a great goal!

I worked hard on creating her an appropriate in-gym programme. This meant:

• Taking into account how much time she actually has to train
• Factoring in that she can’t always go as much as she’d like, so there aren’t too many days scheduled (making it unrealistic) and sometimes has to skip a session
• For every 1st option exercise, I provided two other alternative exercises that use different equipment in case what we want to do as first choice is taken
• Pushing her out of her comfort zone, incorporating exercises that were perhaps new to her or she’d only ever done different versions.

I designed our in person sessions to be challenging and a solid foundational workout, so even if she didn’t get to the gym at all one week, she’d still have had an impactful session with me. As A likes change, I switch the routine up once a month to keep things fresh, but I employ techniques to keep the movements tough, even for A’s level of strength!

“I love training with Georgia. She has taken my strength training to another level and really adapted her programming to suit my busy life. I’ve achieved things I didn’t think possible, all thanks to her perfect mix of honesty, accountability, and empathy. Also, if you ever need a motivational pep talk thrown in the mix, she’s the trainer for you!”

Now, just 2 months into us working together, she has hit the highest deadlift and leg press weights she ever has! The weights she has reached far exceeded what she thought she was capable of which was an absolutely wonderful moment to share with her. Just a few weeks before, she had a moment of doubt, wondering if she was being too ambitious in aiming for her pre-baby weights. I’m so glad she didn’t let that wobble get to her too much, and instead, harnessed that energy.

Consistency, smart training, and accountability helped A build her strength and exceed her own expectations. With new milestones already smashed, I can’t wait to see what the next three months bring for A!

Does some of this sound familiar to you? Do you resonate with A’s challenges and her situation? Do you wish you could see real results and get stronger and fitter, without the stress? Get in touch today to see how I can help you.

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Now consider this statement if the house is your body. Isn’t it funny that people won’t hesitate to sort a problem that involves a big part of their lives – their home – but when it involves themselves, they’re reticent. People will pay £100 an hour for a plumber or an electrician to come and fix something in their house, but they’re less likely to pay to look after the thing that’s going to carry them through their whole life.

Some may argue that moving more and eating well isn’t a question of whether you ‘want’ to do this or not. It’s about, as an adult, taking responsibility for your body, your future and your mental health – in life we have to do things we sometimes don’t want to, because it’s the right thing to do. But this approach isn’t always realistic, as some people are not motivated by this more negative stance. Perhaps thinking about this in a different way can be powerful: we are lucky if we are able to move our bodies, eat well and get regular fresh air. We all know the unparalleled benefits that exercise and good nutrition brings: better sleep; more energy; better bodily functions & mobility; being able to do more with your life; improved physique; living longer; reversing some health conditions; less niggles and injuries and better mental health.

So, why is it that we humans can be so apathetic towards looking after ourselves when we need it the most? Our bodies are our true home. It’s what carries you, your brain and your soul through your whole life. 

Statistically only 16% of the population in the UK has a gym membership. When you put that into perspective of how many people are likely not exercising much or at all, it’s quite shocking. Of course, not everyone who keeps fit has a gym membership, like my clients for example, but it’s a good indicator of the situation the UK is in, which is increased obesity rates.

I think there needs to be a better societal connection between good movement, weightlifting and nutrition and the direct benefits, rather than just focusing on the improvements in health markers. These are the stories like the 75 year old who can now pick up their grandchildren, the busy office worker whose low back doesn’t hurt anymore, the stay at home mum whose core strength is returning and her hormones are being balanced beautifully or the keen golfer whose body is stronger and so now they can return to playing the game they so deeply love.

Let’s reflect on this, and consider how we can put time aside to work on bettering ourselves inside and out, whether we’re at crisis point or not.

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In exercise theory, there are multiple components to good exercise programming. The FITT principle* covers the key areas that should be taken into account:

• Frequency (how frequently is the exercise being done?)
• Intensity (how intense is the exercise?)
• Time (how long is the exercise being done for?)
• Type (what exercise is being done?)

As you can see, intensity is important when it comes to short and long term programming. So, the question remains – how do you increase intensity without increasing weight?

Increase the sets

If you’re only doing 2 sets of an exercise each, you may be best to slowly increase the amount of sets, so the same muscle is being worked harder. This is more likely to lead to fatigue and even going until failure, which is positive!

Increase the reps (repetitions)

This is an easy win for beginners. Keep the weight the same that is hard, and increase reps. Eventually you’ll get to a point where the weight that was once heavy is lighter work, that’s where you go back to the reps you were doing prior, but with a heavier weight. For example, if you’ve been doing 4 reps of an exercise, you may up the reps to 6 now with the same weight.

For reference, these are the categories of rep ranges:

• Strength: 1 – 4
• Hypertrophy (muscle building): 4 – 12
• Endurance: 12 – 20/25

So, do note, if you’re already doing 12 – 20/25 reps, this is high and going much above this won’t be achieving you results – you are doing cardio, not weight lifting. You should definitely be increasing your weight if you want to build any muscle!

Going until failure

Working a muscle until failure is a common tactic used by bodybuilders and amateur weightlifters alike. It involves doing one exercise for a few reps off being burned out for the first set, the second set is similar, and so on until your last set, where you go until you can’t lift the weight any more or your form breaks down enough that you are not doing the move properly. You may find that with each set you are lifting less as your muscle is more worked – that’s good!

Structured tempo work

This is in an incredibly underrated way to seriously increase intensity, and focus on form! This involves slowing an exercise right down to a structured timing pattern. For example, if you were doing squats, you may adopt a 4:1:1 pattern, meaning 4 seconds to go right down, 1 second pause at the bottom and 1 second to shoot up. As you can see, within this method, there’s also room for growth by extending the number of seconds at any given stage (or all)!

Unilateral exercises or training

Unilateral, like tempo work, is another underutilised way to increase the intensity of a workout. Unilateral means exercises only using one limb at a time. It’s also an absolutely brilliant way to work on bodily imbalances – which everyone has – so if you don’t have at least a few unilateral exercises in your workout, change that today! Some great examples are front or reverse lunges, Bulgarian split squats and single arm chest press.

Specific body part days e.g. ‘leg day’, or even harder still, a ‘glutes day’

A common workout structure is a full body. This is a brilliant option for those with less time, or an inability to commit to a certain number of sessions per week. However, it can mean each muscle isn’t being worked as much as it could. Try splitting your workouts up into ‘upper’ and ‘lower’ body days, or further still, you could do ‘back, biceps and triceps’ and ‘glutes and hamstrings’ for example.

Generally slowing down and focusing on form

Taking time to slow down and focus on form is likely to increase intensity. When you remove power, momentum and ‘bounce’ out of the eccentric and concentric parts of a movement, the muscle has to work harder to complete the movement. For example, if you biceps curl quickly and you do not brace your core, you may find the rest of your body takes over and helps swing your arm up and down, making it easier. If you were to instead stand against a wall and slow the movement down, focus on keeping your elbows tucked and the form great, the exercise will categorically be much harder and the target muscle worked more!

Incorporating more balance work e.g. balance boards

This may be worth considering if you have been lifting weights for a little bit of time. This will help you engage more of your body and core to keep you tight and the working muscle (agonist) will have to contract more and more frequently, while also recruiting more ‘stabiliser’ muscles to keep it steady.
Women, take note! If you are on your period, or just before, it is a common symptom to temporarily lose your balance. Be wary of doing any balance-heavy movements, as to not injure yourself.

Change up your exercises

It’s important to remember, your body adapts incredibly well to exercise(s). Muscle memory is recruited and what was once hard gets easier with practice, more flexibility and time. Consider giving your body a shake up and introducing new exercises. This will trigger muscle stimulation and growth. But note, don’t change exercises too frequently if you want to see muscle building results, as your body does need a certain amount of repeated stimulus to develop muscle. Beware of DOMS with this (delayed onset muscle soreness) – this is just a good sign to you that your body has been shocked and is learning to use your muscles differently!

1. To begin with, focus on only changing one or two of these factors at a time, so you have more in your pocket ready to utilise when you need another intensity boost.
2. Later, you can combine elements from above and change up the combinations, too.
3. Lastly, when all else has been truly exhausted, you may be at a stage where you need to consider purchasing more weights, or accessing a gym occasionally.

If you’re interested in at-home personal training with me, book a complimentary consultation and trial session today and I look forward to meeting you!

*developed by exercise physiologist Dr. Ken Hutchins.

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