“I was so relieved when the number on the scale finally went down. That hadn’t worked for years, no matter what I tried. What nobody told me: that at some point I’d be out of breath climbing the stairs in the morning, wondering where my strength had actually gone.”

Birgit is 54, an administrative clerk at a medium-sized company, in the same office for over twenty years. She knows her figures, she knows her routines, and for a long time she also knew her body. Then came the menopause, and something shifted. The weight did not rise dramatically, but steadily, year after year, a few kilos that never came off again. She has done enough diets. They held for a few weeks, sometimes a few months, then everything was back, often with interest.

What Birgit describes is familiar to many women her age. It is not the one big meal that causes the problem. It is the sum of a changed metabolism, less movement in office life and a body that handles energy differently after the menopause. She had almost come to terms with it.

“At some point I thought, well, this is just how it is now. Over fifty and in the menopause. You just somehow tell yourself it’s fine. In truth I was simply frustrated.”

When the doctor brought the injection into play

During a routine check-up, her GP raised the subject with her. They discussed the options openly, and in the end the doctor prescribed Birgit a weight-loss injection with the active ingredient semaglutide. Privately, on her own prescription, with regular follow-up appointments. Birgit was sceptical, but also somehow curious. She had heard about it in the news, though the coverage there was rather critical, and she did not really know what to make of it.

The first weeks were an adjustment. The appetite that had accompanied her for years was suddenly less present. She ate smaller portions, often without noticing, and was full sooner. The weight began to fall, slowly but steadily. After a few months a pair of trousers fitted her again that had been hanging in the wardrobe for years. She was relieved, almost euphoric.

It is still important to her to put this in context: the injection was a medical decision, not a self-experiment. She went to her follow-up appointments, talked about side effects, and the dose was increased slowly. For Birgit this was not a lifestyle product but a prescription-only medicine under medical supervision.

“The first months were a relief. After the many frustrating years, something was finally happening. I stepped on the scale in the morning and saw that it was slowly going down. I was proud of myself.”

Why the stairs suddenly got harder

After a few months, something crept in that Birgit could not place at first. The stairs to the second floor of the office, which she took every day, felt harder. She arrived at the top out of breath. Shopping bags became a burden. In the evenings she was more tired than before, and it was a different kind of tiredness, not the pleasant drained feeling after a full day, but a sort of lack of strength.

She had assumed that less weight automatically means more lightness. The opposite happened. She weighed less, but she felt weaker. That did not add up for her, and it quietly worried her.

“I thought, I’m getting lighter, so everything gets easier. But I had less strength than before. Stairs, shopping bags, the laundry basket up to the first floor. All little things I’d never noticed before.”

For a while she blamed it on her age, on the stress at the office, on poor sleep. Until, at a follow-up appointment, she brought up her observation and her doctor explained to her what might be behind the feeling.

The moment it clicked

Her doctor explained to her that when you lose weight you lose not only fat but also muscle mass, and that this can definitely play a role with the rapid weight loss under the injection. On top of that came a second point that made sense to Birgit: anyone who suddenly eats significantly less automatically takes in fewer nutrients too. Small portions mean small amounts of vitamins and minerals.

“When my doctor said that I’m losing not just fat but muscle too, it clicked for me. I had always only looked at the scale. The number going down doesn’t automatically mean I’m getting healthier.”

Fifty Five Insight: In registration trials (including STEP-1, SURMOUNT-1), summarised in a review (Neeland et al. 2024), roughly 25 to 40% of the weight lost under GLP-1 medicines comes from fat-free mass (including muscle). At the same time the risk of nutrient gaps rises, because the amount of food and the variety of meals decrease. The most commonly observed deficits include vitamin D, magnesium, vitamin B12 and thiamin. Strength training and an adequate protein intake are considered the central levers for preserving muscle in a deficit.

For Birgit, everything suddenly made sense. The heavy stairs, the tired arms, the feeling of having no strength. She had concentrated on the number on the scale and overlooked what this lost weight actually consisted of. Anyone who wants to go deeper into the muscle topic will find the background in our article on muscle loss on the weight-loss injection, and a full overview is provided by the complete guide to the weight-loss injection.

How Birgit restructured things

Birgit is not someone who does things by halves. She restructured her everyday life without turning it upside down. Twice a week she now goes to the gym, a simple full-body programme with machines that a trainer showed her. She consciously watches her protein, especially in the morning and at midday, because otherwise, with the small portions, too little adds up. And she wanted a reliable basic supply that she does not have to piece together anew every day. You can read more about the nutrient gaps that can arise under the injection in our article on nutrient deficiencies on the weight-loss injection.

For the basics she takes BASE by Fifty Five in the morning, our multivitamin and mineral complex. BASE provides, among other things, vitamin B12 and thiamin, which contribute to a normal energy-yielding metabolism. With the small portions, Birgit says, a reliable basic supply was important to her at exactly this point, on her doctor’s advice.

On top of that came RISE by Fifty Five for the supply of vitamin D, which contributes to the maintenance of normal muscle function. Precisely because the muscle topic was at the centre for her, this building block was important to her. And in the evening she takes CALM by Fifty Five, our magnesium complex. Magnesium likewise contributes to normal muscle function and to normal protein synthesis and plays an important role in the electrolyte balance. For Birgit this is the calm conclusion of the day.

“I didn’t want ten different jars standing in the cupboard and to puzzle it out every morning. BASE in the morning, the vitamin D with it, the magnesium in the evening. I can manage that, even on stressful days.”

Birgit’s conclusion: look less at the scale, more at strength

Birgit is not at her goal, and she does not pretend to be. There are weeks when the training gets skipped, and days when she eats too little because the appetite is simply not there. But the heavy feeling on the stairs has become rarer. She feels more agile again, not just lighter but stronger. For her that is the real difference.

What has changed above all is her view. The scale is no longer the only measure. Today she asks herself instead whether she can get the shopping bags up well and whether she still has strength in the evening. That, she says, is more honest than any number.

“I no longer look only at the number. I look at whether I feel strong. That’s a different goal, and honestly a better one.”

Disclaimer:

This article is for informational purposes only and does not replace medical advice, diagnosis, or treatment by a physician or pharmacist. The information provided here should not be used for self-diagnosis or self-treatment. Food supplements are no substitute for a balanced, varied diet and a healthy lifestyle. For any health questions or complaints, please always consult a doctor you trust. Fifty Five accepts no liability for any inconvenience or harm resulting from the use of the information presented here.