How These Drugs Work and How to Protect Your Muscle Mass
Losing weight can be really challenging, especially for those with obesity and type 2 diabetes. These conditions make it harder for the body to regulate weight and metabolism. Fortunately, a class of medications known as GLP-1 agonists can help people overcome biological, psychological, and environmental barriers to weight loss.
You may recognize some of the brand names, such as Ozempic and Wegovy. GLP-1 agonists (short for glucagon-like peptide-1 receptor agonists) were originally designed to help manage type 2 diabetes. However, research trials such as the STEP trials have shown they can also promote weight loss. Other studies, like the SELECT trials, suggest they may lower the risk of heart attack and stroke, while the SUSTAIN trials show benefits in improving glucose control and cholesterol levels.
These medications are also being tested for their effects on heart failure, sleep apnea, Parkinson’s, and kidney disease, but their primary use remains in treating obesity and metabolic disorders.
Who Should Use GLP-1 Medications?
GLP-1 agonists are not intended for vanity weight loss. They are designed for individuals with chronic conditions such as obesity, type 2 diabetes, and cardiovascular disease. If someone is looking to shed a few pounds for an event, these medications are not the answer.
They are expensive, can have side effects, and often lead to rapid weight loss, which includes muscle loss. That’s why it’s essential to understand how these medications work and how to protect muscle mass while using them.
How Do GLP-1 Medications Work?
These drugs mimic the GLP-1 hormone, which plays a role in blood sugar control and appetite regulation. After eating, your body naturally releases GLP-1, which triggers insulin to move glucose from your blood into your muscles for energy.
In type 2 diabetes, the body does not produce enough insulin or doesn’t use it efficiently, leading to high blood sugar levels. The Centers for Disease Control and Prevention (CDC) reports that 38.4 million Americans (11.6 percent of the U.S. population) have diabetes, while 97.6 million adults (38 percent of the population) have prediabetes.
GLP-1 medications help by increasing insulin release to regulate blood sugar, suppressing appetite to reduce calorie intake, and slowing digestion to keep you full longer.
This combination leads to significant weight loss. However, losing weight quickly comes with a downside—muscle loss.
The Risk of Muscle Loss with Rapid Weight Loss
Any rapid weight loss, whether through GLP-1 medications, bariatric surgery, or extreme dieting, can lead to muscle loss. Research in the International Journal of Obesity and Journal of Obesity shows that patients undergoing bariatric surgery lose 20 to 50 percent of their muscle mass.
This happens because lower calorie intake means fewer nutrients to support muscle growth, less protein intake leads to muscle breakdown, and a lack of strength training fails to stimulate muscle maintenance.
This is concerning because muscle mass is crucial for strength, mobility, and longevity. A study in the American Journal of Medicine found that quadriceps strength is a key predictor of mortality. As we age, muscle loss accelerates, increasing the risk of falls, fractures, and loss of independence.
How to Prevent Muscle Loss While Using GLP-1 Medications
To maintain muscle mass, two key strategies are essential.
Resistance Training
The best way to protect your muscles is through strength training. Research in Cardiovascular Diabetology found that when patients combined Semaglutide (Wegovy or Ozempic) with exercise, they lost fat while maintaining muscle mass.
The Physical Activity Guidelines recommend at least two days per week of strength training and 150 minutes per week of moderate-intensity aerobic exercise or 75 minutes per week of vigorous-intensity aerobic exercise.
To build or maintain muscle, studies in the Journal of Sports Science suggest aiming for 12 to 20 sets per muscle group per week. You can split this over multiple workouts or do fewer sessions with more volume.
Some key training tips include training close to failure, mixing light and heavy weights for flexibility, and adjusting movements as needed to avoid pain.
Eat Enough Protein
Protein is essential for muscle repair and growth. A review in Nutrients suggests consuming 1.2 to 2.3 grams per kilogram of body weight per day for muscle preservation during weight loss.
For a 130-pound person, this equates to 71 to 136 grams of protein per day. For a 180-pound person, it ranges from 98 to 188 grams per day. Most people do well within the lower range, while the upper range is better suited for those engaging in high-intensity resistance training.
Good protein sources include lean meats, eggs, dairy products, and plant-based proteins such as tofu, lentils, and beans.
GLP-1 Medications Work Best with a Holistic Approach
These medications are powerful tools, but they are not a standalone solution.
GLP-1 drugs help regulate blood sugar, suppress appetite, and support weight loss. However, they do not build muscle, ensure a healthy diet, or replace a long-term lifestyle change.
When used correctly, alongside strength training and proper nutrition, GLP-1 medications can be life-changing for people with obesity and metabolic conditions. But they are not magic pills. A comprehensive approach leads to the best results.
If you are considering GLP-1 medications, talk to your doctor about treatment options and how to incorporate exercise and nutrition into your plan.
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