We’re used to seeing Serena Williams on our TVs, muscles flexing, smashing a tennis ball past her opponent. But in a recent 30-second commercial, Williams traded the racket for a GLP-1 drug injector pen.

Williams, whose most recent child was born in 2023, has become a spokeswoman in her post-retirement days for Ro, one of the many boutique health care firms to get in on the GLP-1 craze. “They say GLP-1s for weight loss is a shortcut — it’s not. It’s science,” she says during the spot. “After kids, it’s the medicine my body needed.”

Key takeaways

• Patients should be eating a protein-rich, balanced diet and doing some kind of strength training when on an GLP-1 medication.

• Some patients taking GLP-1 drugs have experienced significant muscle loss and weakness.

• Experts worry that too many patients may be trying to use GLP-1 drugs as a shortcut instead of improving their diet and exercise to lose weight.

Here is one of the world’s greatest athletes, giving voice — in commercials running during primetime TV, on the Today show, and on social media — to a frustration that many people have felt. She gained weight after she had kids. And even though, in her words, she was “doing everything right” after the pregnancy, she couldn’t cut as much weight as she liked. That’s where the GLP-1 drug came in and delivered results: Williams lost 31 pounds.

But there’s just one problem with the pitch: GLP-1 drugs like Ozempic and Wegovy are, in some ways, a shortcut.

“Americans always want the fucking pill,” Dr. Robert Lustig, a metabolic scientist at the University of California-San Francisco, told me. “I view GLP-1s like a Band-Aid. … There’s nothing wrong with a Band-Aid. But what if you didn’t clean your wound and you just put the Band-Aid on? The Band-Aid is necessary, but it’s not sufficient.”

The consequences of patients slapping on the Band-Aid — taking a GLP-1 — without treating the underlying issue with the kind of healthy eating and exercise that are still necessary even with these drugs is becoming clear. Scientists have found that some GLP-1 patients can lose significant muscle mass, as well as a loss of functional strength, due to a lack of energy. Rather than feel fitter and ready to go out in the world or onto the tennis court, these are patients who find walking up the stairs to be almost debilitating.

For this story, I sought to understand how this is playing out in American culture. In searching Reddit communities dedicated to GLP-1 drugs, I found lots of normal people whose experience backed up that research: They had long tried to lose weight but could never quite meet their goals — until they went on a GLP-1 drug.

But even as they lost weight, they didn’t feel better. Some of them felt worse, weaker. There are dozens of posts of GLP-1 patients coming to their peers, asking for advice about workouts they could do to stem the muscle loss. A few hope to find the right diet that will allow them to feel energetic and avoid muscle loss while losing the weight — but without having to commit to strength training that needs to go along with it.

While the term “strength training” may conjure images of ripped bodybuilders, doctors increasingly emphasize the importance of muscle training for all of their patients, from the 30-year-old marathon runner to the 65-year-old retiree. That’s because research has shown that more lean muscle helps you age better and protects against hazards, such as falls, that pose a greater and greater threat as you get older.

These drugs are already wildly popular, and their use is likely to keep growing. In November, the Trump administration struck deals with Lilly and Novo Nordisk to lower the cash price of their drugs in........

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