Evidence-graded answer
Do I need to exercise on Wegovy?
Yes — resistance training specifically. Without it, 25-40% of weight lost on GLP-1 comes from lean muscle. Cardio is a bonus; resistance is the non-negotiable.
GLP-1-induced weight loss is uniform across body compartments — fat AND lean mass. Without targeted strength training, patients lose meaningful muscle, which lowers basal metabolic rate and increases the chance of weight regain after stopping.
Protocol: 2-3 resistance training sessions per week, hitting all major muscle groups, with progressive overload. Protein intake of 1.2-1.6 g/kg ideal body weight supports retention.
Cardio (walking, cycling) provides cardiovascular benefit + appetite regulation but doesn't preserve lean mass — strength training is the muscle-specific tool.