More than 30 million adults in the U.S. alone take GLP-1 medications such as Ozempic, and their global market is projected to reach US$105-billion in 2030.Tom Little/Reuters
The Cult of Fitness column by Alex Cyr dives into the wonderful, weird world of fitness trends and why they endure.
The fitness industry has long relied on a handful of tired truisms to promote exercise – phrases such as “no pain, no gain,” “sweat now, shine later” and “there’s no magic pill, just hard work.”
That last one no longer quite holds up in 2025 now that GLP-1 medications, such as Ozempic and Wegovy, originally conceived as treatments for Type-2 diabetes, are being used by millions around the world to shed pounds. More than 30 million adults in the U.S. alone take these medications, and their global market is projected to reach US$105-billion in 2030.
Ozempic and its siblings appear much more pleasant as a weight-loss strategy than adhering to a restrictive diet or a rigorous workout schedule. And while the idea of medicating instead of crushing intervals on the treadmill may sound appealing to some, this shortcut to thinness has put the fitness industry on high alert. In the past year, the GLP-1 rollout has led to physicians warning of the so-called magic pill’s potential dangers as a workout replacement, exercise physiologists scrambling to update training protocols to accommodate its side effects, and personal trainers fearing that their clients will abandon their workout plans in favour of a prescription.
But so far, on the ground, things are fine.
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“It actually brings us more work,” said Ola Tsev, a personal trainer in Toronto.
She said her roster of 30 clients has grown in recent months, as a handful of new exercisers sought her services after a GLP-1-aided weight loss helped boost their confidence and shift their focus to other areas of improvement such as building muscle or cardiorespiratory fitness. A Morgan Stanley survey of 300 GLP-1 users found a similar trend: The number of respondents who said they worked out weekly more than doubled after they started a GLP-1 treatment. “Losing the fat creates more brain space for other things,” Ms. Tsev said. “If anything, these meds have been a net positive.”
A net positive, that is, for those who couple GLP-1s with exercise. Outright replacing one’s workouts with the medication can unlock a host of problems. Most of its well-known side effects are minor, odd, or just inconvenient, such as a loss of taste for coffee and alcohol, sensitive feet, hair loss, sagging breasts, constipation and bad breath. But a randomized controlled study from Denmark suggests that taking GLP-1s without exercising can also erode bone health – in part because reduced body weight decreases stress on the bones, which doesn’t allow them to strengthen. But the study found an important exception: Participants who coupled GLP-1 intake with exercise dropped more overall weight, while preserving more bone density.
“GLP-1s are only approved as an add-on to lifestyle interventions for weight loss. They were never approved as a replacement or stand-alone therapy,” said Simon Birk Kjær Jensen, an exercise physiologist at the University of Copenhagen and the study’s main author.
Dr. Jensen has been researching GLP-1s for a decade. His dissertation’s chief finding was that people who stopped taking these medications quickly gained the weight back unless they developed a regular exercise routine. Another finding: Exercise can also mitigate the unwanted increase in resting heart rate that sometimes occurs while taking GLP-1s.
“Focusing on nothing other than pharmacology is a mistake,” he said. “It’s important to keep it in perspective: The main goal is health gain and not only weight loss.”
Still, Dr. Jensen has no qualms with people using GLP-1s when prescribed the medication. But he said those taking it should focus on resistance training to ensure they do not shed too much lean muscle mass and incorporate aerobic exercise at a relatively high intensity to enhance fat loss and improve cardiorespiratory fitness.
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Already, gyms are evolving to meet the needs of members using GLP-1 medications. Equinox has launched a specialized training protocol designed to help these individuals preserve and rebuild muscle mass, with select coaches completing a GLP-1 certification program to tailor workouts accordingly. Xponential Fitness – the parent company of brands such as Pure Barre and Rumble – has taken a more integrated approach by acquiring Lindora, a weight-loss clinic chain, to combine GLP-1 prescriptions with its fitness offerings. Meanwhile, the International Sports Sciences Association has introduced a GLP-1 weight-loss support training program, which prepares fitness professionals to support clients through muscle preservation strategies and personalized workout plans.
The gradual embrace of these drugs, however, also has a dark side. Ms. Tsev, the personal trainer, is noticing a concerning trend – inspired by celebrity culture – of people seeking GLP-1s to drop those last, pesky 10 pounds. She reminds people that the risk of losing lean muscle mass, a key predictor of maintaining strength late in life, is not worth the marginal benefit of looking a bit leaner in a swimsuit.
“I’m nervous about where that’s all going,” Ms. Tsev said. “The more we glorify it, the more people who are of a healthy body weight will be tempted to start taking it. And I’m afraid that it perpetuates body image issues.”
The widespread availability of GLP-1s is fuelling the problem. Sandy Van, a physician and obesity specialist based in Toronto, receives frequent requests for prescriptions for Ozempic or Wegovy from healthy people who do not have obesity or diabetes. She never prescribes the drug to patients who do not need it, but she knows they can easily access it elsewhere. Some travel down to the U.S., where she says prescriptions are easier to obtain, while others get it online.
“There are telemedicine companies that are designed to offer treatments to anybody who will phone them and give them an arbitrary weight and height,” she said. “It’s a simple search and it’s not ethical care. You shouldn’t be on it if you don’t need it.”
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For those who do need GLP-1s, it’s the gift that keeps on giving. Some of Dr. Van’s patients have used it to control weight dysregulation that couldn’t be tamed by diets, boot camps and training plans. And now, mounting evidence of the positive effects of GLP-1s on cardiorespiratory disease reduction, and even its ability to attenuate various kinds of addictions, from alcohol to food, is increasingly making it sound like a miracle drug.
Still, Ms. Tsev likens the medications to ChatGPT: a versatile aid that can jump-start and catalyze success, but should never become a stand-in for first principles. Taking Ozempic without building the habits to maintain a healthy weight loss, such as exercising regularly and eating balanced meals – much like outsourcing your college essay to OpenAI – is setting oneself up for failure. In other words, overreliance is a bad idea.
After all, arguably the most valuable reward of a consistent exercise routine has little to do with body mass index or washboard abs. It’s learning to do hard things and building the discipline to do so regularly. “And,” as Tsev said, “there still is no magic pill for that.”