Pilates & Strength Training for patients on GLP-1 medications.
If you are losing weight on Ozempic, Wegovy, Mounjaro, or Zepbound, the quality of that weight loss matters as much as the amount. Endurance offers specialized Pilates and strength training designed to preserve muscle, protect bone density, and support the way your body actually moves during and after GLP-1 treatment.
GLP-1 medications can cause 15% to 40% of total weight lost to come from lean muscle and bone, not just fat. Pilates and structured strength work are how you protect what you don’t want to lose.
Weight loss isn’t the same as fat loss.
GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have changed what’s possible for people working on weight loss, blood sugar regulation, and metabolic health. They work — often dramatically. But the way the body loses weight on these medications is different from the way it loses weight through diet and exercise alone, and that difference has consequences worth understanding.
When weight comes off quickly while appetite is suppressed, the body pulls energy from whatever tissue is available — and without the right kind of resistance training, a significant portion of that comes from muscle and bone rather than fat.
of total weight lost on GLP-1 medications can come from lean muscle mass.
— Multiple clinical analyses, 2024–2025
This is what’s behind the visible changes some people notice — flatter glutes (sometimes called “Ozempic butt”), less defined arms, a softer overall shape even at a lower weight. It’s also what’s behind the less visible changes that matter more in the long run: decreased bone density, slower metabolism, weaker posture, and a higher risk of injury and fracture later in life.
The good news is that this is preventable. Research consistently shows that structured strength training during GLP-1 treatment significantly reduces muscle loss and protects bone density — which means the weight you lose comes from the right places, and the body you end up with feels better than the body you started with.
Why classical Pilates is uniquely suited to GLP-1 weight loss.
Most GLP-1 exercise guidance recommends some combination of strength training and cardiovascular work. Pilates is rarely mentioned as a primary modality — which overlooks what classical Pilates is actually built to do.
Classical Pilates on apparatus (Reformer, Tower, Cadillac, Chair) is fundamentally spring-resisted strength training — with several characteristics that make it especially appropriate for the GLP-1 population:
- Adjustable resistance. Spring tension can be increased or decreased instantly to match what your body can handle on a given day. This matters during GLP-1 treatment, when energy and appetite fluctuate.
- Posterior chain focus. Classical Pilates is built around the glutes, hamstrings, back, and core — exactly the muscle groups most at risk during rapid weight loss.
- Bone-loading work. Standing exercises on the Reformer and Chair, plus the resistance work overall, provide the kind of bone-stimulating load that helps preserve bone density during weight loss.
- Low impact. No jumping, no pounding. The spring resistance does the work, which makes it sustainable on days when energy is lower.
- Whole-body integration. The system trains the body as a unit rather than isolating muscles, which preserves the functional strength that lets you move well at any weight.
- Precise instruction. Classical Pilates is taught one-on-one or in tiny groups, with an instructor cueing your specific body. This is especially important when nausea, fatigue, or rapid body changes make standard fitness classes uncomfortable or unsafe.
Pilates alone isn’t always enough for full muscle preservation — most GLP-1 patients also benefit from supplemental strength training. The advantage at Endurance is that you can get both in the same studio, with the same instructor, who understands how the two work together.
A practice designed for where your body actually is.
GLP-1 treatment is not a constant. Energy fluctuates, appetite shifts, the body changes week to week. Our approach is built around that reality.
Start with a consultation
Before your first session, we talk through your medication, your timeline, your goals, your previous exercise history, and any side effects you’ve been navigating. The goal is to understand your body before we touch it.
Begin with private sessions
Most GLP-1 patients start with one-on-one work so we can calibrate intensity, learn how your body responds, and build a foundation safely. Group classes can come later, once we know what works for you.
Build in strength work
Pilates is the foundation. Where appropriate, we layer in additional strength training — using free weights, bands, or apparatus — to ensure you’re getting the muscle preservation signal the research shows is essential.
Layer in nutrition guidance
Movement alone isn’t enough. Adequate protein intake, hydration, and meal timing all matter on GLP-1s, especially when appetite is suppressed. We coordinate guidance on these with what you and your physician are already doing.
Adjust week by week
Some weeks the work goes well; some weeks energy is lower and we scale back. The point isn’t to push through — the point is to be consistent over months and years, which is what actually protects muscle and bone.
Coordinate with your medical team
We are not your doctor. We work alongside your physician, dietitian, or endocrinologist as part of a coordinated approach — and we are happy to communicate with them directly if you’d like.
The right credentials for this work.
GLP-1 work sits at the intersection of strength training, Pilates, nutrition, and medical-adjacent care. Most movement professionals have one or two pieces of this puzzle. Julie Erickson holds all four.
She is a master Pilates instructor with certifications in all three major Pilates traditions (Romana’s, STOTT, Balanced Body), a certified personal trainer (NASM, ACE, AFAA), a certified nutrition coach (CNC), and is currently completing a specialized GLP-1 nutrition credential. She has been recognized as Boston Magazine’s Best of Boston Personal Trainer and serves as an Instructor Trainer and Continuing Education Provider for NASM, ACE, and AFAA.
This combination of credentials is rare anywhere — and as far as we’re aware, unique in Boston for working specifically with GLP-1 patients.
This work is for anyone on a GLP-1, at any stage.
We work with patients across the full GLP-1 timeline:
- Just starting medication — building a movement practice before significant weight loss begins, so muscle preservation is baked in from day one
- Mid-treatment — already several months in, noticing changes in strength, posture, or body composition, and wanting to course-correct
- Approaching maintenance dose — preparing for the long-term phase, where consistent movement becomes essential for keeping weight off and the body strong
- Off the medication — finished the treatment course and wanting to lock in the gains, prevent rebound, and build a sustainable practice
- Patients with complicating conditions — diabetes, PCOS, post-bariatric, or rehabilitation-from-injury situations that benefit from a more careful, customized approach
You don’t need prior Pilates experience. You don’t need to be at a specific fitness level. You don’t need to have lost a specific amount of weight. The right starting point is wherever you are.
Questions about Pilates and GLP-1 weight loss.
Is Pilates enough on its own for GLP-1 muscle preservation?
How often do I need to come to see results?
I’m experiencing fatigue and nausea on my medication. Can I still exercise?
Do I need to tell my doctor I’m working with you?
What about “Ozempic butt”? Is there anything I can do?
I’m completely new to exercise. Will I be out of place?
Do you offer nutrition guidance too?
What does it cost?
How do I get started?
Endurance Pilates and Yoga provides movement, fitness, and general wellness coaching. We are not physicians and do not prescribe, diagnose, or manage medications. The information on this page is educational and is not a substitute for medical advice. Please consult your healthcare provider about your GLP-1 medication, weight loss goals, and exercise plan.
Book a consultation.
A 30-minute conversation about your medication, your goals, and how the work would fit your body and your schedule. No commitment — just a starting point.
