Resistance Training and Weight Loss: Why Muscle Matters More Than the Scale

James Hill:
Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:
And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

James Hill:
Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:
Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

James Hill:
Ready for the “And” factor?

Holly Wyatt:
Let's dive in.

James Hill:
Here we go.

Holly Wyatt:
Jim, imagine someone who has lost, let's say, 50 pounds on a GLP-1 medication. They're thrilled. Their doctor's thrilled. But here's my question. What if they've lost these 50 pounds and they end up weaker? Maybe they don't feel as strong when they walk up the stairs, or maybe they have trouble getting up off a low couch. They have to push a little bit more.

James Hill:
Yeah, Holly, that's an important question. Because when people lose weight, they don't just lose fat. It would be wonderful if all the weight loss came from fat, but they lose lean tissue too. And a big part of lean tissue is muscle. And the scale doesn't tell you the difference between muscle and fat.

Holly Wyatt:
Yeah, we've spent decades just trying to help people lose weight. Now we have medications that can produce this weight loss. But are we paying enough attention to what people are losing along the way?

James Hill:
And this just isn't a GLP-1 issue. It's a weight loss issue in general. Preserving strength and physical function matter, no matter how you lose the weight.

Holly Wyatt:
And I think that's important. This isn't really new, but we haven't really been talking about it because we haven't been able to produce enough weight loss to maybe make it an issue. The other thing is everybody's talking about protein, Jim. I don't know if you've noticed, there's all the labels, protein this, protein that, eat more protein, drink more protein. And everybody's assuming that the protein is going to protect their muscles. That's one of the big reasons why they're wanting to eat the protein. But is protein enough? What about resistance exercise?

James Hill:
Yeah, that's a big reason, Holly, I wanted to do the episode today because you and I have been interacting with a lot of folks who study body composition and muscle function. And I think the message out there that protein alone is the answer may not be the right one. And what we wanted to do today, and Holly, kind of why I like today's episode, we're going into a lot of research. We're going to summarize a lot of research, which we like to do. And we're asking the question about, can you limit loss of muscle mass? Is it protein alone? And in particular, what does resistance exercise do? There's compelling research showing that exercise can help preserve lean tissue during weight loss. And it may be doing something much more important than burning calories.

Holly Wyatt:
Yeah, everybody thinks about exercise and burning calories, but here's something different to think about. So today we're looking at what the science tells us about muscle loss, about protein, and about resistance exercise.

James Hill:
And how people can protect their strength without necessarily spending hours in the gym.

Holly Wyatt:
Because losing weight is one thing, but keeping the strength to live that life, you know, we talk about living larger, is a whole other thing.

James Hill:
So, let's take a few questions and let's see if we can summarize some of the science that helps us answer these questions. So, this is kind of what do we know?

James Hill:
And the first one is, are the GLP-1 medications causing muscle loss? And Holly, there's been a lot of interest and a lot of research around that. We know that anytime you lose weight, you lose muscle and you lose fat. Typically in our studies, we've done a lot of these. 25 to 30% of what you lose will come from muscle. The rest will come from fat. Are the GLP-1 medications causing you to lose more muscle and less fat? And so again, one of the studies that we highlighted here is a meta-analysis in 2026 of 20 randomized trials. And again, what they found, the lean mass loss was roughly 25 to 39 percent, not totally out of the range of what we've seen with lifestyle. That varied a little bit by medication.

James Hill:
With semaglutide, it may have been a little higher, with tirzepatide a little lower. And if you take lifestyle, 26%, 27%, what you're seeing is it's in that range, but there's a tendency for it to maybe be a little higher.

Holly Wyatt:
But I think one thing to make sure that the listeners know is I don't think it was statistically different. So I don't think we know that one medication, for instance, is producing more muscle loss than another or more lean tissue loss than another. And it's in that range. And so always when I hear people say, are GLP-1 medications causing muscle loss? I'm like, I think weight loss is causing muscle loss. And we know that. I don't think that there's any data yet to show that the GLP-1 medications are doing more than we could explain.

James Hill:
I agree, Holly. And another big caveat is this is measuring lean mass and lean mass is not muscle. Muscle is a big part of lean mass. And again, the people that were watching out there doing the research are now beginning to actually measure muscle, both amount of muscle, but more function of muscle. So I've heard some of the researchers say, well, maybe you are losing some muscle, but maybe that's not the best kind of muscle so that you end up, losing muscle, but not necessarily losing functionality. These are the big questions I think we don't yet know the answer to.

Holly Wyatt:
So that's that next layer. It's like not just about the amount, but the function of the amount. Kind of like when we talk about bone, it's not just about losing bone, but does it actually make your fracture risk go up? So the function of the bone or the function of the muscle... And people a lot of times ask me, well, why are we suddenly talking about this if you say it's always been there? I think it's because of the amount of weight loss we're getting.

James Hill:
Absolutely. And this is critically important. I mean, again, Holly, one of the things that you know is that when you gain weight, you gain lean mass. So it's not unexpected that we lose mass. So now, rather than the amount of lean mass, the quality of lean mass, how much is muscle and how functional is that muscle. These are the next levels that it's going to be fascinating to watch the research here.

Holly Wyatt:
And then I think that next level, and we've talked a little bit about this, it may not be the same for the whole population. There could be certain people that are more vulnerable.

James Hill:
I still worry about my people, Holly, us old folks. I worry that we, you know, we can't afford to lose muscle mass. We need it for functionality. So I think you're right. I want to see more research in different groups.

Holly Wyatt:
All right, so let's then move kind of to the next question. Okay, this is what's going on. We kind of know that we're losing it. We're not sure if it's more than we could explain from the weight loss. We have a lot of functional questions. Can resistance exercise preserve muscle? Change that.

James Hill:
I think the answer there is yes. And again, what we pulled out here is a 2026 meta-analysis of 34 randomized trials, about 1,455 participants, overall exercise preserved about one kilogram more fat-free mass than diet alone.

Holly Wyatt:
Okay. Kilogram. So that's what? 2.2 pounds. All right. What do you think about that, Jim? 2.2 pounds.

James Hill:
But that was approximately half of the lean mass loss associated with diet alone. So yes, Yes, I think it's important. A kilogram of lean mass? Yeah, baby, I want it.

Holly Wyatt:
I do too.

James Hill:
Because a lot of that is muscle.

Holly Wyatt:
Yeah. And when you look at the amount in that study about how much they were losing, it's a good percentage of what they were losing that they were now preserving.

James Hill:
Right. And this isn't about calorie burning. The resistance training is about getting stronger. And so while you're losing weight, you're actually working to get stronger. So I think, yes, we can say that resistance exercise does preserve some muscle. Now, it may not be huge, but I think it's enough to make a difference.

Holly Wyatt:
Well, the other thing I think we have to look at is it probably is related to how much weight you're losing.

James Hill:
Right.

Holly Wyatt:
The bigger the negative energy balance and potentially the more muscle or lean tissue that you're losing, how much can it intervene may be related to that too.

James Hill:
But at the end of the day, Holly, I want as much lean mass, as much muscle mass as I can get.

Holly Wyatt:
I agree. And I think the reason we want people to start focusing on that part, we've been focusing on the protein, Jim. We need to focus on this resistance training a little bit more.

James Hill:
Well, and it's both. I think it's the combination of protein and resistance. But protein alone, what happens is the resistance training is sort of the stimulus for the muscles to use the protein to build strength. Without that, the extra protein isn't really going to do much, maybe a little bit, but not as much as adding the resistance training.

Holly Wyatt:
So do we know anything about what happens when you combine taking the medication and combine resistance training?

James Hill:
There's been surprisingly little there. But we pulled out, for example, one randomized trial with exercise and the liraglutide, which is an earlier version of semaglutide. So it's a GLP-1 medication. And so one of the things they found is that, they both lost fairly similar amounts of weight. But in the follow-up, there was more weight gain in the group that didn't exercise, that just used diet alone. And again, you and I are always interested in the long term. So it's not necessarily that the exercise led to more weight loss. The drugs were doing that, but it may have prevented some of the weight regain.

Holly Wyatt:
Yeah. So this is a study that shows more the power of exercise and resistance training and potentially preventing that weight regain. I think there's some studies ongoing really looking at what it does specifically to lean mass or muscle and function.

James Hill:
Yeah.

James Hill:
So, again, let's go back to something we alluded to earlier. Is protein alone enough? Can you preserve muscle simply by eating more protein?

Holly Wyatt:
And I think that's what most people are trying to do, Jim.

James Hill:
Most people are trying to do. Otherwise, look at all these products out there.

Holly Wyatt:
I mean, I don't have that data. I can't say not. I mean, that's...

James Hill:
But I agree. I think most people are looking more protein, more muscle, and may not be that strong a relationship.

Holly Wyatt:
Because here it's not just exercise, it's resistance training that you need. So that's even another kind of layer. And I'm not sure how many people have a resistance training plan, know what to do.

James Hill:
I'll tell you, most people don't. It's something most people don't do. So we pulled a couple of studies here, Holly. One, there was a Dutch trial of 100 older adults, my people. So higher protein alone didn't improve fat-free mass. So there was no significant difference in the protein alone and protein versus training group. So here's one which suggested there wasn't much of a difference, right?

Holly Wyatt:
So it wasn't significant, but the protein plus training group gained a little bit, but it wasn't significant in that study. So it may be a signal. I don't know.

James Hill:
Maybe a signal. And a second one, there were 83 adults with type 2 diabetes. Now it's a different thing. But high protein plus resistance training produced the greatest fat loss, but did not significantly prevent fat-free loss. So we're getting some kind of mixed signaling here. But I think, again, on the data I've seen, protein alone has fairly minimal effects. I'm not going to say no effect because it could have some effect, but it's the protein combined with resistance training that I think is the most powerful mechanism we have on preserving muscle.

Holly Wyatt:
I've heard someone explain it, that the protein may be like the icing on the cake or the sprinkles on the cake, and it might add a little bit. But if you don't have the cake, which is the resistance training, it's not going to work. You really need both of them. And that the amount the protein's adding may be the lesser of the two. Although I think we've got to get some more data on this.

James Hill:
So Holly, are you wearing weighted vests to increase your strength?

Holly Wyatt:
Oh, my gosh. Everybody's wearing these weighted vests. I think this has been going on for a while. I've just started noticing it or what, but it's definitely a big trend. And I think the idea is, can you wear a weighted vest and then don't have to do strength training? Can that substitute kind of for resistance training?

James Hill:
Well, we pulled one good study on this. It was a randomized trial of 150 older adults. So they did weight loss alone versus weight loss plus resistance versus weight loss plus the weighted vest. So the idea was, are you going to see the same effects in the weighted vest and the resistance training. And again, in this trial, they produced about 10% weight loss. Interesting resistance training improved muscle measures. Weighting vests did not. So it suggests that weighted vests aren't replacing resistance exercise.

Holly Wyatt:
Yeah. I think it's important to know, I think the weighted vest started more from a bone standpoint to try to kind of load the bone, which we know is important for bone strength and bone development and prevention of fractures and so forth. So, I'm not sure if this was the primary.

James Hill:
They measured bone here and they didn't see any effect. So, they didn't see that the weighted vest even had a positive effect on bone loss.

Holly Wyatt:
I don't think there's any data to say that these weighted vests are doing anything, Jim.

James Hill:
I think the best advice we have is don't think the weighted vests are replacing the resistance exercise.

Holly Wyatt:
For one thing, I'm not sure if they're enough, and I'm not sure that they're putting the resistance where you need it. I just don't think we understand that enough. I wouldn't be putting all my eggs in that basket for sure.

James Hill:
So given all this, Holly, have we been defining successful weight loss too narrowly?

Holly Wyatt:
Well, we've been talking about this for weeks. I think so.

James Hill:
You better think so, because I think this is so important that we change our thinking from amount of weight loss to the quality of weight loss.

Holly Wyatt:
Or amount of weight loss and, love that, right? These other factors that we need to be looking at, not just the scale. The scale is helpful. And I still think the amount of weight loss on the scale is an important idea. You know, we should monitor that. I'm not giving up on that, but I think there's other things now we should be. One of them is muscle, lean tissue, amount, but also more than anything, maybe the function.

James Hill:
What about strength and mobility and function? You know, we hardly ever measure these in many weight loss studies. And I think that needs to change. I think we need to start measuring those along with the amount and composition of weight loss.

Holly Wyatt:
And for our listeners, yes, we need to start collecting that in our research studies. But, you know, our listeners, here they are today, Jim. They're on these drugs, I would look at my strength, my function right now. I would start measuring that because that's another point of data for you to have, you know, how easy, you know, there's some sit and stand tests, there's walking upstairs, how do you, you know, there's definitely some things you can do. And I think we need to get better at giving people more ideas of what they can do to monitor where they are when they start. And is their function changing over time or strength changing over time?

James Hill:
Because that's what we want. We want function, strength, mobility. I mean, again...

Holly Wyatt:
And to look good. Muscle looks good, too.

James Hill:
That's why you want to preserve muscle, because it actually helps you do better in life.

Holly Wyatt:
And, Jim, I want to bring this back up cosmetically. We want muscle. That's what looks good.

James Hill:
Muscle looks better than fat, right?

Holly Wyatt:
Absolutely. So there's a cosmetic piece to this, too.

James Hill:
Nothing wrong with that. So, Holly, if the medications produce substantial weight loss, And again, the evidence we have so far is that exercise doesn't really add much to weight loss on these medications. Maybe that's not surprising because the medications are more powerful. Does that make exercise important for other reasons?

Holly Wyatt:
I think what you're saying is we've known it doesn't help the amount of weight loss.

James Hill:
Amount of weight loss. Right. And if you're looking just on amount, you would say, oh, you don't need any exercise.

Holly Wyatt:
So now I think this may change. We've said that for years, exercise not that important for the weight loss bags. Now, I may stop saying that, Jim. And I may have another reason. It's not because you're going to lose more weight totally. But now the exercise may be critically important, specifically resistance training when I say exercise, may be critically important for this structure, function, strength. And so that may be one of those things we got a little wrong.

James Hill:
So, Holly, would you go so far as to say resistance exercise should be a routine part of obesity treatment.

Holly Wyatt:
Almost. I think so. Definitely on GLP-1s where you're losing a lot of weight.

James Hill:
What do you think out there in the real world? How many patients are being counseled to engage in resistance training when they get their medications?

Holly Wyatt:
Oh, very few. And if they are, it's just do some resistance training, which is like what we typically eat less, move more, do resistance training. I mean, that doesn't really tell you what to do. So is anybody really getting a plan or some help in this? I would say very, very, if anybody.

James Hill:
Boy, there's a big gap right there.

Holly Wyatt:
Yeah.

James Hill:
So let's actually address that ourselves, Holly, in a few minutes. So what should people do about it? So say some of our listeners have GLP-1 prescriptions, but they've never been given any advice about resistance training and they don't have a history of resistance training. How the heck do you get started?

Holly Wyatt:
Well, here's where we've shown a bias, Jim, and I'm going to call us out on. You and we, I'll put myself in it, talk about the power of dietitians and that everybody should have a registered dietitian.

James Hill:
That's true.

Holly Wyatt:
And maybe we should be talking, everybody needs a trainer, someone, a personal trainer that has been trained in resistance training and knows how to help people.

James Hill:
It's interesting. The American College of Sports Medicine recently developed a certification for trainers who can work with people on the GLP-1 meds. So they're out there. Maybe there's not enough yet. That's a great question because I have always said registered dietitians should be part of a prescription. Maybe a trainer should be part of the prescription too.

Holly Wyatt:
I'm not going to say maybe. I mean, what are we saying right here? That protein may not be enough, that you need this resistance training. And I don't think people know how to do resistance training. I don't feel as comfortable with resistance training. I feel comfortable with the food aspect. I need help with the resistance training part.

James Hill:
I agree. And I think that's a big missed opportunity there to help people with that. Part of the problem, as you know, is, yeah, affluent people can afford a dietician and a trainer. But for a lot of people, they can't. And there's a big barrier, for a lot of people who could benefit from this.

Holly Wyatt:
And should they be covered? We talk about dieticians being covered.

James Hill:
Yes.

Holly Wyatt:
Should trainers with certification that can really put you on a resistance training plan, should that be covered?

James Hill:
If resistance training is a big part of leading to successful outcomes, why would you not cover it?

Holly Wyatt:
I agree. I agree. And so we need some data to show that, I'm sure. You know, we're talking about starting a GLP-1 support clinic here at UAB. And we for sure are going to have dietitians supporting the nutrition piece of it. But we've also reached out to the rec center here and we want to have expertise in that area too because I do think you need both.

James Hill:
So I'm going to do a call out to our listeners who have expertise on the resistance training side. We would love to hear from you. Tips and everything. What would you like people to know? Even people who can tell us more about how do you find one of these certified trainers? We would love to present some of that information. So if you're listening and have that information, reach out to us.

Holly Wyatt:
I think we need to do some more episodes on this where we invite trainers to come in that are certified. And we need to figure out really what certifications we think you should look for.

James Hill:
That's a great idea. We should have someone from ACSM to tell us about the certification, what it means, how to find people.

Holly Wyatt:
Yeah, it's not, you know, we're very comfortable with the nutrition. I think I'm less comfortable with this, the resistance training aspect of it and the requirements for professionals in that area.

James Hill:
So do you have to join a gym to do resistance training?

Holly Wyatt:
No, I think I know enough to know that. You don't have to join a gym. I think the idea is you want to move your muscles in a way that gives you resistance, but it doesn't have to happen in a gym, Jim.

James Hill:
But, you know, in a gym is a great example of what you said. A lot of people would be intimidated. You go in and you see all that equipment. Holy cow, how do you use all that? And that's why you need help with someone who can guide you through it, show you how to use it, give you a schedule for how to use it. So if you are going to think about using a gym, work with a trainer so that you learn how to do it the right way.

Holly Wyatt:
So what counts as resistance exercise?

James Hill:
Well, I think it's moving major muscle groups and progressive resistance. So I'll have to say I've used a trainer for many years to help with my resistance training because it's hard for me to do it on my own. And one of the things they tell me, you have to keep pushing yourself. If you go in and do the same thing, you're not optimizing that. That's what I want to do. I want to do the same thing. And they say, no, got to increase your reps, increase your weight. So it has to be a progressive challenge. And this is where a professional can really help you guide that. Ideally, we recommend that you do strength training or resistance training at least two days a week. I will tell you, I do mine on Monday and Friday, and I do about 30 minutes each.

Holly Wyatt:
Okay.

James Hill:
Okay. I sometimes miss it, but I try not to. There are many ways to do this, but you have to be careful, particularly with older people, people with physical limitations. You can do it the wrong way. Get a professional to help.

Holly Wyatt:
You want to be safe about it.

James Hill:
You want to be safe.

Holly Wyatt:
It's funny. But Jim, you talked about the fact that you want to do the same amount. You don't want to progress. I'm the opposite. So I'll hurt myself. I'm like, oh, I did, you know, 15 pounds last week, let's go up to 40, you know. And I can do it and then I'll hurt myself. So you can go either direction.

James Hill:
Very small increases, but consistently increase. So you said you didn't have to use a gym. If you're not using a gym, Holly, what are some things people can do?

Holly Wyatt:
So resistance bands, I've definitely heard some of the people in the field talk about resistance bands are a great way to add that resistance. And you can get different strengths of bands. So some of them can be light, would be the equivalent of lighter weight to very heavy bands. You can even double up the bands. It's a way of having a bunch of weights without having a bunch of weights. You can have these different cover bands, resistance bands. They're inexpensive. They're portable. Body weight exercises. So you want resistance, but you can use your own body weight to get there. In State of Slim, we do something, and I'm going to go ahead and tell. If you're in State of Slim, you've done these before. We call them potty squats, Jim. And everybody has a toilet, right? So it's like a squat machine in a sense. Everybody has that machine.

James Hill:
It's like an exercise piece of equipment. I'll have to say I've never thought of it that way.

Holly Wyatt:
It is. It's built in and it's sturdy, right? It's sturdy and it's about the right height. So you can use that sometimes, you know, where you sit down and stand up, sit down and stand up. You also can use a chair to do sit to stands wall push-ups squats step-ups, but using your own body weight. That's one way that you can Do resistance training without joining a gym.

James Hill:
What about things like Pilates and so forth? Those tend to be fairly popular. Do those count as resistance?

Holly Wyatt:
I do think they count as resistance. They have some spring resistance, especially if you're using a reformer. If you've ever taken Pilates, Jim, I don't know if you've ever done that.

James Hill:
I'll have to say, I don't know what a reformer is.

Holly Wyatt:
Yeah, so there is a way to get some resistance with Pilates and a reformer. You know, everyday activities, you can make them more resistance-focused when you're getting groceries or gardening, using the stairs. You're putting your own body weight up the stairs. But sometimes that's maybe not enough to progress, right? You want that ability to progress.

James Hill:
So there are options for people that don't want to or can't afford a gym or a fitness center. There are ways you can do it on your own, relatively inexpensive. Major thing, do it consistently, aim for two days a week.

James Hill:
All right, Holly, if you were talking to someone taking a GLP medication about this, what would you tell them to do?

Holly Wyatt:
So I would tell them based on the data we have, even though it's not perfect, that I would want them to start resistance training two days a week during the weight loss So that we could try to, minimize or attenuate the amount of lean tissue slash muscle that they're losing. And I would want to combine that resistance training with protein and overall nutrition. And I would recommend that. I would also, if they don't know what they're doing, I would probably say, let's get you some help. Let's at least get you a few training sessions with someone that can help you do that safely.

James Hill:
Are there online classes and so forth, Holly? I don't even know.

Holly Wyatt:
Oh, there are. There's online. There's even machines now. I call them machines, but they're things you can put in your house where the trainer kind of comes to you, a video.

James Hill:
All right. We definitely need to find an expert who's a certified trainer to come on and tell us a little bit more specifically all the things we can do. You and I are groping around here, you know, a little bit, which doesn't usually bother us. But I think we need an expert.

Holly Wyatt:
I told you before we came on, I said, I don't know if I feel completely confident in everything.

James Hill:
Well, I feel so strongly about this, which is why I really push to do this episode. Because more and more I'm seeing the data out there that resistance training is not a nice thing to do. It's absolutely essential in this GLP-1 era.

Holly Wyatt:
I agree. And the other thing I wrote down, Jim, is to create what I'm calling a strength report card. It's tracking. Can we start tracking some things that can be helpful? Are you getting stronger, or at least not weaker? Can you do more repetitions? Can you do more resistance? Is getting out of a chair easier? You know, can you climb the stairs? Here's one for you, Jim. You travel a lot. Can you take your suitcase and put it up over your head in the airplane?

James Hill:
Absolutely. I do that all the time.

Holly Wyatt:
Yeah.

James Hill:
But that's important because I see people who can't.

Holly Wyatt:
Right. That's a pretty good measure because there's that resistance going on there.

James Hill:
Yeah.

Holly Wyatt:
So, Jim, what don't we know yet?

James Hill:
I would say one of the big ones, and this is very, very important, is how much of the lean mass you lose with GLP-1 meds is actually skeletal muscle versus connective tissue and other things. I think those studies are being done, and I think we will learn about this over the next little while.

Holly Wyatt:
Even if, let's say it says that GLP-1s don't produce more muscle loss than any other form of weight loss, I still think this is important because you're losing it, right? So we're not going to have to see that the GLP-1s do more to make this important, in my opinion. And that's where I think people are getting confused. It's like, this is happening. You are losing muscle. We know that when you lose weight.

James Hill:
Back to minimizing loss of muscle by one kilogram is important, I would take it.

Holly Wyatt:
Yes.

James Hill:
The other thing is we don't know who's most at risk of losing strength or function. Again, older people. I worry about it. I worry about, you know, because so important to maintain strength and function, anything that lessens that, I worry.

Holly Wyatt:
And then on top of that, I worry more about, let's say you lose it. Can you get it back?

James Hill:
Well, that's exactly right. And again, what's the optimal combination of resistance training and protein? Protein is everywhere. Resistance training is nowhere. I mean, we need a better job, Holly, of combining those two.

Holly Wyatt:
I know we don't see things as a resistance training as much as we see protein, you know, and out there being advertised.

James Hill:
Big one for me, as you know, I always think about long-term weight loss maintenance, whether you're on the meds or off the meds, does preserving muscle during weight loss give you that long-term advantage? I think it does, but we don't have any data yet.

Holly Wyatt:
Bottom line for me is we don't have the data yet, but I don't think we can wait for that data.

James Hill:
Right.

Holly Wyatt:
So if I was on a GLP-1, my patients that are on a GLP-1, I would recommend resistance training plus adequate protein.

James Hill:
We have to get that as a routine part of treatment.

Holly Wyatt:
Yes.

James Hill:
All right. You want to do a couple of listener questions?

Holly Wyatt:
Let's see. I think there was a couple that fit well with this episode. Here's one, Jim. I travel a lot. I can't keep a regular gym schedule. I can relate to that. What is the minimum effective strength routine I could do in a hotel room? We're going to need help on this, Jim. These are the type of questions we need to get help on.

James Hill:
We need an expert.

Holly Wyatt:
Yeah. But I do think I am an expert in traveling and I'm trying to get your exercise in. So I can do that. And you can do stuff in a hotel room. I think the bands are your biggest friend in a hotel room because you can bring them in your bag. You can do 10 to 15 minutes as a great starting point. You can then go online and get exercises to do with the bands. Even in a hotel room, you can find that online. So you can still travel and do the resistance training, even if you don't have a gym or can't get to a gym. I think there is a way to do that. And like we talked about I think two sessions per week Is a reasonable goal to start. I think you can still make it work.

James Hill:
All right, I'll do one more. If I stop exercising for a few weeks, have I lost all my progress? This is a tricky one because you do lose progress if you don't exercise. A few weeks probably isn't going to do it, but you don't want to go too long without exercise. I keep thinking the benefits of exercise are cumulative short-term things because when you stop exercising, you do lose those effects over time. A few weeks probably isn't going to change things a lot, but you want to try to do some. If you know you can't do your regular exercise, try to do something during that time.

Holly Wyatt:
Well, here's where the metabolic flexibility part we talk about, exercise contributing to metabolic flexibility, may be different than resistance training, improving muscle, or helping you preserve muscle. Those are two different kind of outcomes, and it might be the timing is different in those two.

James Hill:
My guess would be the effects on metabolic flexibility may be longer, of longer duration than the effects on muscle. But again, we don't know that. But best thing is to try to do it regularly. If you have to stop exercising, say you get injured or something, you want to get back on it as soon as it's feasibly possible to do it. And again, try to get a couple of weeks of resistance. Some weeks, Holly, I do it. Some I do one day. But I always try to and usually at least get in one. More the better.

Holly Wyatt:
I will tell you, if you miss some workouts for whatever reason, don't try to come in and make up for them. I've done that before Jim and that is not what you want to do. Yes, don't do that because then you're so sore you can barely walk. I have that firsthand. All right, a couple vulnerability questions.

James Hill:
All right.

Holly Wyatt:
All right. Let's do this one. Has there been a time when you knew what the science said about strength training, but you still struggled to make it a priority yourself?

James Hill:
Absolutely. Holly, as you know, I've been a regular exerciser for many, many years, but for many years, I really minimized resistance training. I could go and do aerobic. I loved it. I could watch TV or do other stuff on the treadmill, on the bicycle, on the elliptical. And I just didn't have the motivation to doing resistance training. But the more I learned, particularly as I aged, the more I recognized I had to do it. And I can't tell you that I just look forward so much to those Mondays and Fridays. But they're a part of my life. I do it. I really feel good after I do it. So, yes, I've prioritized that in recent years much more than I used to. All right, Holly, has your own experience with running, Pilates, or strength work changed how you think about what it means to be fit?

Holly Wyatt:
Well, I don't know if it's those, you know, my experiences. As I get older, I definitely think those experiences have made me think about what it means to be fit. You know, I'm a runner. I still, that's my preferred form of activity. A lot of it is because the mind part of it, I can really get my best, most creative ideas when I'm running and can kind of get into flow. But I have to admit, as I'm getting older, this functional piece, preserving the muscles, what it's going to mean to me in 10 years, and maybe I need to work on it now versus wait for 10 years is starting to pop in my head. And I will admit that I do not like resistance training, that I do not do it on a regular basis at this point. I am a regular runner. I'm a regular exerciser. But I am not a regular resistance trainer. I don't enjoy it as much. So I've got to figure this out. What's going to motivate me to get this resistance training in.

James Hill:
See, I think that's the key is what is the motivation?

Holly Wyatt:
Yeah, I have it for the running. I don't have it for the resistance training.

James Hill:
Okay, Holly, give us the top three things we've dealt with in this episode.

Holly Wyatt:
Wow. I think the first thing is that weight loss and fat loss or muscle loss aren't the same thing, meaning we have to look at, you have to think about I'm losing this much weight, but you also need to think about how much is fat, how much of it is muscle, We need to look at how much we're losing on the scale, important, but also and understand that we're losing both and how we can potentially do something to prevent or attenuate, not lose as much of that muscle.

James Hill:
Losing fat, good. Losing muscle, bad.

Holly Wyatt:
There you go, Jim. That was great. All right. What's another one?

James Hill:
Well, resistance exercise matters. And that's why I wanted to do this episode. And you and I have muddled through this a little bit. And I think we realized that we don't have the expertise we need to be precise about some of these things. But hopefully what we've tried to show is the evidence is consistent and solid that resistance exercise is critical to preserve muscle during weight loss, during weight loss maintenance. And again, I think we're both motivated now to go out and find an expert who can come on and be a little bit more precise and maybe give you some more information. But I think we have enough information to know that everybody on a GLP-1 medication should be doing resistance exercise.

Holly Wyatt:
I think we have the science, the data that it's probably a good thing to do now, we could use some help on how you do it. The practical side.

James Hill:
So if you're out there, help us.

Holly Wyatt:
Yeah, really, how do you do it? And who do you look for that has the credentials to help you? It's not just anybody.

James Hill:
We promise we're going to follow up and give you that information.

Holly Wyatt:
We need credentials to be able to help people with this. I think the third thing is that protein and resistance exercise work together. We're getting the message of eat more protein, eat more protein, eat more protein. And I think that's important. And we've talked about that on other episodes. But protein alone isn't a substitute for challenging your muscles, that they really are going to work best when you can do the resistance training and the protein. And if you're spending all this time and effort to get in the protein, well, spend some of that time to say, how am I going to stimulate the muscle with the resistance training so that you can be successful?

James Hill:
So, Holly, I'm going to conclude that successful weight loss is about more than simply reaching a number on the scale.

Holly Wyatt:
Yeah, I agree. We want people to lose weight, but we also want them to be stronger. We want them to be healthier and more capable of doing the things that they love to do.

James Hill:
Okay, so get out there and do some resistance exercise. And we will be back to you soon with hopefully more helpful information about this topic. So thanks everybody for listening to Weight Loss And, and we'll see you next time.

Holly Wyatt:
Bye everybody.

James Hill:
And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:
If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

James Hill:
We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at weightlossand.com. Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:
And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.