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True to my word, I recently acquired oral semaglutide. I've been aware of the drug since initial weight loss trials, and the moment it was available, I got my diabetic and overweight mom to begin it. She had a rough start, the nausea and GI upset was unpleasant to say the least, but it settled down and she's fine now, probably lost 5kg. My current goal is to convince her to increase her dose from 7mg to the next step up, which is long overdue.
I gained about 5-6 kilos over about 4 months, both because of starting an antidepressant that increases appetite, and because a change in workplace made me far more sedentary.
This, alongside a recent breakup, jogged me into gear. I've begun working out, aiming for muscular hypertrophy rather than strength. No point being able to lift a boulder if you don't look it. However, the semaglutide works, and has drastically slashed my appetite. My body only wants about half what I'd normally eat, and I have to force myself to eat more despite feeling full.
My question is, to what extent can I achieve both significant weight loss as well as some muscle gain? Due to recent weight gain, I believe I could manage a mild to moderate caloric deficit (~10%) without overly compromising my gains, as long as I consume enough protein. To the more experienced gym goers here, does that sound correct? Any tips or tricks?
(I'll buy some creatine soon enough, stuff works)
Exercise.
That's it.
Both I and my brother are on semaglutide, and we're both consistently working out, and I've not noticed any loss in muscle mass.
If anything, I now have much more energy, allowing myself to push harder and faster, but that's just with me.
Just out of curiosity, is there any reason you choose oral over injection?
Thank you. Glad to hear from someone in the same boat.
Oral over injection? No particular reason. I wouldn't say that I'm so averse to needles that I couldn't dose myself up. But all else being equal, I'd prefer the pill.
This question prompted me to actually check the difference in price. And it's a large one. 7mg oral sets me back $100/m, even the lowest (0.5mg) dose of the injectable pen, Ozempic, would be closer to $500/m.
I see no real advantage in the injections when they're priced that steeply. You need a higher dose orally, but that's not reflected in the pricing.
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The conventional wisdom and proper scientific studies will tell you that you can't do it. I'll tell you that you can in certain limited circumstances but that getting on Semiglutide and trying to force yourself to eat more protein to gain muscle feels like a bit of a self-licking ice cream cone. You'd be much better off cycling from trying to build muscle to trying to cut weight. When you try to build muscle while also trying to restrict your appetite to lose weight, there's a risk you aren't going to do either, and you're going to find yourself months from now having achieved neither. I've never tried it with semaglutide, but I speak from experience on the topic. That said, here's my largely woo-woo experience with recomping.
I assume when you're saying you're doing hypertrophy-focused workouts you mean moderate-to-high reps in lots of exercises? Don't do that. Everyone I know who hops on semaglutide, and most people on cuts anyway, lack energy so you don't want to be trying to do long workouts with tons of sets of tons of exercises. You'll wear yourself out and increase the likelihood of injury.
What you want to do if you want to retain muscle and maybe build a little, while losing fat is two things: convince your body that it needs as much muscle as possible, while also convincing your body that it needs to be lighter. Do the former by doing low-rep high-intensity work in the weightroom, do the latter by doing bodyweight exercises.
I'm convinced that the body is "smarter" than we think it is in terms of building muscle or burning fat, in repsonse to the stimuli it gets from the outside world. Your body interprets calorie restriction as famine, food is less available. In that scenario, if you don't need maximum strength, your body is going to discard muscle as unnecessary. But just a few sets of high intensity lifts, and your body is going to assume that it needs that muscle to keep getting food in a famine environment, and will preserve it.
Similarly, if you're doing a lot of pull ups and push ups, climbing, muscle ups, etc your body knows that the resistance it faces is relative to its own weight and wants to reduce the load, or at least not increase it, and responds by leaning out. Exercise science tells us that resistance is resistance, but popular myth will point out that push ups and pull ups lean you out in ways that lifting never does.
This is my wild speculation on the topic at hand.
I think that's what I'm doing, 3x10 or till failure, with progressive overloading.
Ozempic drastically reduces my appetite, but I can still eat more if I want to.
Once I'm back in the UK, I might have difficulty going to the gym 5x a week as I'm currently doing, so maybe it'll balance out?
To a degree, semaglutide suppresses that famine response, or perhaps just the hunger itself. You still lose muscle with the fat, but that's true of any weight loss technique. Unfortunately, all the studies I've seen suggest that it's possible to retain muscle on semaglutide while working out, with nothing on trying to gain more. That's to be expected, since the primary demographic of interest are obese people and not gym nuts.
Thanks for the advice! I think I'll try and do it all for a month or so, but if turns out that's not helping, then I'll choose between cutting and bulking till I get good results.
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Based on a vague recollection of your training history, you should be able to at least temporarily recomp effectively.
One of the nice things about strength vs muscular mass is it's much easier to measure benchmarks , especially with respect to proficiency. For someone with no training history they should be able to go from untrained to somewhere in the novice/intermediate range while maintaining or even losing weight. My recollection is you had taken training "some what seriously" before, which probably brought you to mid-intermediate. In that case it should take 50-75% of the time it took the first time to reach the same place. All doable while in a 0.25-0.5% BW per week lost deficit. So if you went from a 65kg to a 100 kg bench in 9 months before, myonuclei retention might get you there in in 4-6 months. There is a bit of a compounding effect where if you stop and restart repeatedly strength and size seem to come back even faster. Longer if it's been more than 4 years. Beyond the proficient level and outside of a retraining effect recomping is a slow and painful process.
Protein recommendations I would still shoot for the tried and true 1 g/lb body weight. 2 g/kg bw for round metric numbers is probably fine. There had been some (pretty sus) analysis that got cemented as lore for lower recommendations. The newer stuff seems to have rediscovered the tried and true. Why would you expect a hard threshold in the first palce? If you are not that lean 1 g/cm height works surprisingly well as a benchmark. The easiest way to drastically increase protein uptake is to have a pre and post workout whey shake. Whey is very fast digesting so should not decrease appetite much for your "normal" meals. If you don't want to do dairy for some reason brown rice/pea combo, or soy protein is probably fine. If you are worried about phytoestrogens from soy, corner an endocrinologist in a dark corner of the hospital and wring the truth out of them. Report back what exactly the deal is with phytoestrogens is, I'm interested in knowing.
You over-estimate my previous progress. I was working out in a highly suboptimal manner, and several years back. That being said, I can tell that some muscle memory is still there, as I remember that my initial forays into working out were far more painful.
Thanks for the detailed advice! I'm concerned about how I can pay you back with a review of phytoestrogens. I'm no expert on that topic, but I, with low confidence, remember that my previous reviews of it put it into the "low concern" category. This shouldn't substitute a more informed opinion.
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