GLP-1 Medications, Weight Loss, and Physical Therapy: What Providers Should Know

GLP-1 receptor agonists and related incretin-based medications, including semaglutide and tirzepatide, can produce substantial weight loss and important cardiometabolic benefits for many patients with obesity and/or type 2 diabetes.

Weight loss from GLP-1 medications usually comes mostly from fat mass, but some fat-free mass and lean mass loss can occur. Current evidence does not support the blanket claim that GLP-1 medications automatically cause frailty or clinically meaningful sarcopenia, but high-risk patients deserve thoughtful monitoring.

Physical therapists should not manage GLP-1 prescriptions, dosing, or medication side effects independently. PTs can, however, screen medication history, monitor functional changes, prescribe progressive exercise, support long-term activity habits, communicate with the prescribing provider, and refer when symptoms fall outside PT scope.

Resistance training, aerobic exercise, adequate recovery, and appropriate nutrition conversations are especially important. APTA recognizes that diet and nutrition are relevant to PT-managed conditions and that PTs may screen and provide general information while referring to dietitians or other qualified providers when care exceeds professional or personal scope.

The best conversation is not “Are GLP-1 medications good or bad?” The better conversation is: How do we help this specific patient preserve function, build strength, stay safe, and remain connected to the right healthcare team?