EverStrong

Guide

Your first 90 days on a GLP-1: the month-by-month plan

The first three months decide most of what the medication does to your body composition. Appetite drops fastest, the dose climbs, side effects arrive, and habits either get built or do not. This is the plan we run, month by month.

The short answer

Week one: set your protein number, book two 30-minute strength sessions, and take a baseline of the three numbers. Month one: the lowest step, the first nausea, and protein held at the floor while appetite falls. Month two: the first dose step, the smallest appetite you will have, and the shake doing most of the work. Month three: the first stall, the first honest strength test, and the point where the people who kept muscle and the people who did not start to look different. The dose schedule throughout is your prescriber's; the food and the training are yours.

Start with your protein number

Why the first 90 days decide the body you end up with

Appetite drops fastest in the first three months, the dose climbs in steps, side effects arrive and leave, and habits are either built or not. Across 20 randomised trials, an average of 35.2% of the weight lost on semaglutide (Ozempic, Wegovy) was lean mass. Losing the same weight through diet alone cost 26.2% as lean mass, which was not significantly different from the medications (p = 0.42). The muscle comes off because the weight comes off, not because of the injection. Adding resistance training brought it down to 17.5%, the most favourable result of any approach studied. Eisa N et al, Diabetes, Obesity and Metabolism 2026

Nobody in those trials was given a protein target or a training programme, which is what makes the last figure the interesting one. The people we coach who start both in week one hold their strength test steady while the scale falls. The people who start in month four are trying to rebuild what the first 90 days took.

Before the first injection, and week one

  • Set the number 1.2 to 1.6 g of protein per kilogram of your goal body weight (0.55 to 0.7 g per pound). For a 70 kg (154 lb) goal that is 84 to 112 g a day, at 0.3 to 0.4 g per kg a meal, which is 21 to 28 g a sitting. The calculator does it in ten seconds.
  • Take the baseline One strength test (the 30-second sit-to-stand, or goblet squat repetitions at a fixed weight), a tape around the upper arm and the waist in centimetres or inches, and your weight, same day and time. Log the test in the strength test tracker. In a 2026 review of 35 studies in the Annals of Internal Medicine, not one reported whether people could actually do more or less afterwards. Scans were measured. Getting out of a chair was not. Batsis JA et al, Annals of Internal Medicine 2026 Yours is the only one that will be, so take it in week one; without a baseline, nothing you measure later means anything.
  • Book the two sessions Two 30-minute full-body sessions a week, six movements: squat pattern, hinge, push, pull, carry, core brace. Put them in the diary now, on the days you expect to feel best. The programme is in strength training on a GLP-1.
  • Shop for the small appetite Protein powder, milk, Greek yoghurt, eggs, tinned fish, cottage cheese, chicken thigh. The foods index has the serve sizes. Nothing that needs an appetite to be eaten.
  • Talk to your doctor about the rest Blood pressure, diabetes and other medications may need reviewing as the weight comes off, and that review is theirs. Ask what pace of loss they expect, so you know what fast looks like.

Month one: the lowest step

Most schedules hold the lowest step for a few weeks, so the appetite effect in month one is often milder than you were braced for, and some people are disappointed by it. Use the month. This is the easiest eating you will have for a while, so the habit of protein first at four sittings goes in now, while food is still possible. The per-medication guides to your first month on Ozempic, Wegovy, Mounjaro and Zepbound set out the month in detail.

Expect some nausea and some constipation, most of it in the two or three days after each injection. Small, cold, low-fat, protein-first meals settle most of it; GLP-1 side effects: what to eat has the food answer for each. The injection day planner lays out the day before, the day of and the day after your dose, and it is the tool most people use most in month one. Early weight loss includes a lot of water; do not read the first fortnight as the pace.

Month two: the first dose step

The step up is where appetite usually falls hardest, and where most of the muscle loss we see begins. Food that was manageable in week three becomes impossible in week six, protein falls with everything else, and the person feels fine, because there is no hunger to tell them anything is wrong. Dose increase week covers the week itself, and hitting protein on 800 calories a day covers the arithmetic when intake is at its lowest.

The tools for month two are the shake and the alarm. A 30 g scoop in 250 ml (8.5 fl oz) of milk is about 33 g of protein in ninety seconds and is the easiest serve of the day. Two alarms, mid-morning and mid-afternoon, replace the hunger cue you no longer have. Keep both strength sessions, shorter if you must, on the days you eat best, which on a weekly injection are usually days four to seven. Expect fatigue and feeling cold as intake falls; fatigue and energy on a GLP-1 explains the three-day test that finds the cause.

Month three: the stall, and the first real read

Somewhere around week ten to twelve the scale slows or stops for a fortnight, and it feels like failure. Usually it is not. Water shifts, a bigger meal, a strength session and the body settling on a dose all flatten the scale for a while. Weight loss stalled after three months sets out what to check first. The tape and the strength test read through it: a flat scale with a shrinking waist and a steady test is a good fortnight, not a bad one.

This is also when the first honest verdict on muscle is available. Compare the strength test with the week-one baseline. If it has held or climbed while the weight fell, the plan is working. If it has fallen three or four weeks running, the loss includes muscle, and the fix is protein to the ceiling and load in both sessions, starting this week. The muscle loss risk calculator scores your rate of loss, protein, training, age and sex and tells you which factor to change first. Hair shedding often appears around now, two to four months in, and usually reflects rapid loss and low protein together; see hair shedding on a GLP-1.

Every Sunday, for all 90 days

  1. One strength test, the same way

    Fat loss does not make you weaker, so a number that falls three or four weeks running is a real signal, and it is fixable.

  2. Seven-day protein average

    Not the best day. Under 1.2 g per kg of goal weight is where strength tests start to fall.

  3. Upper arm tape

    Same spot, relaxed. The waist shrinks whatever you do; if the arm shrinks as fast, that is muscle.

Weight is number four, same day and time. The scale tells you what you lost. These tell you what you kept.

The two things we sell, and who they are for

Everything above can be run from the free tools and these guides. If you want it written down and printed, the Keep Muscle Kit is A$47 / US$29 / £23: the workbook, the Sunday numbers tracker, the 2-day strength plan, the injection-day card and meal plans at 100, 120 and 140 g of protein. It covers the first 90 days completely.

If you want the year rather than the quarter, the Keep Muscle System is A$149 / US$95 / £74: twelve PDFs including the Kit, the Coming Off Plan, a 12-month muscle calendar, the plateau playbook, the protein field guide, the strength progressions manual and a credit for a Personal 7-Day Plan. It is for the person who has decided this is a year-long project, which, for keeping the result, it is. Neither is required to start. The protein number and two sessions this week are.

What the prescriber owns, all the way through

The dose, the schedule, the timing of every step, and what happens after a missed dose. Nausea or vomiting that stops you keeping fluid down, pain in the upper abdomen, or any symptom that frightens you. The pace of loss if it is faster than they expected. Blood pressure and diabetes medication as the weight comes down. Nothing on this page, and nothing in coaching, ever involves changing or skipping a dose to make eating easier.

After day 90

The dose usually settles, the side effects fade, and the risk changes shape: from eating too little in a hurry to eating too little for a long time. Six months on a GLP-1 covers the second stall, over 50 on a GLP-1 covers the muscle maths for the people most at risk, and coming off a GLP-1 covers what the trial extensions show about regain and how to keep the result. Whatever comes next, the three Sunday numbers do not change.

Free, one page

Forty foods, ranked by protein per bite

The hard part is not knowing you need protein, it is hitting the number on a day when food is the last thing you want. One page, grams and ounces, what a real serve looks like, and the first-bite rule for when appetite is gone. Print it and put it on the fridge.

Then five short emails over five days on keeping muscle while the weight comes off, and a short note every fortnight after that if you want it. One click to stop, any time.

Sent. Check your inbox in the next minute or two, and look in junk if it is not there.

Questions people ask

What should I do in the first week on a GLP-1?

Set your protein target from your goal weight, take a baseline strength test and arm and waist measurements, book two 30-minute strength sessions a week, and shop for protein that needs no appetite: powder, milk, yoghurt, eggs, tinned fish. Ask your doctor about any other medications that may need reviewing.

When does muscle loss start on a GLP-1?

From the first weeks of a large deficit, and fastest around the first dose step when appetite falls hardest. Across 20 randomised trials, an average of 35.2% of the weight lost on semaglutide (Ozempic, Wegovy) was lean mass. Losing the same weight through diet alone cost 26.2% as lean mass, which was not significantly different from the medications (p = 0.42). The muscle comes off because the weight comes off, not because of the injection. Adding resistance training brought it down to 17.5%, the most favourable result of any approach studied. Starting protein and training in week one is what changes that.

Is it normal for weight loss to stall at three months?

Yes, a flat fortnight around weeks ten to twelve is common and usually reflects water, a dose settling or a bigger meal. Read the waist tape and the strength test rather than the scale. A stall with a falling strength test is different and means protein and load need fixing.

Do I need the Kit or the System to follow this plan?

No. Everything here runs on the free calculator, the strength test tracker and these guides. The Kit (A$47 / US$29 / £23) is the printed version of the first 90 days; the System (A$149 / US$95 / £74) is the year-long version with the Coming Off Plan and the 12-month calendar.

What should I ask my prescriber during the first 90 days?

What pace of loss they expect, whether your other medications need reviewing as the weight comes off, and what to do about any missed dose. Tell them about vomiting, abdominal pain, dizziness, or loss faster than they predicted. Never change a dose yourself.

What the research says about these three months

The first three figures explain why week one matters. The fourth explains why we ask you to write down a chair test rather than book a scan.

Across 20 randomised trials, an average of 35.2% of the weight lost on semaglutide (Ozempic, Wegovy) was lean mass. Eisa N et al, Diabetes, Obesity and Metabolism 2026

Losing the same weight through diet alone cost 26.2% as lean mass, which was not significantly different from the medications (p = 0.42). The muscle comes off because the weight comes off, not because of the injection. Eisa N et al, Diabetes, Obesity and Metabolism 2026

Adding resistance training brought the lean share of weight lost down to 17.5%, the most favourable result of any approach studied. Eisa N et al, Diabetes, Obesity and Metabolism 2026

In a 2026 review of 35 studies in the Annals of Internal Medicine, not one reported whether people could actually do more or less afterwards. Scans were measured. Getting out of a chair was not. Batsis JA et al, Annals of Internal Medicine 2026

The papers these numbers come from

  • Eisa N, Barood O. Lean Mass Changes With Incretin Therapy Versus Lifestyle Intervention: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Diabetes, Obesity and Metabolism, 2026. 20 randomised controlled trials, 15,782 participants. doi:10.1111/dom.70666
  • Batsis JA, Gavras A, Gross DC, et al. Effect of Incretin-Based and Nonpharmacologic Weight Loss on Body Composition: A Systematic Review. Annals of Internal Medicine, 2026. 35 studies, median duration 26 weeks. doi:10.7326/ANNALS-25-00478
  • Arslan S. Medical nutrition in the glucagon-like peptide-1 (GLP-1) era: Protein strategies, micronutrient monitoring, and lean mass preservation. Clinical Nutrition ESPEN, 2026. Narrative review, guideline-informed targets. doi:10.1016/j.clnesp.2026.103305

Last reviewed 18 September 2026. We update these figures when a larger or better study replaces them, and we say what changed. How we handle evidence.

The free tools that go with this

The Keep Muscle Kit

The first 90 days, written down in five PDFs

The workbook, Sunday numbers tracker, 2-day strength plan, injection-day card, and meal plans at 100, 120 and 140 g protein. Instant download.

Get the Kit

A$47 / US$29 / £23, one payment.

Read next

Every guide, by medication and situation

EverStrong provides nutrition and strength coaching and education. It is not medical advice and does not replace your prescribing doctor. Consult your doctor before starting a new exercise or nutrition plan, especially with a heart, kidney, liver or metabolic condition, if pregnant, or with a history of disordered eating.