Evidence on GLP-1 drugs and muscle loss remains murky

Recent research on glucagon-like peptide-1 (GLP-1) drugs for weight loss indicates these medications may lead to significant reductions in lean body mass, including muscle. The STEP 1  and SUSTAIN 8 of semaglutide trials found 39–40% of weight lost on the GLP-1 drugs was lean mass. A 2021 meta-analysis of 18 randomized controlled studies showed significant drops in fat-free mass with GLP-1 drugs, including oral and subcutaneous semaglutide and older GLP-1 drugs such as lixisenatide, exenatide, and liraglutide. The meta-analysis focused on both GLP-1 receptor agonists and sodium-glucose cotransporter (SGLT-2) inhibitors.

Sizing up the GLP-1 impact on lean mass: Mixed signals

While some data suggests that GLP-1 drugs are associated with muscle loss, there may be more to the story than meets the eye. In STEP 1 and SUSTAIN 8, the proportion of lean mass to total body mass still increased overall, pointing to an overall improvement in body composition​​. And data from the …

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