Ozempic and exercise: should you work out on semaglutide?

If your healthcare provider has prescribed Ozempic as part of your treatment plan for type 2 diabetes or weight loss, you probably already know that the drug is meant to be used in combination with diet and exercise. 

In the case of Ozempic and other drugs in the same family, like Wegovy, adding exercise to your daily routine is not just something your doctor wants you to do because they always recommend exercise. These drugs were actually tested and approved by the FDA in combination with diet and exercise, so it’s important to make these simple lifestyle changes while taking the drug, to get the best results out of them. 

Of course, you may have questions about working out while taking Ozempic, especially if you’re new to exercise. Don’t fret! We explain how exercise and Ozempic both contribute independently to weight loss, and may work better together. 

Plus, we share four tips for getting started with exercise. 

Ozempic (semaglutide) is an injectable prescription medication that is FDA-approved to control blood sugar levels in people with type 2 diabetes, and, in those who also have heart disease, reduce their risk of experiencing a cardiovascular event, like a heart attack or stroke. While Ozempic is not approved for weight loss, its active ingredient, semaglutide, has been found to produce significant weight loss in people who take it, leading many health providers to prescribe it off-label for this purpose.

In fact, semaglutide’s proven weight loss effects led the makers of Ozempic, Novo Nordisk, to create a separate FDA-approved version of the drug specifically for weight loss, which is known by the brand name Wegovy. Studies of people with high body weights — both with and without type 2 diabetes — may lose anywhere from nearly 10% to 15% of their body weight within a year and a half after starting semaglutide.

Ozempic helps with weight loss in a number of ways, from how full you feel to what you feel like eating. As a glucagon-like peptide-1 (GLP-1) receptor agonist, Ozempic mimics the GLP-1 hormone naturally produced in your gut. GLP-1 tells your pancreas to release more insulin after you eat, while limiting the release of glucagon—a hormone that helps bring glucose out of storage and into the bloodstream. Both of these effects keep blood sugar down. 

Ozempic also slows down digestion, keeping food in your stomach for longer. This further limits the release of sugar into the bloodstream, helping to prevent blood sugar spikes. But, it also makes you feel full sooner, so your appetite decreases and you eat less food. 

Lastly, Ozempic might interact with your brain’s food reward system: in addition to telling your brain that you feel full, Ozempic may affect how you feel about different foods, such as reducing your enjoyment of high-fat foods. This may explain how the drug helps curb emotional eating and other behaviors that contribute to weight gain, according to one small study of people with obesity. 

Ozempic and other GLP-1 drugs are supposed to be used with lifestyle changes like a reduced-calorie diet and increased exercise. That’s because in addition to the feel-good benefits of exercise — like better sleep, mental health, and sex drive — exercise also leads to weight loss.

A lack of physical activity can increase both insulin resistance (a condition in which your body becomes less sensitive to the hormone insulin) and metabolic risk. Exercise, on the other hand, actually improves insulin sensitivity, by increasing the amount of glucose your muscles use. Exercise may further improve glycemic control when combined with Ozempic, a big benefit for people with type 2 diabetes. 

“Exercising while taking Ozempic raises total daily energy expenditure, thereby increasing caloric deficit,” shared Dr. Nadav Fields, DO, founder of CR8 Health and a double board certified physician in internal medicine and obesity medicine. “This ultimately leads to quicker weight loss.” 

Depending on the type of exercise, your workout can help you burn fat, build lean muscle mass, or both. For example, pairing cardio with strength training can supercharge both weight loss and reduce your cardiovascular risk. Resistance training, meanwhile, may increase your resting metabolic rate. Remember: the more muscle you have, the more energy (and calories) your body will burn during the day. 

Lastly, exercise simply makes you feel better. All those endorphins contribute to a happier mood, and research shows that exercise helps manage mental health conditions like anxiety, depression, and other mental disorders.  This positive outlook may make it easier for you to keep up with the other lifestyle changes and habits that lead to weight loss, like eating better foods and continuing to exercise.

If it’s your first time exercising regularly and you’re not sure where to get started, don’t worry. Follow these tips to get started working out.

1. Start small

Even smaller amounts of exercise — like 15 minutes of moderate-intensity walking each day — can be beneficial, especially when you’re just getting started.

In a clinical trial of Ozempic, participants started with a goal of 100 minutes of physical activity per week, focusing on moderate-intensity exercise. Follow their lead and get started with three 30-minute workouts per week. Then, aim to increase your physical activity by 25 minutes every month, until you’re working out for 200 minutes per week. 

2. Find a workout that works for you

Different types of exercise offer different benefits. Some research has found that aerobic exercise, like running, produces more weight loss and fatty tissue loss, in part because you tend to expend more energy during an aerobic workout. 

However, both aerobic training and high-intensity interval training (HIIT) can lead to similar weight and fat loss if you consume the same amount of calories. “I highly recommend HIIT (high-intensity interval training) for my Ozempic patients to maximize their weight loss,” said Dr. Fields. “This type of exercise improves cellular health, metabolic flexibility, and results in more efficient weight loss.”

Maintaining and building muscle mass while taking Ozempic is important, which is where resistance training comes in. Indeed, studies have found that combining aerobic and resistance training offers more cardiovascular benefits than either one alone. The Ozempic website offers a combination workout at three levels (beginner, intermediate, and advanced) designed for people with type 2 diabetes. 

“The weight loss promoted by [Ozempic] certainly takes an aggressive hit to lean muscle mass,” shared Dr. Rich Joseph, Chief Medical Officer of Restore Hyper Wellness and a certified personal trainer. “And there is likely a subset of patients, particularly those who start with a lower body fat percentage, who will lose muscle mass at the same or greater rate than fat mass, which has adverse consequences for health and longevity.” To combat this, Dr. Joseph recommends that some patients increase strength training and protein intake while taking Ozempic.

Ultimately, though, it is important to find an exercise you enjoy — as that’s the kind of exercise you’re most likely to continue doing, which will lead to long-term weight loss. 

3. Make exercise part of your routine

Like any habit, it’s easier to exercise when you make it part of your routine. 

Choose the days and times you’ll work out, and schedule them on your calendar. You can choose a specific time, or pair exercise with another activity — like always exercising after work, or on weekend mornings.

4. Make exercise fun 

The best exercise is the one that you enjoy and want to keep doing, and working out doesn’t have to be work. Make your workout fun, so it becomes something you look forward to rather than dread and you keep doing it. 

Maybe you sign up for a fitness class with a friend, or catch up on your favorite TV show while you walk the treadmill. Or, you listen to your favorite podcast or music when you’re lifting weights. Studies show that people who listen to music while working out tend to exercise longer and build more endurance, without feeling more fatigued. 

Finally, tap into your motivation. Are you exercising to be healthier and happier? Remembering your motivation can help you keep pushing when you feel like tapping out.

If you have any questions about exercising while taking Ozempic, talk to a healthcare professional.

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Current version

May 10, 2023

Written by

Amelia Willson

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.