Dropping Weight Without Losing Strength

A Fire Fighter’s Guide to GLP-1s

Seattle fire fighter Scott Dau lost nearly 50 pounds with the help of a GLP-1, and he kept his strength along the way. Here’s what he and Dr. Marcie Hamrick want you to know about these increasingly popular medications.

When Scott Dau suits up now, turnout gear and SCBA included, he weighs about what he used to weigh before he put on his gear. “I lost the equivalent, almost, of all my gear,” he says.

Over roughly a year on a GLP-1 medication, Scott dropped 45 to 50 pounds, about 23% of his body weight. A colleague who ran into him off shift didn’t recognize him and asked whether he had a brother in the department. “Dude, it’s me,” Scott told him. He shared his experience on a recent episode of Listen Up L27 with Dr. Marcie Hamrick, Medical Director at the Station 2 Clinic.

It’s not really about the weight

“Weight isn’t really the issue that ultimately we’re trying to treat,” Dr. Hamrick says. “It’s what comes along with excess weight.” She often sees those conditions in fire fighters: high blood pressure, sleep apnea, high cholesterol, prediabetes, joint problems, and early cardiovascular disease. They matter more in a job that takes you from the station recliner to climbing stairs in full gear with no warning.

That’s why GLP-1s aren’t meant for someone who just wants to drop a few pounds. Dr. Hamrick says they’re worth considering for people with obesity or for those who are overweight and have a weight-related condition.

“I should be able to do this myself”

Fire fighters take pride in their self-reliance, and Dr. Hamrick often hears some version of I don’t want to depend on medication. She also hears fair questions about long-term effects, muscle loss, and nausea. Her answer is to weigh the pros and cons for each person.

Scott had spent years beating himself up about self-discipline. Diets, fasting, and supplements didn’t budge his weight or his creeping lab numbers. “I always thought it was me,” he says. What pushed him to try a GLP-1 was something a longtime colleague, Tim O’Mahoney, used to say: the best retirement healthcare is not needing it.

Quieting the food noise

GLP-1 medications don’t work by making you feel sick, Dr. Hamrick explains. They mimic a natural hormone that acts on both the gut and the brain. They slow digestion, help you feel full sooner, and reduce the urge to eat. Many people also notice that “food noise” quiets down.

That matters in a firehouse. “People are good cooks,” Scott says. “You’re like, man, that’s good. I’m just gonna have one more portion.” After a month or two on the medication, that urge faded. Scott still loves to eat. He just doesn’t feel the need for thirds anymore.

Losing fat, not muscle

For fire fighters, the primary concern with significant weight loss is strength. In studies of GLP-1 medications, roughly three-quarters of the weight lost is fat, and the remaining quarter is lean mass, including muscle. That’s why Dr. Hamrick emphasizes adequate protein and consistent functional strength training.

Scott did both and checked. Once a month, he stepped on the InBody scale at the clinic and sent the results to his doctor. His measurements suggested that his skeletal muscle mass increased as his weight dropped, and his estimated visceral fat fell from 11 millimeters to just 4.

What it means on the fireground

The most common side effects are nausea, diarrhea, constipation, and acid reflux, especially when starting or increasing the dose. Scott says he had none, but he quickly adds that others might. “I don’t want to be the guy whose coworker tries it and misses two weeks of work,” he says. Less common but potentially serious complications are another reason to review your medical history with a clinician before starting.

Reduced food and fluid intake also increases dehydration risk, which can cause lightheadedness or dizziness. Now add turnout gear, heat, and an all-out fire response. “I just worry about people getting lightheaded or dizzy during a fire,” Dr. Hamrick says. Hydration and fueling aren’t optional, even when you don’t feel thirsty or hungry.

The hard part is eating enough. In his first weeks, Scott sometimes reached dinnertime and realized he hadn’t eaten all day. He learned to eat on purpose and make it count: protein, vegetables, fruit, whole grains, and fiber. Protein targets on these medications are often 100 to 150 grams a day, and your provider or a nutritionist can set a goal that works for you.

Play the long game

More isn’t always better. Dr. Hamrick starts with a low dose and increases it only if needed. She tracks side effects, food intake, health markers, and how the person feels—not just the scale. Plateaus are normal, so a stall isn’t automatically a reason to go up.

Scott’s goal was 170 to 175 pounds, which he once thought was out of reach. He’s now about 168 and stable on the same dose, and he’s discussing what maintenance might look like. That matters: people who stop GLP-1s often regain much of the weight they lost, though many maintain their weight on a lower or less frequent dose. Dr. Hamrick emphasizes that those decisions should be individualized.

A tool in the toolbox

GLP-1 medications aren’t right for everyone, and side effects and results vary. But for fire fighters struggling with excess weight and related health risks, they offer another option. They work best alongside good nutrition, hydration, strength training, and medical guidance. They’re also easier to access now. Scott paid out of pocket when he started, but the HealthCare Trust now covers GLP-1s. The Trust reasoned that covering the drug would cost less than treating the high blood pressure, diabetes, and heart disease caused by excess weight.

Dr. Hamrick calls them “a tool in the toolbox.” For her, it comes down to one question: “Would meaningful weight loss improve a person’s quality of life, function, and long-term risk? If the answer is yes, I think they should consider this tool to help them get there.”

Want to learn more?

Seattle fire fighters can talk with Station 2 Clinic about whether GLP-1 treatment makes sense for them. For more from Scott and Dr. Hamrick, listen to the full Listen Up L27 episode, Beyond the Scale: GLP-1s, Weight Loss and the Fire Fighter.