GLP-1, Obesity & Chronic Disease Exercise Program

The GLP-1 Problem Nobody Talks About

GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound are changing lives. The weight comes off. But the research tells a more complicated story:

• In the STEP-1 trial, 39–45% of total weight lost on semaglutide was lean muscle mass — not fat
• The SLIM LIVER study found a 9.3% decrease in core muscle volume with semaglutide
• Tirzepatide (Mounjaro/Zepbound) fares somewhat better, with ~25% of weight lost as lean mass in the SURMOUNT-1 trial — but that’s still significant

Muscle isn’t just about looking strong. It’s your metabolic engine, your joint protection, your fall prevention, your functional independence. Losing it trades one health risk for another.

The question isn’t whether GLP-1s work. It’s whether you’re protecting what you can’t afford to lose.

Who This Program Is For

Whether you’re on a GLP-1 and want to protect your muscle mass, managing diabetes and need supervised exercise, or preparing for surgery and need to build your body’s capacity first — this program is built for you.

What We Measure (And Why It Matters)

Every patient starts with a Health Capacity Exam — the same clinical rigor we bring to ACL athletes and post-surgical patients, applied to metabolic health:

• Body Composition — BMI, waist-to-hip ratio, waist-to-height ratio. Tracks whether you’re losing fat or losing muscle — the critical distinction for GLP-1 patients
• Cardiovascular Fitness — resting heart rate, blood pressure, and VO2 max estimation via our Talk Test protocol. We find your ventilatory thresholds (VT1/VT2) to prescribe exercise at the exact intensity that’s safe and effective for your heart
• Physical Activity Vital Sign — your current weekly activity benchmarked against CDC guidelines (150 min/week)
• Grip Strength — one of the strongest predictors of all-cause mortality and overall functional capacity
• Functional Testing — sit-to-stand speed, gait speed, balance — the movements that determine whether you live independently

Every number is tracked over time. You’ll see your progress in black and white — not just on the scale, but in the metrics that actually predict your health outcomes.

Pre-Surgical Optimization

Scheduled for a joint replacement or major surgery? Your fitness level going into surgery is one of the strongest predictors of how you’ll come out. Deconditioned patients lose aerobic capacity at 0.43% per day during immobilization. Three weeks of bed rest causes a 27% decline in VO2 max — equivalent to 40 years of aging.

Our pre-op program identifies risks early and builds the reserve you’ll need. Your surgeon handles the procedure. We make sure your body is ready for it.

Why Forward Physical Therapy

Most PT clinics focus on injury recovery. We built infrastructure for long-term, data-driven care. Our Return+ testing system — the same platform that tracks ACL athletes over 18 months — tracks your body composition, cardiovascular fitness, grip strength, and functional capacity across your entire program.

Every visit is 1-on-1 with a Doctor of Physical Therapy. Not an aide. Not a circuit of machines. Your clinician knows your numbers, your medications, your history, and your goals — because they’re the same person every time.

This program doesn’t exist anywhere else. We built the tools, we have the data, and we’re ready to put them to work for you.