More and more athletes are using GLP-1 receptor agonists—medications like semaglutide or tirzepatide—as part of their journey with weight loss, appetite control, or insulin resistance. These drugs can be powerful tools, but they change how the body responds to food, training, and recovery. For women layering in menopause or post-bariatric surgery, the picture gets even more complex.
This isn’t about judgment. It’s about education. If you understand what’s happening under the hood, you can adjust your approach and still train and perform in ways that feel good.
GLP-1s in the Athletic Body
On the surface, GLP-1s make eating feel simpler: you get fuller faster, your appetite quiets down, and blood sugar stays steadier.
But for an athlete, that “win” can come with hidden costs. Food and fluids move more slowly through your stomach, which means fueling for workouts can suddenly feel like trying to eat Thanksgiving dinner before heading out for intervals.
Nausea, early fullness, or even just the absence of hunger cues can leave you under-fueled without realizing it.
That’s not a small thing. Under-fueling shows up as fatigue, stalled progress, nagging injuries, or the feeling that your body is working harder than it should. Pair that with the fact that GLP-1s don’t just target fat loss but can also strip away lean mass, and the margin for error gets narrow. Without intentional strength work and enough protein, it’s easy to lose the very muscle that drives your performance.
When Bariatric Surgery Meets GLP-1s
For athletes who’ve had bariatric surgery, the challenge multiplies. Stomach capacity is already limited and nutrient absorption is altered. Add a GLP-1 on top, and fueling can feel like an uphill battle. Solid foods often backfire, leaving you bloated or nauseous, while liquids slip through more easily.
That means shakes, gels, and sports drinks aren’t just convenient—they may be the only way to get enough fuel in. Regular lab checks for micronutrients matter too, since deficiencies can creep in quietly and sabotage recovery.
Menopause and the Recovery Equation
Menopause changes the rules of the game. Estrogen supports muscle maintenance, bone health, glucose uptake, and tendon elasticity. Take it away, and suddenly bones are more fragile, muscle is harder to hang onto, and connective tissues don’t bounce back like they used to.
Hormone replacement therapy can help, but not everyone chooses it—or even accepts that they’re in menopause to begin with. If HRT isn’t on the table, strength training, smart nutrition, and consistent recovery habits become even more important. This isn’t about fragility; it’s about being proactive so your body has what it needs to keep up with your training goals.
Hypermobility and Connective Tissue
If you’re hypermobile, your joints and connective tissues are already less stable. Layer in estrogen loss and the appetite suppression of GLP-1s, and you’ve got a recipe for fragile tissues and slow healing. What protects you here is controlled, consistent strength work—slower lifts, isometrics, stability training. Pair that with steady protein intake, and you’re giving your collagen and connective tissue the raw material they need to hold up.
Rigidity in Mindset and Programming
Not everyone adapts easily when physiology shifts. For some athletes, especially those who are neurodivergent, routine is sacred. The problem is that GLP-1s and menopause don’t respect old routines.
Hunger signals aren’t reliable anymore, recovery changes, and “what used to work” suddenly doesn’t.
For athletes in this space, the solution isn’t flexibility—it’s structure. Predictable rules and systems take the place of “listening to your body.” Fueling agreements like “always have 30 grams of protein after a workout” or “take one gel every 30 minutes on long runs” work because they don’t require adaptation in the moment. They become the new routine, and that’s where performance is protected.
GLP-1s aren’t inherently good or bad for athletes. They’re tools. But like any tool, they come with trade-offs. If you’re on them, you have to recognize that satiety cues won’t tell you the truth about your fueling needs.
If you’re navigating menopause without HRT, muscle, bone, and tissue health demand more intention. If you’ve had bariatric surgery, fueling needs a liquid-first strategy. And if you thrive on rigid routines, you may need new rules that lock in the behaviors your physiology now requires.
The bottom line is this: you can thrive as an athlete in this landscape. It just takes awareness, intentional planning, and sometimes, re-writing the rules you thought were fixed.