🏃🏽‍♀️Training on GLP-1s: What Active 40+ Women Should Know

Much like hormone therapy, the conversation around and interest in GLP-1 medications like Ozempic, Wegovy, Mounjaro has taken off in recent years and shows no signs of slowing down. In fact, many menopause medical services and practitioners are routinely offering midlife women both, as research is showing that menopausal women using hormone therapy may experience greater weight loss when using GLP-1 medications like semaglutide.

Active women are very interested. Over the past few years, the number of women in our Hit Play Not Pause podcast group using, asking, and posting about these medications has increased exponentially. Many are happy with their results. Some struggle with side effects. There are still lots of questions. So, I thought it was worth laying out some of the basics of what active midlife women specifically need to know: how they work; how they impact muscle and bone; what they mean for fueling, hydration, GI and LEA risks, and what happens when you go off of them.

Note: This is focused on women who are using them for weight loss, not to manage diabetes. I’d also invite you to check out my conversation on the topic with longtime GLP-1 researcher and triathlete Dr. Jody Dushay.

What GLP-1 Medications Actually Do

GLP-1 receptor agonists (like semaglutide, tirzepatide, and their cousins) were first developed for type 2 diabetes. They:

Act on the brain to reduce appetite and increase feelings of fullness
Slow gastric emptying, so food stays in your stomach longer, sending “we’re good down here” signals, which contributes to that feeling of fullness
Help the pancreas release more insulin when blood sugar rises, improving glucose control in people with diabetes

To say they’ve been game changers for some people is an understatement. Many who have struggled for years, if not decades, have been able to lose weight and improve their metabolic health. For many, these drugs also truly help them exercise, which is something Dushay told me she really cherishes.

“A much bigger win is to get someone to achieve their athletic goals or physical fitness goals, like being able to walk up a hill. I had a patient who wanted to swim across Walden Pond…And she did it,” she said.

That’s a big freakin’ deal. But these meds are not without their challenges. You can have nausea, reflux, constipation or diarrhea, gallstones, fatigue and, if you’re not careful, pretty pronounced muscle, and maybe bone loss. Dushay said that 80 to 90% of people in her practice experience some side effects.

Anecdotally, in our group, many women report side effects, but many find them manageable, or they get better overtime and/or with dose adjustments.

Special Considerations for 40+ Active & Athletic Women

Obviously, side effects can be disruptive for training and performance, so working with an informed medical professional to dial in your treatment plan is important. For midlife athletes, there are also some other considerations:

Muscle Maintenance

You’re already swimming upstream against midlife and menopausal muscle and bone loss. Add GLP-1s and rapid weight loss and that loss gets worse. Studies suggest 15–40% of total weight lost can be lean mass if you’re not actively protecting it, especially if you’re losing weight quickly (other forms of rapid weight loss have similar risks).

Losing muscle and bone is never good, as we’ve talked about many times in this space. So resistance training is non-negotiable. Same goes for nailing your protein intake, since eating protein helps stimulate muscle protein synthesis for building and repairing muscle tissue. Aim for 1.4 to 2.2 grams per kg a day depending on how hard you’re training.

It’s also a good idea to get a baseline DEXA scan at the beginning for a baseline and continue to monitor your body comp and bone health along the way.

We’ve written more on the Feisty website about the side effects for active women when it comes to fueling, hydration, and gastric emptying.

On Sale Now: Certificate in Coaching Women Endurance Athletes

Endurance coaching has largely been built on research that wasn’t designed with women in mind. Not because women are “different” in a negative way, but because female physiology, life stages, and lived realities were historically underrepresented in sport science, product development, and coach education.

After talking to coaches at workshops, through our online communities and at events over the past few years, we know that coaches need more than a one-off education session.

That’s exactly why we created the Certificate in Coaching Women Endurance Athletes.

And because this is our beta cohort, you’re not just enrolling in a course, you’re helping shape it. Your experience, questions, and feedback will directly influence future versions. We’re building this with you, not just for you.

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👀 What Caught My Eye

When people eat only unprocessed, whole foods, they naturally consume over 50% more food by weight—mostly fruits and vegetables—yet still end up eating about 330 fewer calories per day compared to when they eat only ultra-processed foods (UPFs), according to a new study.

The study is actually a reanalysis of a landmark 2019 NIH trial on ultraprocessed foods, which found that eating an ultraprocessed diet increases energy intake by about 500 calories a day compared to an unprocessed diet.

When the researchers looked at the whole-food eaters, they saw that they instinctively gravitated toward high-volume, micronutrient-rich options like produce. This pattern delivered more essential vitamins and minerals even while reducing energy intake, a behavior researchers call “micronutrient deleveraging,” suggesting humans have a built-in “nutritional intelligence” that guides us to nutrient-dense foods when they’re available in their natural form. Whatever the underlying mechanism, the end result is pretty clear: whole foods rule.

🔥Badass Athlete of the Week Goes To…

🙏 First, thank you Lindsey Vonn for showing us what it takes to dream big on the world’s largest stage. Many of us are old enough to remember “the thrill of victory and the agony of defeat’ from ABC's Wide World of Sports. Lindsey was brave enough to show us both. It didn’t end the way she wanted, but in her own words from her Instagram:

I tried. I dreamt. I jumped.

I hope if you take away anything from my journey it’s that you all have the courage to dare greatly. Life is too short not to take chances on yourself. Because the only failure in life is not trying.

I believe in you, just as you believed in me.

We also need to give a rousing round of applause to Austrian snowboarder Claudia Riegler, who at age 52, just completed her fifth Winter Olympics to become the oldest female athlete to ever participate at the Games.

As reported in Reuters, she was dropped from the national team at 30 for being “too old,” which set her on a 20-year mission to prove them wrong. “They told me I was too old. I said to myself, 'no – that can't be the truth'. I had to find my own truth," she said.

And she did. Check out her Instagram where she encourages you to “followyourheart. 💖And then follow yours.

👉Want a chance to be featured? Click here to share your badass story

👩🏻‍💻 Hit Play Research Round Up

We spend a lot of time scouring the latest research for news you can use to stay strong and feisty forever. Here’s what’s making waves this week:

♥️ High Lp(a) = higher heart risk. A new study shows that women with lipoprotein(a) levels above 30 mg/dL have a higher 30-year risk of cardiovascular disease—even if they’re otherwise healthy. Ask your clinician to check your Lp(a). If it’s elevated, discuss strategies to lower your risk. Research also shows oral hormone therapy may significantly reduce Lp(a) over time (with oral being more effective than transdermal estrogen).

🍦Eating more yogurt linked to less belly fat, according to a new review. This 2025 analysis including 28 studies and about 196,000 adults found that higher dairy intake is linked to 16% lower odds of abdominal obesity. Higher amounts of yogurt was related to a 21% reduction in abdominal obesity. It’s observational, but yogurt’s probiotic and protein content may help support weight management. Look for low-sugar added varieties.

🩺 Early menopause doesn’t increase diabetes risk. A study of 147,000 women found no independent link between early or premature menopause and diabetes. Once researchers adjusted for lifestyle and heart-health factors, the higher diabetes rates disappeared. Bottom line: Midlife diabetes risk is driven more by modifiable habits—like diet, smoking, and weight—than by the age menopause starts.

Come lift with us!
No egos. No competition. No body judgment. Just solid strength training, real confidence, and a community of Feisty women who lift heavy sh*t — and lift each other up. This is the strength retreat that was made for YOU!

Led by strength coach Cassi Niemann, you’ll spend the weekend building real skills: dialing in technique, understanding the “why” behind your lifts, asking all your questions, and gaining the confidence to move heavier weights on your own. Expect hands-on coaching, supportive energy, and a room full of women who are there to get stronger together.

Join us in Atlanta, April 17-19, 2026! Learn more here.

What's On My Mind...

Sometimes you need extra steps to set yourself up to stay in a workout routine—especially if it’s something you don’t love to do just to do it. I’ve been reminded of that while I’m working remotely for a few weeks. At home, I use my Tonal 4 or 5 mornings a week. There’s no Tonal here, but I brought some weights (as well as my bike and running gear). I rode and ran lots right away while the weights sat completely ignored. So I found a few 20 minute plans, put them on my desktop, and put “lift” on my calendar. They were the prompts I needed to do what I needed to do. Just keeping it real. Even health and fitness advisors need extra help sometimes.

Listen to this week's episode of Hit Play Not Pause - Why So Many Midlife Women Stop Wanting Sex—and What Helps

Feisty 40+ is written by Selene Yeager. Edited by Maya Smith. Ads by Ella Hnatyshyn

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