GLP-1 medications, weight loss & conversation we’re not having
I want to make it clear that I (Jessica Fisher) am not a psychologist or medical doctor. This newsletter is based on my own research and professional experience. If any of the topics discussed trigger you or make you feel uncomfortable, please do seek support from a qualified professional.
Hey, Hi, Hello dear reader.
You’ve probably seen it everywhere lately. GLP-1 medications. Rapid weight loss. Dramatic transformations. People say their dramatic weight loss is just from “fasting” (I call BS!).
It’s a huge topic in women’s health right now and like most big trends, the conversation is focusing almost entirely on weight, rather than how we safely and sustainably change our bodies. But, there’s something important being talked about far less. Muscle.
Current research around rapid weight loss, whether through medication, aggressive dieting, or both, consistently shows that some of the weight lost isn’t just fat.
A portion of it is lean mass, which includes muscle tissue (Wilding et al., 2021; STEP trials). This matters. Especially for women. Because muscle isn’t just about aesthetics or looking “toned” (a word I personally hate). Muscle is a metabolically active organ that plays a critical role in overall health.
It helps support:
Metabolic health
Blood sugar regulation and insulin sensitivity
Bone density and skeletal strength
Hormonal balance
Mobility and physical independence as we age
In other words, muscle is not just something we build for appearance. It’s something we build for long-term health and resilience.
Women already face unique challenges when it comes to maintaining muscle. From around our mid-30s onward, we naturally begin losing muscle mass at a slow rate, a process called sarcopenia. This process tends to accelerate during perimenopause and menopause as oestrogen levels decline.
Oestrogen plays a protective role in maintaining both muscle tissue and bone density, which is why strength training becomes increasingly important during this phase of life (Sipilä et al., 2020).
Without intentional strength training and adequate protein intake, women can gradually lose:
muscle mass
strength
bone density
metabolic efficiency
So when rapid weight loss occurs on top of that and lean mass is lost along with fat, we may unintentionally accelerate those declines. That’s not something we should ignore.
This isn’t a judgement on medication. For some women, GLP-1 medications can be medically appropriate and genuinely life-changing. But medication alone shouldn’t be the entire strategy. When weight loss occurs without resistance training and adequate nutrition, particularly enough protein, there’s a real risk of losing the very tissue that keeps us metabolically resilient and physically strong. At the moment, we’re still learning about the long-term outcomes of these medications, particularly around body composition. That’s why the conversation needs to shift slightly.
Instead of focusing only on how quickly weight can come off, we should also be asking:
How much of that weight loss is muscle vs fat?
Are we supporting the body while weight loss happens?
Are women being guided on strength training and nutrition alongside medication?
Because a quick walk around the block and hoping the weight falls off isn’t really a plan. Education matters when it comes to our health. The goal shouldn’t simply be smaller.
It should be:
stronger
more capable
more resilient
metabolically healthier
Muscle plays a huge role in all of that, and for women, building and maintaining muscle is one of the most protective things we can do for our future health.
Question of the week
“If weight loss is the goal, are we paying enough attention to what we might be losing along the way - especially muscle?”
**If you have any concerns about someone you know, or your own health when it comes to quicker fixes, or have any questions please speak to a health professional. If you would like some training sessions and guidance on strength training to support your health goals, message me any time.