Wegovy exercise plan: Managing nausea, heart rate changes, and energy

Jump to: Why exercise feels different | Managing exercise nausea | Heart rate concerns | Starting when energy is low | Your Wegovy exercise plan | Preventing muscle loss | Building exercise tolerance | Take home message

Exercise on Wegovy can feel much more challenging than what you’re used to.

Up to 10% of people taking semaglutide report fatigue¹, but in reality, many more notice their workouts feel harder, their heart rate rises more quickly, and they become breathless during activities that used to feel easy.

Still, the feeling of fatigue and tiredness on Wegovy typically eases as your body adjusts to the medication.

Recent research from Second Nature found that 44% of people reported feeling more tired than usual after 4 weeks on Wegovy, with this percentage dropping to 22% by week 8.

If you’re experiencing these changes, you’re not alone. This guide will help you to exercise safely while your body adjusts, with a practical week-by-week plan that works when you’re dealing with side effects.

Why exercise feels different on Wegovy

When you start Wegovy, you’re likely eating around 25% less than before².

Your brain notices this and puts your body into energy-saving mode – making exercise feel much harder than it should.

It’s a bit like when your phone battery gets low and it goes on ‘low power mode’. Your body’s doing the same thing, trying to preserve energy by making you feel more tired during workouts.

On top of this, many people notice their heart beats faster during exercise than it used to. You might find:

• Your heart rate is 10-20 beats higher while doing the same workout
• You’re breathless walking up stairs that never bothered you before
• You feel dizzy or lightheaded during exercise
• It takes ages to feel normal again after working out

These effects tend to be worse in the day or two after your weekly injection, but they do get better as your body gets used to the medication.

Managing exercise nausea

Nausea affects nearly half of people taking Wegovy¹, and exercise could make it worse. Here’s what helps:

Getting the timing right: Wait at least 2-3 hours after eating before you exercise. Many people find morning workouts work best, before the day’s nausea kicks in. If you’ve taken your injection the day before, opt for something easy like a walk in the park, stretching, or take a day off.

What to eat (or not eat) before exercise: If you need something before working out, keep it simple; maybe half a banana or an apple. Stay hydrated during your workout by sipping throughout.

Knowing when to stop: If you feel nauseous or other side effects are getting too uncomfortable, there’s no shame in stopping. There’s always the next day.

If exercise keeps making you feel sick, try swimming or gentle yoga instead – many people find these easier on the stomach.

Heart rate concerns: what’s normal, what’s not

Your heart rate will probably be higher during exercise on Wegovy – that’s normal. But it’s good to know what’s okay and what needs attention.

What to expect:

• Heart rate 10-20 beats higher than you’re used to
• Feeling more out of breath at your usual pace
• Needing longer rest breaks between exercises

When to seek support:

• Heart rate going above 85% of your maximum (that’s 220 minus your age)
• Any chest pain, severe breathlessness, or feeling faint
• Heart pounding that continues after you stop exercising

If you’ve got a fitness watch, you can use this to keep an eye on your pulse. If not, just check your pulse manually.

Start your workouts at about half your usual intensity and build up slowly over 4-6 weeks. If these symptoms don’t improve or get worse, check with your GP.

Just remember: feeling different during exercise is expected, but chest pain or severe symptoms always need immediate medical attention.

Starting when energy is low: the if/then approach

Most people feel some level of fatigue on Wegovy, especially when the dose goes up.

Having a backup plan means you can keep moving even on days you’re feeling side effects more than usual:

• If I’m too tired for the gym, then I’ll do 10 minutes of gentle stretching at home
• If I feel dizzy during exercise, then I’ll stop and do seated exercises instead
• If my usual run feels impossible, then I’ll walk the route instead
• If nausea strikes mid-workout, then I’ll switch to gentle walking
• If I can’t face any exercise, then I’ll do housework that involves movement

Having these plans ready means you don’t have to make a decision; you just do it. And remember – something is always better than nothing when it comes to keeping the habit going.

Your Wegovy exercise plan

Here’s a realistic plan that builds your fitness safely while dealing with side effects:

Important points:

• Don’t make things longer and harder in the same week; it’s recommended to increase either the intensity or duration of exercise, but typically not both
• If side effects get worse when your dose increases, ease back on your intensity for a few days until you feel better
• It’s better to choose exercise and movement you enjoy as you’re more likely to maintain the habit

Preventing muscle loss

When you lose weight quickly, you’re more likely to lose some muscle and bone mass along with fat³.

On Wegovy, it’s essential to lose weight slowly and sustainably to maintain muscle and bone mass to avoid other health complications over time.

Tips to avoid muscle loss on Wegovy:

• Ensure 25-30g of protein at every meal (that’s about a palm-sized portion)
• Do some strength exercises over the week
• Even 15 minutes makes a difference; you can break this up by ‘snacking on exercise’ over the week

Here’s a simple routine you can do at home:

1. Push-ups against the wall: 10-15 times
2. Standing up and sitting down from a chair: 10-15 times
3. Squats in the kitchen: 10-15 times
4. Resistance band pulls: 10-15 times
5. Plank on your knees: hold for 15-30 seconds

If you’re just starting to introduce exercise to your routine, set a minimum goal of doing 1 push-up, or 1 squat and then progress from there. At the start, it’s more important to build the habit.

Building exercise tolerance

The fatigue experienced on Wegovy can make us feel like our exercise tolerance has decreased.

As we adapt to the medication, it’s important to adjust our exercise to allow our body the time it needs to adapt.

Week 1-2: Start slowly. Enjoy casual walks, light exercise, and rest when you need to.

Week 3-4: Build gradually. Add 2-3 minutes to whatever feels comfortable. Keep it easy enough that you could chat while doing it. Focus on maintaining consistency rather than trying to work too hard.

Week 5-8: Finding your new normal. You may be able to push a bit harder now. Try different activities like swimming or cycling. Compare how you feel to a few weeks ago, not to before you started Wegovy.

After 2 months: Energy usually improves once you’re on a steady dose and your body has adapted to the medication. Still, exercise may feel harder compared to before you started the medication.

Your fitness might not be the same as before Wegovy, and that’s okay. It’s not about getting back to where you were – it’s about finding what works for you now.

Take home message

Exercise on Wegovy will likely feel harder at first, but it does get easier as your body adjusts and your fitness improves.

The side effects, like faster heart rate, nausea, and feeling more tired than usual, are perfectly normal and will naturally ease after a while.

Most people find their energy comes back, and exercise feels more normal after 8-12 weeks on a steady dose.

Until then, doing something regularly – even if it’s gentle – is better than pushing hard occasionally and feeling uncomfortable or unwell after.

The goal is finding exercise you can keep doing long-term, not trying to match your pre-Wegovy fitness.

References

1. Wilding, J. P., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.
2. Friedrichsen, M., et al. (2021). The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes, Obesity and Metabolism, 23(3), 754-762.
3. Neeland, I. J., et al. (2024). Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes, Obesity and Metabolism, 26 Suppl 4, 16-27.
4. National Institute for Health and Care Excellence. (2023). Semaglutide for managing overweight and obesity. Technology appraisal guidance [TA875].
5. Rubino, D. M., et al. (2022). Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes. JAMA, 327(2), 138-150.