I Lost 100+ Pounds on GLP-1s, So Why Does My Back Hurt?
- Jennifer Hardy
- Sep 24
- 5 min read
Of all the things I expected when I went through a quick period of weight loss with Zepbound, having MORE back pain wasn't one of them. I did reap the rewards of less pressure on certain joints, like arthritic knees, but the back pain was impossible to ignore.
If you’ve dropped weight on GLP-1s and find yourself clutching your spine when you sit or stand, you’re not alone. Here we’ll break down why it happens, what you can do about it, and how to keep your body from fighting against your progress.
How Weight Loss Causes Back Pain
While sometimes our back hurts during weight loss due to a new exercise regimen, there are several other factors to consider.
Muscle Imbalances Start Showing
Rapid weight loss can reveal weak spots in your core and back. Extra weight may have acted like a brace, and once it’s gone, strength issues become obvious. Without targeted training, those imbalances can trigger pain.
Your Center of Gravity Shifts
Dropping pounds changes how your body distributes weight. Even small shifts alter how the spine carries load, which can leave muscles straining to keep you upright until your posture readjusts.
Loss of Muscle Mass
Not all weight lost is fat. If muscle mass goes with it, you’re left with less support around the spine. That lack of structural stability often translates into lingering aches. If you're not following a healthy GLP-1 nutrition lifestyle, you risk losing weight that comes from muscles, not just fat.
Dehydration Hits the Joints
Water keeps discs, joints, and muscles functioning smoothly. Weight loss, especially if it’s paired with appetite changes from GLP-1s, can mean you’re drinking less. Without enough fluids and electrolytes, tissues stiffen, muscles cramp, and your back ends up taking the hit.
Gaps in Nutrition
Cutting calories can also cut key nutrients. Calcium, vitamin D, magnesium, and protein are all crucial for bone density and muscle strength. Without enough of them, your spine and surrounding muscles are more vulnerable to strain.
How Perimenopause Can Exacerbate Back Pain
Perimenopause throws a hormonal curveball that can make back pain feel worse. Estrogen helps protect bone density and keep connective tissues flexible. As levels dip, bones may weaken and joints stiffen, putting extra stress on the spine.
Hormonal shifts also affect muscle recovery, so aches linger longer than they used to. Add in sleep disruptions from hot flashes or night sweats, and your body has even less chance to repair itself.
The result? Back pain that feels amplified, right when you’re already trying to manage the changes from weight loss.
5 Ways to Minimize Back Pain During Extreme Weight Loss
Most of the ways you can reduce back back during extreme weight loss go hand in hand with best practices for a GLP-1 diet.
1. Build Strength
Walking and cardio help with weight loss, but your back needs strength. Add in planks, bridges, or light weights a few times a week to keep your core and spine supported. Focus on identifying the muscles that, if stronger, would support your sore spots.
Pain in the lower back often signals weak core or glute muscles.
Pain between the shoulder blades may point to weak upper-back or postural muscles.
General stiffness can be linked to tight hamstrings or hip flexors pulling on the spine.
I make a point to do 10-20 minutes of stretching each morning and before bed, and do a light at-home workout with core strengthening at least three times a week. My weights and stretching gear are all on a designated shelf in my bedroom, so no excuses.
2. Rethink How You Sit
Slumping on the couch or hunching at your desk makes pain worse. Be mindful of how you sit—feet flat, shoulders back, hips supported. Even swapping to a chair with good lumbar support can make a difference.
I became so much more aware of how bad my posture was as I was dropping pounds. A few products were game changers for me.
Everlasting Comfort Adjustable Cloud Foot Rest: I didn't realize how my odd foot positioning sitting at my desk was impacting my posture. I'm very tall, so my legs never quite seem to fit well under a desk. This keeps my hips and spine aligned better while allowing me to correct posture errors without discomfort.
Ergonomic Chair for Big & Tall: I splurged to get a chair that matched my frame and helped support my weight while still allowing me to comfortably sit for hours.
Posture Corrector for Women: This handy little strap device pulled my shoulders back and helped minimize the neck hump and keep the right muscles engaged while giving relief to all the overworked ones from bad posture.
Multifunctional Memory Foam Pillow: Works as a cervical support pillow or as a prop to keep you from constantly looking down while scrolling or reading, easing neck and back strain.
3. Drink More Than Water
Crash dieting often eats away at muscle. Prioritize protein and include resistance training so you’re not left with a weaker frame holding up a lighter body. We've talked about the importance of protein on a GLP-1 diet, and it's one of many reasons you can't skimp on food to achieve a goal weight.
Hydration isn’t just about H2O. Make sure you’re getting electrolytes—think bananas, leafy greens, or low-sugar electrolyte drinks—so your muscles and joints don’t seize up.
4. Supplement Properly
I’ll be real: I’m a picky eater, and there are vitamins and minerals I know I’ll never get enough of from food alone. GLP-1s can make this trickier since smaller portions and appetite changes mean fewer nutrients overall.
Supplements like calcium, vitamin D, magnesium, and B12 are worth asking your doctor about. They’re especially important for bone health, muscle function, and energy when your diet is limited.
5. Stretch It Out
I learned from a medical massage therapist that some of my back pain was coming from muscles that are tough to reach with massage alone. When your body changes quickly, those hidden muscles—like the psoas, hip flexors, and deep shoulder stabilizers—don’t always keep up. They tug on the spine and create pain you can’t easily rub out.
MEDICAL MASSAGE VS. TRADITIONAL MASSAGE: What's the difference for those with back pain from extreme weight loss?
Stretching becomes essential here. It restores balance, improves circulation, and helps your body adjust to its new alignment. Adding tools like cupping or gua sha scraping can dig deeper, loosening tight fascia and boosting blood flow.
One of my favorite tools is the Psoas Muscle Release, which is easy to adjust as you lose weight. I also use it for those stubborn knots between my shoulders and habitually tight calf muscles.
Together, these practices make recovery smoother and keep soreness from becoming chronic.
Keep Moving on GLP-1s, Even When Your Back Hurts
When your back aches, it’s tempting to park yourself on the couch and stay there. But too much rest only makes sore muscles tighter and stiff joints stiffer. Gentle movement, such as walking, stretching, and even light strength work, helps your body learn its new baseline after weight loss.
I realized a big part of my soreness came from being dormant for too long. My body needed to understand that movement is the new standard, not the exception. I also treat any ongoing pain with Epsom salt baths and a CryoDerm hot and cold combo pack.
Of course, your doctor should guide your plan, but staying active keeps circulation flowing, muscles engaged, and pain from becoming your new normal.
