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What do weight loss drugs mean for a diet industry built on eating less and exercising more?

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2 years ago

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What do weight loss drugs mean for a diet industry built on eating less and exercising more?

NEW YORK –


Ever since college, Brad Jobling struggled with his weight, fluctuating between a low of 155 pounds when he was in his 30s to as high as 220. He spent a decade tracking calories on WeightWatchers, but the pounds he dropped always crept back onto his 5-foot-5-inch frame.


A little over a year ago, the 58-year-old Manhattan resident went on a new weight loss drug called Wegovy. He’s lost 30 pounds, and has started eating healthier food and exercising — the habits behind many commercial diet plans and decades of conventional wisdom on sustainable weight loss.


Yet Jobling’s experience also has altered his perspective on dieting. He now sees obesity as a disease that requires medical intervention, not just behavioural changes. In fact, he thinks he will need to stay on a drug like Wegovy for the rest of his life even though it has taken some of the joy out of eating.


“I don’t see how you can maintain (the weight) without medication,” Jobling said. “Obviously, it’s all about self-control. But I think it’s less of a struggle to really maintain healthy eating when you got that assistance.”

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Like the lives of the people taking them, recent injected drugs like Wegovy and its predecessor, the diabetes medication Ozempic, are reshaping the U.S. health and fitness industries. They have proven successful in eliminating unwanted pounds more quickly and easily than consuming fewer and burning more calories alone. Such is their disruptive power that even established diet companies like WeightWatchers and brands like Lean Cuisine are getting makeovers.


Although celebrities like Oprah Winfrey have spoken publicly of the drugs as revolutionary, some health experts worry that businesses without any expertise will start dispensing the prescription medications along with bad advice and unproven therapies.


A demand too big to ignore


At least 3 million prescriptions for the class of medications known as GLP-1 agonists were issued each month in the U.S. during the 12 months that ended in March, according to data from health technology company IQVIA. They include semaglutide, the drug in Ozempic and Wegovy, and tirzepatide, the drug in Mounjaro and Zepbound. Morgan Stanley research analysts have estimated that 24 million people, or 7% of the U.S. population, will be using GLPT-1 drugs by 2035.


The world’s leading diet programs have taken note of such statistics and incorporated the popular drugs into their existing subscription plans.


WeightWatchers, which was founded in 1963, last year acquired telehealth provider Sequence, enabling members to get prescriptions for weight loss drugs. WeightWatchers is sticking with its focus on behaviour change as the cornerstone of weight reduction but launched virtual clinics that provide customized exercise and nutrition plans, as well as prescription care, for individuals who want to lose 20% of their body weight on average.

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“The weight loss space will be led by the acknowledgement that weight loss is a matter of health care,” WeightWatchers CEO Sima Sistani told analysts earlier this year. “This is a paradigm shift because weight loss has been and, unfortunately, often still is viewed as a vanity issue.”


The Mayo Clinic, which first offered a weight management plan in book form in 1949, has published an updated version of the longtime bestseller, titled “The Mayo Clinic Diet: Weight-Loss Medications Edition.”


The Mayo Clinic Diet program also has expanded to include access to weight loss drugs and advice on managing any side effects, according to Digital Wellness CEO Scott Penn, whose company developed an online platform for the original program.


The new drugs have made being very overweight “feel more medical as a condition,” he said.


Gyms and diet food companies look to muscle in


Luxury athletic club operator Life Time launched a membership program last year that offers comprehensive medical testing, personalized training and a host of alternative therapies like cryotherapy. Members of the Miora program also can get Ozempic and other weight loss drugs through the medical staff of a clinic that opened in Minneapolis last year.

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Jeff Zwiefel, executive director of Life Time Miora, called the new drugs a “game changer” for the fitness industry.


“We have an opportunity and an obligation and a responsibility to help people achieve results in conjunction with medical providers and make sure that that’s the way to go,” he said.


Fitness chains are banking on the idea people on the drugs will lose enough weight to overcome any self-consciousness or physical limits that kept them from exercising. The gym franchise Equinox started a new personal training program in January for prescription-holders who want to preserve or build muscle mass as they shed unwanted pounds.


The world of drug-assisted weight loss also is altering the ambitions of food companies. Sales of SlimFast, a line of meal replacement shakes and snacks sold at supermarkets, have dropped as people turn to weight loss drugs and retailers cut shelf space for diet products, the brand’s parent company, Glanbia, told investors in February.


Since the drugs suppress the appetites of people taking them, Glanbia and other companies are marketing their products as a source of adequate nutrients for people taking GLP-1s. Swiss multinational Nestle SA thinks it can benefit from the drugs’ popularity and is expanding its Lean Cuisine frozen meals and OPTIFAST protein shakes.

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“Diets are cool again,” Nestle SA CEO Ulf Mark Schneider told analysts in February. “It’s something that people used to do quietly on the side, uncertain about their outcomes.”


Promising results and a wealth of unknowns


Research has shown that about a third of people lose 5% or more of their body weight with diet and exercise alone, according to Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medical School. In comparison, the medicine in the diabetes drug Mounjaro helped people with obesity or who are overweight lose at least a quarter of their weight when combined with restricted calories and exercise, a new study showed.


But some experts worry about businesses marketing the drugs or serving as fitness coaches for patients on the medications. Dr. Cian Wade, a health care consultant for the global strategy and management firm Kearney, said he’s concerned about a proliferation of clinics that don’t have as much experience with obesity and related health conditions.


“There’s a potential worry that for some patients, (the clinics) will not have the right expertise at hand to be able to appropriately manage the side effects, nutrition-related issues,” he said.


Since GLP-1 medications are so new, it’s unclear how many patients will stick with their drug regimens, which produce intolerable side effects for some people. Another reason patients may drop the drugs is cost. A month’s supply of Wegovy costs US$1,300, and Zepbound is priced at $1,000.

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‘The new version of me’


Lisa Donahey, 54, an actress and singer who lives in Los Angeles, started Mounjaro under a doctor’s care a year ago to address her Type 2 diabetes. At the time, Donahey, who is 5-foot-7-inches tall, weighed 260 pounds and was a veteran of diet plans like Jenny Craig, WeightWatchers and Nutrisystem.


Her weight has since dropped to a little less than 190 pounds. She goes to a gym. After always being cast as a character actor, she’s looking for new roles. Having used the medication to give her “a kick-start,” Donahey said she plans to wean herself off Mounjaro once she loses another 40 pounds.


“I had a sense of hopelessness that I was destined to be this way and just could not do it by myself,” she said. “Now, with my weight being managed and the new version of ‘me’ is emerging, I just feel so empowered, excited and hopeful.”

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I’ve been doing the bird dog exercise instead of planks to improve my core strength – it’s even better for beginners

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July 1, 2026

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I’ve been doing the bird dog exercise instead of planks to improve my core strength – it’s even better for beginners

While the bird dog exercise mainly works the core muscles, improving stability and strength, it also targets the lower back, shoulders, hamstrings, and glutes, making it one of the better full-body exercises you can do.

Over the years, I’ve done plank after plank and seen few benefits. It’s just not the exercise for me. I can hold the position for about a minute before everything starts shaking and my forehead starts sweating. Even with practice, it feels torturous.

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?

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July 1, 2026

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Boutique Fitness Is Redefining How Americans Work Out. Which Drop-In Classes Are Worth Booking?


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I pushed myself too hard at the gym – and ended up in the hospital

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23 hours ago

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June 30, 2026

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I pushed myself too hard at the gym – and ended up in the hospital

In January 2025, I attended my first bootcamp class.

I had spent the day hunched over my laptop, anxious and craving an intense workout that would dispel my worries. I booked the class at a nearby gym, and the five-star reviews promised the all-consuming exercise I wanted: “Militant style instructor, but very motivating,” read one. Another: “Hardest workout of my life; extremely rewarding.”

The gym was no-frills – just a room with a mirror. After a standard warm-up, we did four sets of lateral shuffle push-ups across the floor, interspersed with standing, weight-bearing exercises.

When my turn came, I dropped to plank position and started doing steady, shallow reps, focusing on my form.

But caution soon fell away. Upbeat music was booming and someone was always advancing beside me. When the instructor encouraged us to lower all the way down, I obeyed, even though my form suffered. I had rarely done more than a handful of pushups at a time, and in the final set, I was exhausted, collapsing on every rep and barely prying my torso off the floor.

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The rest of class was a blur. I became nauseated, told the instructor I needed to pause, and stepped outside to suck cold winter air into my lungs.

Back in the studio, I sat on the sidelines and waited for the dizziness to recede before slinking to my spot for the core section and cooldown.

Later that night, I felt what I thought was typical post-workout muscle soreness. I was satisfied; the ache was proof of a successful workout.

But the next day, lifting my arms to wash my face was exhausting. Searing pain kept me awake that night. Two days after the class, my arms were so stiff I couldn’t raise them more than a few inches, even to brush my teeth.

When I Googled my symptoms – pain, weakness and a new one, dark urine – something frightening came up: exertional rhabdomyolysis, a condition wherein extreme exercise causes muscle cell contents to flood the bloodstream, potentially overwhelming the kidneys. One article warned that debilitating pain after a new, intense activity was a sign to visit the emergency room.

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I went to the ER but suspected I was overreacting. After all, the internet always offers the worst possibility.

Doctors use bloodwork to test for exertional rhabdomyolysis; typically, they diagnose it if a patient has too much of a muscle enzyme called creatine kinase (CK) in their blood – at least 1,000 units per liter, or five times the normal range. However, there is little consensus on this number, says Dr Barry Boden, an orthopaedic surgeon at The Orthopaedic Center in Maryland, who specializes in sports medicine. Some recent guidelines suggest that only higher amounts – as much as 10,000 units – warrant diagnosis and inpatient treatment.

My CK count was so high the machine in the emergency room couldn’t measure it; a nurse had to do a second blood draw and send it to a more precise lab. They put me on an IV drip and eventually reported the exact number: 57,000.

Thus began my seven-day hospital stay. My mom and sister traded shifts, acting as my arms for the week – scrubbing my teeth, feeding me, washing my face. I had never felt so helpless and irresponsible. What had I done to myself?

What is exertional rhabdomyolysis?

Normally, during exercise, muscles tear a little and then rebuild. There may be a little extra CK in a person’s blood as a result, which healthy kidneys can filter out.

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But excessive exercise can harm muscle cells so much that their contents – including CK and a protein called myoglobin – overload the system. “When the cell membrane starts to break down, the chemicals within the muscle cells start to get released, which can cause damage to other organs around the body,” said Boden. “ If there’s enough of those chemicals from the muscle that reach the kidney, it can cause damage to the kidney.”

The symptoms are muscle pain (even while at rest), weakness and dark urine, though few people experience all three. Treatment involves early and aggressive administration of IV fluids to help the kidneys filter the toxins. It’s possible to manage a mild case with at-home oral hydration, but it’s always important to consult a doctor because mild symptoms don’t always mean low CK elevation, said Dr Petr Schlegel, a CrossFit trainer and professor at the department of physical education and sports at the University of Hradec Králové in the Czech Republic.

Exertional rhabdomyolysis is dangerous and fatal in very rare cases; researchers estimate that 10% of patients develop acute kidney injury (AKI), and some suffer other serious complications.

How common is exertional rhabdomyolysis?

Before I had rhabdomyolysis, I had never heard of it; I thought the worst that could come from a workout was a broken bone or a regurgitated lunch. I now know it can happen to anyone, although people with certain conditions, such as sickle-cell trait and hypokalemia, are predisposed. Despite the common misconception that only unfit people can get it, even elite athletes are susceptible.

 “Anybody can get it – anybody that’s pushed to an extreme, taking a big jump in their exercise level, or doing something they’re not used to doing,” said Boden. “Everybody has muscles, and if the muscles are damaged enough, you can develop rhabdomyolysis.”

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Boden authored a study estimating there were over 40,000 exertional rhabdomyolysis cases in US hospitals from 2000 to 2019. But he said it’s impossible to get a precise count, as no organization collects the data.

This number is likely an underestimate, as the condition is probably under-reported, said Schlegel. Since the symptoms closely resemble those of delayed onset muscle soreness – the normal ache people expect after a workout – individuals may not seek care.

Data indicate exertional rhabdomyolysis is on the rise. In Norway, Australia and the US, researchers have observed an increase in hospital records between the 2000s and 2010s. This year, hospitals in a Canadian province reported a surge in cases.

Researchers suspect the popularity of high-intensity workouts is behind the rise. They are efficient and produce measurable progress, but are risky if misused, said Schlegel: “Evidence suggests that high-intensity exercise, especially when combining strength and endurance elements, carries the greatest potential to induce [exertional rhabdomyolysis].”

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Can you prevent exertional rhabdomyolysis?

Prevention guidance has been pretty consistent since the earliest studies from the 1960s: vary exercises to avoid overloading one muscle group, incorporate rest, and gradually build intensity when starting something new or after time off.

Starting low is especially important when targeting large muscle groups – such as biceps, triceps and quads. “It’s that hyperintense going from zero to 100, really intense workouts of large muscle groups, that puts people at risk,” said Dr Bryant Walrod, a sports medicine physician and the head team physician for the Ohio State Buckeyes. Weight matters, but so do reps; an outrageous number of low-weight exercises or calisthenics – hundreds of pushups or squats, for example – is the trigger in many cases. Walrod also advises doing a different kind of workout from one day to the next.

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Eccentric exercises like push-ups – where muscles lengthen – are particularly likely to cause injury. In a 2024 article about how to prevent rhabdomyolysis in student athletes, the National Federation of State High School Associations called push-ups the “No 1 cause” of rhabdomyolysis. In April, Texas families filed a lawsuit against a charter school after 20 children were hospitalized after hundreds of pushups.

Walrod said collegiate sports professionals became more vigilant about prevention after University of Iowa football players were hospitalized with exertional rhabdomyolysis in 2011. “That case spurred better control of workouts, better monitoring, and better input from the trainers and strength coaches.”

“Where we see most of the cases is that athletes are being pushed or threatened or punished [contrary to industry standards],” said Dr Rebecca Stearns, COO at the Korey Stringer Institute for preventing sudden death in sports. Coaches are not exercise physiologists, and even when well-intentioned may not have adequate training to prevent overexertion, said Boden.

Similarly, there’s no guarantee fitness instructors understand the risk. “People may be going in unconditioned and doing too much too soon,” said Walrod of these classes. CrossFit incorporated prevention into its trainer curriculum after reports of severe cases among participants, but in general, class participants should self-monitor.

How do you identify overexertion?

I was discharged from the hospital with a firm instruction: no exercise except walking for a month. I had to learn what an appropriate challenge felt like – how to self-monitor, discern between safe discomfort and overexertion, and advocate for myself. But when is hard too hard?

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Unfortunately, sensing that something is wrong is a subjective measure; there is no universal metric.

“I never have a very satisfying answer to that, but I do think it’s a line we need to be vigilant about always, and it changes from day to day,” said Dr Natalia Petrzela, author of Fit Nation: The Gains and Pains of America’s Exercise Obsession, longtime fitness instructor, and professor of history at The New School.

“You know your body the best, and if you feel like something isn’t right, it’s time to speak up,” said Walrod. Sports medicine physicians advise people to stop exercise immediately if unusual pain occurs; in the event that there is excessive muscle breakdown, it’s critical to stop the movement right away.

Speaking up in a class setting can be difficult. Many feel self-conscious about pausing or modifying activity, especially if an instructor is singling them out. Petrzela said that she motivates participants in her class but also expresses a key caveat: “Only you know what you can do today.” She said this language “helps [them] find that very important and difficult-to-discern line”, adding that this nuance might get lost in classes with less experienced instructors who give inflexible instructions.

During that fateful class, I ignored the alarm bells. Maybe I was desperately chasing endorphins or wanted to prove to myself that I wasn’t weak. Ironically, my arms atrophied to below baseline as a result.

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Over a year later, I’m still building my strength back – but not at bootcamp. I opt for low-impact methods such as barre and pilates where I can modify if needed, and there is no need to keep pace with others.

Sometimes I tell instructors about my medical history, so they understand what’s happening if I pause. Verbalizing it also reminds me to be careful. Finally, I avoid anything new or especially difficult when I’m having a hard day.

Fitness culture taught me that pain is gain – but now I know that’s not always true.

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