Quality Plus Quantity: Evaluation of a Virtual GLP ‐1 Programme With Physical Activity Support to Promote Healthy Body Composition Change During GLP ‐1 Weight Loss

AIMS: Glucagon-like peptide-1 (GLP-1) receptor agonists can produce rapid weight loss, but this loss is frequently accompanied by disproportionate loss of lean mass, particularly during the early phase of GLP-1-treatment. Physical activity (PA), particularly resistance training, is the most effective behavioural strategy for enhancing fat reduction while preserving lean mass. Our primary aim was to evaluate whether a 12-week virtual GLP-1 lifestyle companion programme that includes PA coaching was associated with increased weight and fat loss coupled with preservation of muscle mass among adults with obesity who initiated GLP-1 therapy for weight loss ≤ 8 weeks prior to baseline. MATERIALS AND METHODS: In this quasi-experimental trial, 245 adults (151 intervention and 94 control) received either a virtual GLP-1 lifestyle companion programme with personalised, strength-focused PA coaching or usual care. Body composition was captured using home bioelectrical impedance analysis scales. Primary outcomes were 12-week between-group differences in change in weight, percent body fat and percent muscle mass. RESULTS: Participants in the GLP-1 lifestyle companion programme lost an adjusted mean of 6.0% of their baseline body weight versus 3.3% in the control group (between-group difference 2.8%, p < 0.001). Compared with controls, they also experienced a larger decline in body fat percentage (-3.3% vs. -1.6%, p < 0.001), a greater increase in muscle mass percentage (+0.6% vs. +0.2%, p < 0.01) and greater improvements in psychosocial and behavioural outcomes. CONCLUSIONS: Personalised, virtually delivered PA programming may meaningfully improve the quantity and quality of weight loss during GLP-1 therapy.