GLP-1 Active

When your sessions fall

The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.

Week by week

1. Before you begin
   Before you begin

   Your pathway starts with a 45-minute visit with Cindy Cathcart, your Whole Health Coach. Before it, read week 0 and complete your baseline questionnaires: the mood screens, a three-day record of what you ate, and the three function measures we will repeat at weeks 4 and 8. Week 0 also says plainly what this pathway promises and what it does not, and it does not promise a weight. Nothing here is a test and nothing is graded.

2. Week 1
   Starting well: the titration window

   Why the stomach and bowel side effects track your dose rather than arriving at random, and why the week after a dose goes up is the worst week to judge the whole treatment. What the trials actually reported, including the inconvenient numbers. Which of the standard nausea advice is evidence-backed and which is expert opinion: we tell you which is which rather than letting you find out later. The gallbladder, and why upper right abdominal pain is on the same-day list. And why your Whole Health Coach will decline a dose question every time, and what she will do instead.

3. Week 2
   Eating when you are not hungry

   The problem underneath the side effects: you are eating about a third less, and your requirements did not fall with your appetite. That flips the question from what to leave out to what to put in first, because you will run out of appetite before you run out of plate. The protein number, where it comes from, and what it rests on, which is research in people losing weight without these medications. What 25 to 35 g looks like in real food. Who the target does not apply to. And why fiber supplements are out here, even though the evidence for them in ordinary constipation is real.

4. Week 3
   Starting to train

   The resistance prescription, and the floor underneath it: one set per movement pattern, twice a week, about ten minutes, which is a real session and not a failed one. Why resistance work rather than walking alone, from a trial where every group lost the same weight and only the lifting groups kept the muscle and the bone. Joint-friendly substitutions offered by default, and the four things that stop a session. Two rules specific to your medication that are ours, not the literature's. And what you are actually training for right now, which is protecting rather than building.

5. Week 4
   Holding the line

   Module 1 closes with the thing most likely to end your treatment, which is not a side effect. It is cost, coverage or supply, and it arrives without warning. What the persistence studies actually show, including that they disagree with each other. The first 72 hours if your access changes, which is our clinical guidance and carries no citation because no research exists on it. And choosing your action number now, while it is still abstract, so a rise later prompts a conversation rather than a disappearance.

6. Week 5
   What you are actually losing

   Module 2 is called Protein and muscle, and it opens with the finding that explains why weeks 2 and 3 asked what they asked. About a quarter of what comes off is lean tissue, and the same is true of people losing weight on no medication at all: the split is what happens to a body losing weight rather than something the drug is doing to you. What changes is the absolute amount, because the total is roughly four times larger. Whether that loss is actually harmful is genuinely unsettled, and both sides of the argument are published, so you will not be handed a settled answer here. And why this pathway measures what your muscle does rather than estimating how much of it there is, which is the order the diagnostic frameworks themselves put things in.

7. Week 6
   The protein number, and where it comes from

   Week 2 gave you a number to hit. This week is where it came from, what it will and will not do, and why we ask for it three times a day rather than once a day. Why a per-meal target rather than a daily total, and the published figures the lower end of ours sits on. The ceiling, which is lower than the supplement aisle suggests. What protein does for fullness and what it does not do, which is change how much you eat at the next meal: we are not asking for it as an appetite tool, because the medication has already done that. The denominator problem, where none of the source papers says which body weight they mean and our answer is clinical judgment rather than a research finding. And the practical difficulty underneath all of it, which is volume rather than motivation.

8. Week 7
   Training to hold, not to build

   Week 3 gave you a training prescription. This week is what that training can and cannot achieve while you are on this medication, because the difference decides whether you read your own progress correctly. Strength goes up and muscle does not, and both of those come out of the same analysis: the energy deficit you are in prevents lean mass gains outright, and that is arithmetic about energy availability rather than anything about you. What to watch instead of the scale when your weight slows while your clothes keep changing. The progression order, repetitions before load and load before sets, which is ours rather than the literature's. The rules that end a session. And the honest gap: no trial has tested any of this in people taking these medications, so the best available answer is not a validated one.

9. Week 8
   Measuring what matters

   Week 8 closes Protein and muscle. It is a measurement week: nothing here is a test, nothing decides whether you continue, and none of it needs anything you do not already own. The four measures, and how to do them the same way you did them in week 0, which matters more than doing them precisely. Why function rather than a scan or a body-composition scale, and what we will not conclude from your numbers. What would count as a signal this early, and why everything unchanged is a good outcome at eight weeks rather than a null one. And why the questionnaires repeating at this boundary is the point rather than the paperwork.