The loss of muscle mass observed with GLP-1 receptor agonists (such as Ozempic) is not a direct pharmacological effect of the medication, but rather the mechanical consequence of a significant caloric deficit that is not compensated for by adequate protein intake and resistance training.

noli's read

The scientific community largely agrees that lifestyle takes precedence over the medication, viewing muscle wasting as an avoidable side effect of energy restriction. Current research supports this view: studies published in 'Nature Medicine' and randomized controlled trials (RCT) show that the loss of lean body mass while on GLP-1s is proportional to total weight loss and the magnitude of the caloric deficit, rather than any specific muscle toxicity. Science confirms that maintaining muscle mass during rapid weight loss imperatively requires high protein intake and a mechanical stimulus via resistance training, as highlighted in systematic reviews on body composition maintenance. The idea that the medication 'destroys' muscle is therefore a popular exaggeration, although the rapid rate of weight loss induced by these substances makes muscle maintenance more complex in practice. The community strongly converges toward an approach based on the foundations (nutrition/exercise) rather than polypharmacy.

the sources

1. 1Wilding JPH et al. (STEP 1) 2021
2. 2Jastreboff AM et al. (SURMOUNT-1) 2022
3. 3Jastreboff AM et al. 2023
4. 4Wilding JPH et al. (STEP 1 extension) 2022
5. 5r/AdvancedFitness