Maximizing the ROI of weight-loss programs: Why GLP-1 success starts with muscle retention

For health insurers and employers, GLP-1 medications like semaglutide have changed the game in obesity care. These treatments offer a way to reduce chronic disease risk, lower metabolic claims, and trigger weight loss.₁

GLP-1s are more commonly known under brand names like Ozempic, Wegovy, Saxenda, Mounjaro, and Rybelsus. These medications deliver striking short-term results, but without physical activity support, GLP-1 patients often revert back to old habits.₃ That can drive unintended clinical and financial consequences. From lean muscle loss and metabolic rebound to re-prescription cycles and downstream MSK claims, a pattern is emerging that undercuts long-term ROI.⁴

GLP-1 programs need to be supported with structured activity and nutrition guidance to protect sustainable outcomes.

The weight loss rebound problem: short-term wins, long-term costs

One of the biggest concerns with GLP-1 use is sustainability. Many patients rebound to old habits after stopping treatment.

The research is clear: weight loss achieved through GLP-1s often isn’t permanent. Studies show:

• Up to 70% of users discontinue GLP-1 medications within one year.₂
• Up to two-thirds of the weight lost is regained after stopping medication.₃

This rebound effect isn’t simply about willpower. It reflects a structural gap in how GLP-1 plans are designed.

The weight comes off fast. But without a supporting structured movement program to support the weight loss, physical activity habits don’t change. Lean muscle mass declines. Up to 39% of lean muscle mass is lost during GLP-1 usage, so weight loss is not just isolated to fat.₄

Lean muscle loss is a dangerous side effect of rapid weight loss without activity. It puts members at higher risk of falls, chronic MSK conditions, metabolic slowdown, and even costly surgeries.⁴

GLP-1s suppress appetite and slow digestion. These medications are not designed to stimulate muscle retention or build metabolic resilience. Without physical activity, lean mass deteriorates and long-term success is compromised.⁴

Muscle loss undermines GLP-1 ROI

During weight loss, it’s not just fat that’s lost. 

Clinical research shows that up to 39% of lean body mass is lost during GLP-1 usage₄

That’s not just a side effect. It’s a clinical liability.

Lean muscle plays a critical role in:

• Regulating resting metabolic rate (how many calories the body burns at rest)⁴
• Supporting mobility and reducing fall risk⁴
• Preventing chronic MSK pain⁴
• Enhancing insulin sensitivity and glucose control⁴

When muscle is lost during weight loss programs (especially if fat is regained after discontinuation) patients end up with worse body composition and higher health risk than where they started.⁴ Insurers are left to manage the risk of escalating costs that come with downstream healthcare issues.⁴

Weight loss re-treatment rates are rising

If weight returns after discontinuation, the most common next step is re-prescription. This pattern is becoming more frequent and more expensive.

Re-treatment is linked to:

• Increased pharmacy spend.₅
• Lower efficacy on repeat cycles.₆
• Greater MSK and disability risk tied to deconditioning.⁶
• Lower satisfaction and higher dropout rates.⁶

What earlier interventions can protect value and reduce re-treatment?

Structured movement programs.

Regular physical activity establishes healthy new habits, triggers positive behavior change, and critically prevents lean muscle loss. This builds the foundation needed for weight loss programs to succeed over the longer term.

Inactivity is the silent threat to GLP-1 ROI

Most GLP-1 users are not physically active when they begin treatment. Only 1 in 4 U.S. adults meet the CDC's physical activity guidelines.₇

That means many begin treatment from a place of:

• Sedentarism
• Metabolic risk
• Muscular deconditioning

These are individuals who often start from metabolic risk, physical deconditioning, and long-standing inactivity.

Which means when they lose weight through medication but don’t build strength, they lose more than fat. They lose muscle.⁴ And muscle loss rarely appears in claims data.₉ But the downstream impact is clear:

• Higher MSK claims¹⁰
• Increased chronic pain, falls, and disability¹¹
• Absenteeism and productivity loss¹²

These silent costs drive hidden ROI erosion for employers and health plans.

Movement is the multiplier

GLP-1s can initiate change, but it’s positive behavior that sustains long-term weight loss.⁸

Structured movement plans do two things to protect return on investment of weight loss programs:

1. Preserve lean muscle mass, which safeguards metabolism and physical function
2. Drive behavior change, helping patients establish new habits that persist after medication ends

Without these anchors, the outcomes of GLP-1 treatment and weight loss programs are fragile.⁸ 

The moment the prescription stops, progress often unravels. The real ROI in weight loss isn’t in pounds lost. It’s in fat lost for good, and healthy function retained.⁴

The business case for adding movement plans to weight loss programs

GLP-1s are expensive.

• Up to $10,000 per member per year⁵
• Projected to account for up to 9% of total medical spend in some plans⁵

Now layer in the silent costs:

• Sarcopenia (muscle loss) is linked to $900 in excess healthcare costs per employee annually¹³
• Physical inactivity contributes to 27% of total employee medical spend¹⁴

If members on GLP-1s are inactive and losing muscle, employers face the risk of absorbing hidden downstream MSK and chronic care costs across pain claims, productivity loss, re-treatment, and long-term disability.₁₀₋₁₂

Sword Move is the ideal movement plan to support weight loss programs

Weight loss plans and GLP-1 prescriptions should be accompanied by structured movement programs to help retain lean muscle and trigger positive behavior change.

Sword Move is built to close this clinical gap. 

What is Sword Move?

Move delivers whole-body, movement-first exercise programs to help members build sustainable activity habits, retain lean muscle, and reduce the risk of MSK conditions. Each Move member is assigned an expert movement specialist with a Doctor of Physical Therapy. The personalised care plan is adapted as the patient progresses, with ongoing expert support from their assigned PT.

How does Move work?

Move is designed to support scalable, sustainable behavior change and muscle retention by combining smart technology with expert clinical support. Here's how the platform delivers personalized care that fits into real lives:

• Wearable technology gives real-time tracking

Every Move member who needs one receives a complimentary wearable to track activity, heart rate, and step goals, with no setup required. Members can also connect their own Apple Watch, Fitbit, or Android device via Google’s Wear OS. All data is shared in real time with their Physical Health Specialist to personalize care and keep progress on track.

• Personalized support from clinical experts

Each member is paired with a Physical Health Specialist who provides weekly updates, tailoring the plan to match the member’s progress. Even better, the digital delivery model means members can complete their exercises at any time and place to suit their lifestyle. This accessibility leads to significant increases in engagement and adherence.

• Tailored movement plans that fit real life

Plans include targeted exercises and step goals customized to each member’s lifestyle, job, and progress. No travel is required, so members can perform their exercises at a time and place that suits their schedule. Quick check-ins ensure the plan evolves as they do, making habit-building and muscle retention easier.

What real-world movement outcomes look like

Here’s what structured, guided movement can do for the same population that GLP-1 programs serve.

Data from Sword Move shows:

• 69% of “inactive” or “insufficiently active” members reach “active or healthy active” levels within 10 weeks⁸
• Members average 4.5 movement sessions per week⁸
• Sedentary time reduced by 1 hour 22 minutes per day for previously “inactive” or “insufficiently active” members⁸
• 91% report feeling moderately or much better⁸

These improvements directly counteract the risks of GLP-1 rebound and muscle loss. Move’s proven results are significant and sustained. And they can be tracked, measured, and tied to outcomes-based pricing.

Maximize ROI with a new model for GLP-1 care

What does it take to maximize healthcare spend on weight loss treatment? GLP-1s are an effective weight loss intervention, but smarter implementation with supporting structured movement programs will significantly increase your return.

Here’s how leading employers and health insurers are getting ahead:

1. Audit your GLP-1 outcomes

• Track not just weight loss, but adherence, discontinuation, and re-prescription rates.
• Compare results with MSK claims, pain diagnoses, and productivity trends.

2. Add movement before, during, and after prescription

• Introduce structured activity during pre-authorization to assess readiness.
• Require movement alongside medication to retain lean mass.
• Support members post-discontinuation to prevent rebound and relapse.

3. Incentivize outcomes, not access

• Choose partners who offer outcomes-based pricing models.
• Only pay when members move, engage, and improve.

Don’t just offer weight loss treatment in isolation. Support GLP-1 prescriptions with structured movement plans to protect muscle, develop positive behavior change, and drive lasting successful outcomes.

FAQ: Protecting ROI in GLP-1 programs

Why does muscle loss matter in weight loss ROI? Muscle regulates metabolism. Losing it slows calorie burn, increases fall risk, and drives MSK costs — all of which hurt your long-term return.

Can movement really improve medication outcomes? Yes. Movement helps preserve lean mass, reinforces healthy behavior, and supports energy balance — reducing the chance of rebound weight gain.

Is it feasible to scale movement support? Yes. Virtual, clinically guided programs like Sword Move deliver personalized plans and tracking for members at any fitness level, with outcome-based accountability.

How should I start? Begin with an audit of current GLP-1 trends and MSK spend. Then explore pre-authorization or wraparound movement strategies with clinical partners who tie success to outcomes.