Nobody explains the lifting and eating part.
Your prescriber is right that strength work and protein matter. Knowing that and doing it inside an actual week are different problems. The second one is mine.
I am Ian Kendall, a health coach in Portland, and I work with people anywhere. I am not a prescriber and nothing here is medical advice. I work alongside the person who wrote your prescription, never instead of them.
Wellcoaches Certified Health Coach · ACLM Lifestyle Medicine Coach · NASM Certified Personal Trainer · Pain Free Performance Specialist · Former professional baseball player
Some of what comes off is muscle.
Across the trials, roughly a quarter to a third of the weight lost on these medications is lean tissue rather than fat. The researchers are careful about that and so am I. It is a similar share to other ways of losing weight, it is not unique to the drugs, and measured physical performance is generally maintained.
The finding worth your attention is the other one. In the same review, fewer than half the people taking these medications were reaching even the minimum recommended protein intake. Appetite suppression is the point of the drug. It is also what makes eating enough genuinely hard, and there is no prescription for that part.
Both figures come from Rossi and colleagues, Muscle loss and GLP-1R agonists use, Acta Diabetologica, 2025. Across the trials reviewed, roughly 25 to 30 percent of the weight lost was lean tissue, and 43 percent of participants reached the minimum recommended intake of 1.2 grams of protein per kilogram a day.
Three things, and none of them need a gym.
Same as everything else I write. What to try, how you will know, and permission to drop it.
Protein at the meal you still want
Work with the appetite you have left, not the one you used to have.
Put the protein at the start of whichever meal you are most likely to actually finish, which for most people is earlier in the day. One palm of it, first, before anything else on the plate.
You will know inside a week whether it holds
Two sessions, heavier than feels sensible
Resistance work is the thing the research keeps pointing at.
Two full body sessions a week. Six to ten hard repetitions rather than twenty easy ones. If you could have done fifteen, it was too light. Bands and bodyweight count while you build up to more.
Judge this at four weeks, not four days
Plan for the week after a dose goes up
This is the week people quietly stop, and then do not start again.
Expect it to be rough and decide now what the smallest version looks like. Keep the two sessions, make them shorter. Drop to your floor rather than to nothing.
Coming back inside a week rather than a month is the whole thing
What I do not do, in writing.
I do not prescribe, adjust, pause or advise on medication, and I will not offer an opinion on your dose. That is between you and whoever wrote it.
If your prescriber or a dietitian has given you protein targets, we work to those. I do not set them and I do not overrule them.
If eating has become difficult in a way that is not about appetite, that is a registered dietitian or a therapist rather than a coach, and I will say so rather than keep you.
I will not tell you that coaching preserves your muscle. Resistance training and adequate protein are what the research recommends. What I do is make those two things happen inside your week.
The same two things I offer anybody.
There is no medication surcharge and no separate program. The work is the same work, pointed at the thing you are actually dealing with.
Groundwork
Eight weeks with six to eight other people, one evening a week over video. Weeks one to four get the eating and the energy steady. Weeks five to eight put the strength work on top of it.
- Programming in an app from day one, written for what you have
- A private call in week one and another in week eight
- Ends on a date set before you start, then a month on your own
Training
A recorded review of your lifts every week, from somebody watching what the dose is doing to your strength. The programming comes with it, written for your equipment and the week you actually have, and rewritten every four weeks as the dose and the appetite change.
- Messages answered inside a working day
- Rewritten around a rough fortnight rather than abandoned
- First week is on me, cancel any time, no exit call
You already tell people to lift and eat protein.
This is somewhere to send them afterwards. There is no fee to you, no referral arrangement of any kind, and nothing comes back to you about your patient unless they ask me to send it.
I hold a Wellcoaches certification on the national board track, ACLM lifestyle medicine coaching, NASM personal training and the Pain Free Performance specialism. I am insured through Hiscox and I am glad to send a certificate, a scope of practice summary or a sample of what a patient receives.
Or write to me at ian@elevatewellbeing.coach. If somebody would rather not work with anyone, the thirty one free experiments ask for nothing and never will.