By Dr. Hassan Kafri, M.D
In the quest for effective weight management, the role of GLP-1 agonists like semaglutide(Wegovy, Ozempic) and tirzepatide(Mounajro, Zepbound) has been transformative, especially for patients struggling with obesity and diabetes. However, as we celebrate these advances, it’s crucial to address an often-overlooked consequence: muscle loss. Understanding this side effect can help us optimize health outcomes beyond mere weight reduction.
What is GLP-1 and How Does It Affect Your Muscles?
Glucagon-like peptide-1 (GLP-1) agonists are a cornerstone in managing metabolic conditions due to their ability to enhance insulin secretion and suppress appetite. Yet, the muscle mass loss associated with these medications poses a concern. A study reported in the Journal of Clinical Endocrinology & Metabolism found significant reductions in skeletal muscle mass among patients using GLP-1 agonists for weight loss, which could undermine metabolic health and physical function.
Why Should You Care About Muscle Loss?
Muscle mass is not just critical for physical activity but also for cardiovascular health. Muscles play a vital role in maintaining glucose metabolism, which is essential for heart health. The loss of muscle not only affects mobility but also increases the risk of metabolic syndrome and cardiovascular events.
The Case of Bobby: A Real-Life Impact
Consider the case of Bobby, a 45-year-old male with a background of high blood pressure and hyperlipidemia, who gained weight due to depression following a family tragedy. After starting on Wegovy, a GLP-1 agonist, Bobby lost 20 lbs but noticed an increase in his LDL levels and no improvement in blood pressure. When he came to see me, his body composition analysis showed that he had lost 8lbs of muscle and only 12 lbs of fat. The provider who prescribed his GLP-1 overlooked the importance of a protein-rich diet and the specific risks associated with his cardiac health.
Strategies to Prevent Muscle Loss
- Protein Intake: High protein diets are recommended to counteract muscle loss. Research suggests that increasing protein intake while on GLP-1 therapy can help preserve muscle mass during weight loss.
- Strength Training: Engaging in regular strength training is another effective strategy. A review in the journal Sports Medicine indicates that combining strength training with weight loss medication can help maintain muscle mass and functionality.
- Monitoring and Adjustment: I ve teamed up with Enara Health to help our team monitor patients’ body composition throughout their treatment. This proactive approach allows for timely adjustments in their management plan, ensuring that both weight loss and muscle health are addressed.
- Balanced Diet: A diet rich in vitamins D and C, omega-3 fatty acids, and antioxidants is also crucial. These nutrients support muscle repair and growth, enhancing the benefits of GLP-1 treatment while mitigating its drawbacks.
The Role of Your Provider in Your Journey
Kafri Heart and Vascular partners with Enara Health to build an integrated care team that does not just prescribe medication. Our integrated care team, including dietitians and exercise physiologists, develops personalized plans that complement GLP-1 therapy with lifestyle modifications to support overall health and prevent muscle loss.
Conclusion
While GLP-1 agonists are effective for weight loss and diabetes management, understanding and mitigating their impact on muscle mass is essential. As a cardiologist, I want to ensure that your health journey reduces fat while preserving muscle, supporting both your metabolic health and quality of life. If you’re getting a GLP-1 from a doctor or provider who is not tracking your muscle vs fat loss, you might find yourself losing health rather than losing weight.
