Virtual GLP-1 program with strength coaching improves both quantity and quality of weight loss

A new evaluation published in the journal Diabetes, Obesity and Metabolism found that adults with obesity who combined GLP-1 medication with a virtual program offering personalized, strength-focused physical activity coaching lost more weight, and lost it in a healthier way, than those who received usual care ^[1].

The quasi-experimental study followed 245 adults who had started GLP-1 therapy for weight loss no more than eight weeks before joining the study. Of these, 151 people enrolled in a 12-week virtual GLP-1 lifestyle companion program that included personalized coaching focused on resistance-type activity, while 94 people received usual care ^[1]. Researchers tracked body composition using at-home bioelectrical impedance analysis scales, a method that estimates fat and muscle mass along with total weight ^[1].

After 12 weeks, the coached group lost an adjusted average of 6.0% of their starting body weight, compared with 3.3% in the usual-care group, a difference of 2.8 percentage points that the researchers said was statistically significant ^[1]. The coached group also lost more body fat, with body fat percentage dropping 3.3 points compared with 1.6 points in the control group ^[1]. At the same time, the coached group gained more muscle mass as a share of body weight, up 0.6 percentage points versus 0.2 percentage points in the control group ^[1]. The study authors also reported greater improvements in psychosocial and behavioral measures among people in the coaching program, though the paper does not specify exact figures for those outcomes ^[1].

The researchers note that GLP-1 drugs can produce rapid weight loss, but that loss often includes a disproportionate share of lean muscle mass, especially early in treatment ^[1]. Physical activity, and resistance training in particular, is described in the paper as the most effective behavioral strategy for cutting fat while protecting muscle ^[1].

Why it matters for patients

People using GLP-1 medications such as semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound) commonly ask not just how much weight they will lose, but what kind of weight. Muscle loss during rapid weight loss is a recognized concern because it can affect strength, metabolism, and long-term health. This study suggests that adding structured, virtual coaching centered on strength-building activity, alongside GLP-1 treatment, was associated with a body composition that included more fat loss and less muscle loss compared with usual care, on top of greater overall weight loss ^[1].

The study was quasi-experimental rather than a randomized controlled trial, meaning participants were not randomly assigned to the two groups, which can leave room for other differences between groups to influence the results. It was also sponsored by Omada Health Inc., the company behind the coaching program being evaluated, and all six authors are full-time employees of that company who receive salary and equity compensation, though the company reports it had no role in how the data were analyzed or interpreted beyond what is described in the study ^[1]. Body composition was measured using home bioelectrical impedance scales rather than more precise clinical imaging methods, which the source does not further validate for accuracy in this context ^[1].

What happens next

The paper does not describe any planned follow-up studies, longer-term tracking of participants, or independent replication of these findings. Whether these body composition differences persist beyond 12 weeks, or translate into different long-term health outcomes, is not addressed in the source and is not yet known.