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.