Something happened at a leadership program with a major Australian bank a couple of months ago that surprised me.
Dr Tom Buckley, a physician with more than 30 years of clinical and hospital experience, said something unremarkable. He said: “you need to become the CEO of your body and brain”.
The room stopped. Pens came out. Serious executives who run billion-dollar balance sheets wrote it down like it was news.
It probably was.
I’ve been sitting with why that landed so hard. These were intelligent leaders. They understood governance, risk, resource allocation. They were sophisticated thinkers in every domain they operated in, except the one they actually lived in.
That conversation happened in the context of something you can no longer avoid: GLP-1 receptor agonists. Ozempic. Wegovy. Mounjaro. Drugs that suppress appetite, regulate blood sugar, and are producing significant results in reducing cardiovascular risk and inflammation. Drugs your doctor may already be mentioning.
Dr Tom and I recorded a full conversation on the science. I’m not going to summarise it here. What I want to do is name the thing that isn’t getting enough air time.
The Mechanism Is Real
GLP-1 drugs work because they mimic something the body already does naturally. After eating, glucagon-like peptide-1 signals satiety, slows gastric emptying, and helps regulate blood sugar. In most people, that signal is short-lived. These drugs extend it. You stay fuller for longer. Blood sugar stabilises. The craving cycle quiets down.
The evidence is significant. Seventy-six randomised controlled trials. Nearly 40,000 patients. Average reductions in blood sugar markers that are clinically meaningful. Approximately a 20 per cent reduction in major cardiovascular events, based on the SELECT trial — the largest dedicated cardiovascular outcomes study of a GLP-1 drug to date. These are not marginal effects.
The science says: this works.
That is not the problem.
What the Drug Doesn’t Do
Here’s what the research also shows. Within one year of stopping these drugs, approximately two-thirds of people who’ve lost weight regain it. Some regain less. Some regain more than they started with, because they’ve lost muscle mass, their metabolism has slowed, and they’ve come off the drug without changing a single underlying behaviour.
Dr Tom was precise about the physiology. You don’t lose fat cells on these drugs. You shrink them. The architecture is still there. And the psychological and emotional relationship with food — the patterns, the comfort eating, the habits built across decades — none of that is touched by the medication.
The drug suppresses the signal. It doesn’t resolve what’s driving it.
I’ve seen this in leadership contexts for years, with different content. A leader enters a coaching program. They get structured, they perform, they make progress during the engagement. The program ends and within six months, the old patterns return. Not because they didn’t try. Because the underlying cognition, the deep-seated beliefs about capacity, about permission, about what kind of leader they are, was never addressed.
This isn’t a GLP-1 problem. It’s the oldest trap in performance: treating the symptom and calling it a strategy.
The Part That’s Actually Dangerous
Dr Tom made a point I want to underline, because it’s being almost entirely ignored in the popular press.
If you go on a GLP-1 drug and you’re not actively working to preserve muscle mass, you’re not just shrinking fat cells. You’re losing muscle. And you may be losing bone density. These are the structural materials of a long, functional life.
Muscle is not vanity. Skeletal muscle is the physical infrastructure of longevity, cognitive function, and sustained energy. Grip strength predicts lifespan. The muscle you carry in your 50s and 60s is one of the strongest predictors of whether a fall in your 80s becomes a rapid decline. Dr Tom was unambiguous: if you’re on these drugs and not doing resistance work, you are running a real risk.
Which brings me back to the CEO framing. A chief executive who reduced the company’s overhead by cutting the R&D budget and the maintenance team wouldn’t call that a strategy. They’d call it an asset strip. Using these drugs without protecting muscle mass is the same move.
What to Do About It
If you’re on GLP-1 drugs, considering them, or advising someone who is, here’s what the evidence and our clinical experience says matters alongside the prescription:
Protect muscle actively. You’ll lose some muscle on these drugs regardless. Counter it with strength and resistance training at least twice a week. Not for how you look, because skeletal muscle powers everything else.
Maintain nutrition quality. The drug suppresses hunger. It doesn’t tell you what to eat. On lower overall calories, quality matters more. Adequate protein, fibre, healthy fats. If you’re eating less, what you eat needs to carry more weight.
Get the why right before you start. Not the surface reason. Drill down. Why do you want to change your weight? Why does that matter? Keep going until you reach something that actually holds. Unless you understand what’s driving the behaviour, you’ll return to it when the drug is no longer suppressing it.
Use the window to build the habit. The period on the drug is an opportunity. The hunger is quieter. Use that space to establish the routines and food relationships you want to sustain. The drug gives you a window. What you build in that window is what you keep.
Know your set weight. Know the range where you feel functional, strong, and like yourself before you start. Otherwise you’re chasing a number that may not be physiologically or psychologically sustainable.
The Question Worth Sitting With
The executives at that bank program weren’t writing down something new. They were writing down something they already knew was true and had been quietly deferring.
GLP-1 drugs, used carefully and under proper medical guidance, are legitimate and powerful tools. In five years they’ll likely be among the most commonly prescribed medications in Australia. But a tool is not a strategy. And suppressing a signal is not the same as building the system that makes it unnecessary.
The question every leader using these drugs should sit with isn’t whether the drug works.
It does.
The question is: what are you actually trying to fix?
If that question is landing, particularly if you lead a team or an organisation where this gap between performance and sustainability is visible, Performance Intelligence works with senior executives and leadership teams to build the operating systems, habits, and mental skills that make high performance sustainable.
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About the Author
Andrew May is a mental skills coach, leadership advisor, keynote speaker, and author. As founder and CEO of Performance Intelligence, he works with senior executives and high-performing teams across Australian business, elite sport, and the Australian Defence Force to build the systems, culture, and mindset that make high performance sustainable. He holds a Bachelor of Applied Science in Exercise Physiology and a Master’s in Coaching Psychology, and has served as mental skills coach to the Wallabies, NSW Waratahs, Manly Warringah Sea Eagles, and World Champion boxer Tim Tszyu. He is the author of MatchFit and The Ripple Effect, and host of the Performance Intelligence Podcast.
REFERENCES
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2. Wilding JPH et al., Diabetes, Obesity and Metabolism, 2022; DOI: 10.1111/dom.14725.
3. Leong DP et al., The Lancet, 2015;386(9990):266–273.
