26: How to Avoid Muscle Loss with GLP-1 Medications with Dr. Ali Novitsky

Aug 14, 2023

We know movement is important but when you don't know where to start, or what's reasonable, or why you're doing it, those mental blocks can get in the way of success.

I recently sat down with a true leader in this space, Dr. Ali Novitsky, who is on a mission to help people ditch the “all or nothing” approach and optimize their health. Dr. Novitsky takes a really holistic approach, focusing on mental, emotional, and physical health. Today, I’m sharing her take on the benefits of movement, how to avoid losing muscle mass on GLP-1 medications, and whether body composition scales are really worth it.

What are the benefits of movement?


Just being more active in our everyday lives can have huge benefits. You don't have to have a Peloton to be in good physical health. Getting steps in each day is a great example of this and we know that if we're getting 5, 000 or more steps a day, we actually improve our longevity.

Movement in general is going to increase our total daily energy expenditure, aka the calories that we burn, but that’s not really where the focus should be. We want our body to be functional. Let’s shift the goal to being able to carry our groceries when we're 90, or to walk without a walker for as long as we can. And to do those things, getting those steps in is crucial.

Strength Training

When women hit the age of 30, they start losing muscle mass at about 1 to 3% per year. 

Strength training helps us to maintain lean muscle mass and keep our body functional. A lot of people are now saying that muscle is the new anti aging mechanism. 

People often don’t realize that strength training also improves insulin sensitivity. When you engage in strength training, your muscles require more energy to perform the exercises. This increased demand for energy triggers your cells to become more sensitive to insulin. As a result, insulin can more efficiently transport glucose into the muscles, reducing blood sugar levels and improving insulin sensitivity.

Over time, strength training is something that is so overlooked because people think it's about the calorie burn. But if you look at our daily energy expenditure, our basal metabolic rate makes up 70% of our calorie burn. And how do we increase our basal metabolic rate? With muscle mass.

We know exercise alone is going to decrease the incidence of so many different cancers and so many different chronic diseases. So, in general, exercise is good for everything, but remember that it doesn't have to be this marathon or all out sprint all the time. Ten minutes a day is a big deal and more than most people are doing.

How do I get started with strength training?

When we get into the strength training piece, remember that it doesn't have to be all about big, heavy barbells and going to CrossFit, and hitting the gym. You actually don't need any equipment to do any strength training - you can use your body weight. 

Dr. Novitsky recommends starting with a yoga class to help with breathing and balance. Having a realistic step count is also a good place to start. If 5,000 isn't available right now, start with 2000 and then slowly build your steps. 

Once you get comfortable with where your body is, you’re going to feel more comfortable to go ahead and move up and try one strength training. Most people find that they gain strength pretty quickly because our muscles actually want to be strong. So when you start taxing them just a little bit, you start gaining strength very quickly.

Will GLP-1 medications make me lose muscle mass?

GLP-1 medications are not going to cause muscle to go away. The problem is that they decrease your appetite, which makes you not crave protein. Losing muscle mass can absolutely be avoided by simply getting enough protein and making sure that you're moving your muscles. And it doesn't have to be excessive.  

In general, Dr. Novitsky advises women to eat three solid portions of protein a day (around 30 grams or about the palm of your hand). This is still perfectly possible even if you are a vegetarian. On  top of this, she advises you to move your muscles against resistance once a week. Prioritizing these two things and being willing to stay consistent with these protein goals will definitely support you in not losing muscle mass on these medications.

Are the at-home body composition scales accurate?

For $300 or less, Dr. Novitsky recommends getting an InBody at-home scale to test your body composition. However, you have to give yourself a little bit of grace because there are some water fluctuations. Make sure that you're well hydrated when you're doing the testing, that you're testing at the same time, and that you don't have clothes on. You also want to be in the same hydration status every time you check it. Dr. Novitsky advises looking at the data just once a month rather than daily. In general she looks for skeletal muscle mass and body fat mass and wants to see skeletal muscle mass above body fat mass. 

If it’s not possible to have this type of scale at home, measurements can still be useful. In general for fat loss, a waist circumference is the easiest and best measure, and knowing that it does correlate with cardiovascular risk is really useful for us. Measuring the hips would come second, and then arms and legs third.


Learn More About Dr. Ali Novitsky:

Ali Novitsky, MD is the CEO and founder of The FIT Collective™,
www.thefitcollective.com. She is Triple board certified in Obesity Medicine,
Pediatrics, and Neonatology. She is a Certified Master Coach, Nutrition and
Fitness Expert, International Speaker, Blogger, and Host of The Podcast
"Life Coaching for Women Physicians” which will soon be rebranded to Fit
Woman Collective™.
Ali attended Temple University School of Medicine and completed her
Pediatric residency and Neonatal Fellowship at Thomas Jefferson/AI duPont
Hospital for Children. She completed her coach training at The Life Coach
School and The Coach Firm. 
Ali helps high performing women to achieve optimal health by optimizing
their unique potential with simple strategies backed by science. Ali also
offers CME coaching programs designed for physicians. Her programs are
ever evolving and currently include: Fit Woman Collective™, Fit Dad
Collective™, and Transform®.
Ali has a trademarked nutrition program called Mindful Macros® where she
combines an intuitive and gentle nutrition approach to achieve optimal health
results. Ali is married to her med school sweetheart, Mark, and together they
have two daughters and a mini labradoodle.

Connect with Dr. Navitsky: