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Skinny Fat
The primary concern with using glucagon-like peptide-1 (GLP-1) agonist drugs for weight loss is the potential loss of muscle mass (lean body mass) along with fat mass. Clinical studies have indicated that a significant portion of the total weight loss achieved with GLP-1 agonists like semaglutide (Ozempic) and tirzepatide (Mounjaro) results from a reduction in lean body mass, which includes skeletal muscle.
In the STEP 1 and SUSTAIN 8 trials for semaglutide, about 39-40% of the total weight lost was due to a decrease in lean mass, primarily muscle. A 2021 meta-analysis of 18 randomized controlled trials also found significant reductions in fat-free mass (lean body mass) with the use of GLP-1 agonists.
The loss of muscle mass is concerning for several reasons:
1. **Metabolic Health**: Muscle is crucial for metabolism, insulin sensitivity, and glucose uptake. Significant muscle loss can negatively impact metabolic health and increase the risk of insulin resistance and type 2 diabetes.
2. **Physical Function**: Maintaining adequate muscle mass is essential for physical function, mobility, and independence, especially in older adults who are already at risk for age-related muscle loss (sarcopenia).
3. **Quality of Life**: Excessive muscle loss can lead to weakness, fatigue, and a decreased ability to perform daily activities, potentially impacting quality of life.
4. **Bone Health**: Muscle mass is closely linked to bone health and strength. Significant muscle loss can increase the risk of osteoporosis and fractures.
While some degree of lean mass loss is expected during weight loss, the extent of muscle loss observed with GLP-1 agonists is concerning, particularly for individuals with low muscle mass or those at risk for sarcopenia.
To address this issue, researchers and pharmaceutical companies are exploring strategies to preserve muscle mass while using GLP-1 agonists for weight loss, such as combining them with muscle-preserving agents or targeting specific pathways like myostatin inhibition. Additionally, incorporating resistance training and ensuring adequate protein intake are recommended to help mitigate muscle loss during GLP-1 agonist treatment.
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By Mitchel Schwindt, M.D. | author | online courses | coaching | consulting
5
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The primary concern with using glucagon-like peptide-1 (GLP-1) agonist drugs for weight loss is the potential loss of muscle mass (lean body mass) along with fat mass. Clinical studies have indicated that a significant portion of the total weight loss achieved with GLP-1 agonists like semaglutide (Ozempic) and tirzepatide (Mounjaro) results from a reduction in lean body mass, which includes skeletal muscle.
In the STEP 1 and SUSTAIN 8 trials for semaglutide, about 39-40% of the total weight lost was due to a decrease in lean mass, primarily muscle. A 2021 meta-analysis of 18 randomized controlled trials also found significant reductions in fat-free mass (lean body mass) with the use of GLP-1 agonists.
The loss of muscle mass is concerning for several reasons:
1. **Metabolic Health**: Muscle is crucial for metabolism, insulin sensitivity, and glucose uptake. Significant muscle loss can negatively impact metabolic health and increase the risk of insulin resistance and type 2 diabetes.
2. **Physical Function**: Maintaining adequate muscle mass is essential for physical function, mobility, and independence, especially in older adults who are already at risk for age-related muscle loss (sarcopenia).
3. **Quality of Life**: Excessive muscle loss can lead to weakness, fatigue, and a decreased ability to perform daily activities, potentially impacting quality of life.
4. **Bone Health**: Muscle mass is closely linked to bone health and strength. Significant muscle loss can increase the risk of osteoporosis and fractures.
While some degree of lean mass loss is expected during weight loss, the extent of muscle loss observed with GLP-1 agonists is concerning, particularly for individuals with low muscle mass or those at risk for sarcopenia.
To address this issue, researchers and pharmaceutical companies are exploring strategies to preserve muscle mass while using GLP-1 agonists for weight loss, such as combining them with muscle-preserving agents or targeting specific pathways like myostatin inhibition. Additionally, incorporating resistance training and ensuring adequate protein intake are recommended to help mitigate muscle loss during GLP-1 agonist treatment.
Hosted on Acast. See acast.com/privacy for more information.