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Weight-loss drugs like Ozempic have been shown to cause a rapid loss of muscle mass and bone density. Clinical trials have shown that GLP-1 agonist drugs like Ozempic can lead to a significant loss of lean muscle mass. This loss of muscle mass is known as sarcopenia, which can negatively affect a person's quality of life by reducing their stamina and ability to perform daily activities. However, this side effect is not unique to Ozempic, as muscle loss is common when losing a substantial amount of weight, regardless of the method used. To prevent muscle loss, doctors recommend making lifestyle changes such as increasing protein intake, staying hydrated, and incorporating strength and resistance training into one's exercise routine.
| Characteristics | Values |
|---|---|
| Loss of muscle mass | 13.9% loss of lean muscle mass (6.9 kg or 15 lb) during treatment |
| Loss of muscle strength | Stamina and resting metabolic rate decrease |
| Lifestyle changes | Increase protein intake, incorporate strength and resistance training |
| Side effects | Sarcopenia, lower bone density |
| Preventative measures | Regular strength training, aerobic exercise, adequate protein, fluid and nutrient intake |
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What You'll Learn
Strategies to prevent muscle loss
While medications like Ozempic can be effective in helping individuals with diabetes, insulin resistance, or obesity lose weight, they can also lead to a rapid loss of muscle mass and bone density. This condition is known as sarcopenia, which is typically associated with aging. To prevent muscle loss, here are some strategies to consider:
Prioritize Protein
Consuming an adequate amount of protein helps preserve lean muscle. It is recommended to consume 60–90 grams of high-quality protein each day. Supplements, including whey protein drinks, can help reach this goal, especially if nausea or decreased appetite makes eating challenging. Aim for 25–30 grams of protein per meal, and consider lean protein options like air-fried chicken breast or low/non-fat Greek yogurt and cottage cheese.
Exercise Regularly
Exercise is crucial for maintaining muscle and bone health. Aim for at least 30 minutes of exercise 3–4 times a week, including weight-bearing cardiovascular exercises, strength training, and resistance training. Walking, lifting weights, jump rope, tennis, pickleball, Pilates, and resistance bands are excellent options. Progressive resistance training (PRT) is highly recommended, as you gradually increase your workout volume as your strength improves, preventing plateaus.
Stay Hydrated
Water intake is essential for muscle function and recovery after exercise. Muscle is 76% water, so dehydration can lead to muscle cramps and fatigue. Aim to drink half of your body weight in ounces of water daily. For example, a 200-pound person should aim for 100 ounces of water per day.
Focus on Slow and Steady Weight Loss
While rapid weight loss may be tempting, it is healthier to lose weight gradually. Crash and low-calorie diets can lead to muscle loss and harm your health in the long run. Instead, focus on a well-balanced diet with adequate calories and protein, and incorporate exercise into your routine for sustainable weight loss and muscle preservation.
Consult with Professionals
Before starting any weight-loss journey, speak with your doctor. Working with a trainer and a registered dietitian can also be beneficial. They can provide personalized guidance on diet and exercise plans to help you safely and effectively reach your goals while minimizing muscle loss.
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Lifestyle changes to prevent muscle loss
Lifestyle changes can help prevent muscle loss, especially when losing weight quickly. Weight-loss drugs, such as Ozempic, can lead to a decrease in muscle mass, so it's important to consider the following lifestyle changes to prevent this:
Diet
Eating a well-balanced diet is vital for preserving muscle mass. Protein is key here, as it provides the body with amino acids, which are used to build muscle. It is recommended to consume 60–90 grams of high-quality protein each day. Animal sources such as meat, eggs, and milk are considered the best due to their provision of all the essential amino acids. Supplements, including whey protein drinks, can also help reach the required amount.
Exercise
Exercising regularly is crucial for maintaining muscle. Aim for at least 30 minutes a day, 3–4 times a week, and include a mix of weight-bearing cardiovascular exercises and strength or resistance training. Walking, lifting weights, jump rope, tennis, pickleball, Pilates, and resistance bands are all excellent options.
Slow and Steady Weight Loss
While it may be tempting to pursue rapid weight loss, it is better for your body, bones, and muscles to lose smaller amounts of weight over a longer period. Crash diets or low-calorie diets can be harmful in the long run, so focus on a sustainable approach.
Hydration
Staying properly hydrated is essential for muscle function and recovery after exercise. Muscle is 76% water, so dehydration can lead to muscle cramps and fatigue. Aim to drink half of your total body weight in ounces of water each day. For example, a 200-pound person should aim for 100 ounces of water daily.
Consult Professionals
It is important to consult your doctor or healthcare provider before starting any weight-loss journey or making significant lifestyle changes. Working with a trainer or a registered dietitian can also be beneficial in ensuring you take a safe and effective approach.
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Causes of muscle loss
Muscle loss is a common side effect of weight loss. Weight-loss specialists explain that one-quarter to one-third of the weight lost is muscle, regardless of the method used to lose weight. This condition is called sarcopenia, which is the age-related progressive loss of muscle mass and strength. Sarcopenia is a type of muscle atrophy primarily caused by the natural aging process. However, it can also be caused by physical inactivity and an unhealthy diet.
There are three types of muscle atrophy: physiologic, pathologic, and neurogenic. Physiologic atrophy, or disuse atrophy, is caused by not using muscles enough. This type of atrophy can be reversed with exercise and better nutrition. Pathologic atrophy is associated with aging, starvation, and diseases such as Cushing's disease. Neurogenic atrophy is caused by an injury or disease affecting nerves that connect to the muscles. When these nerves are damaged, they can't trigger the muscle contractions needed to stimulate muscle activity. As a result, the body starts breaking down the muscles, leading to a decrease in size and strength.
Certain lifestyle changes can help prevent muscle loss while losing weight. These include consuming an adequate amount of protein, exercising regularly, and staying hydrated. It is recommended to consume 60–90 grams of high-quality protein each day and engage in at least 30 minutes of exercise 3–4 times a week to maintain muscle health. Additionally, drinking enough water is crucial as muscle is 76% water, and dehydration can contribute to muscle loss, fatigue, and muscle cramps.
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Clinical trials on muscle loss
Clinical trials have shown that Ozempic can lead to muscle loss. In a 68-week clinical trial, participants lost an average of 23 pounds of fat and 15 pounds of lean muscle. This is supported by another study that showed that those taking Ozempic lost on average 60% fat and 39% muscle mass.
However, it is important to note that muscle loss is common when losing a substantial amount of weight, regardless of the weight loss method used. Weight-loss specialists explain that one-quarter to one-third of the weight lost is muscle, regardless of the method used.
To prevent muscle loss, it is recommended to prioritize protein intake, exercise regularly, and stay hydrated. A well-balanced diet that includes protein and makes exercise a part of your weekly routine will help protect muscle mass, bone health, and overall health.
Additionally, drug companies are working on developing combination treatments that prevent muscle loss. Strategies to help prevent muscle loss include regular strength (resistance) training, aerobic exercise, and adequate dietary protein, fluid, and nutrient intake.
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Drugs to prevent muscle loss
Weight-loss drugs such as Ozempic, Wegovy, and Mounjaro have been shown to cause a rapid loss of muscle mass and bone density. This condition is known as sarcopenia, which is characterised by a decrease in muscle mass, bone density, and resting metabolic rate. While this phenomenon is not unique to semaglutides, it is a common side effect of rapid weight loss.
To prevent muscle loss, it is recommended to increase protein intake and incorporate strength and resistance training into your fitness routine. A well-balanced diet that includes 60–90 grams of high-quality protein each day can help preserve lean muscle. Supplements such as whey-protein drinks can also help reach this target, especially if nausea or decreased appetite are side effects of the medication.
In addition to diet, regular exercise can help maintain muscle and bone health. Aim for at least 30 minutes of exercise 3–4 times a week, including weight-bearing cardiovascular exercises, strength training, and resistance training. Walking, lifting weights, jump-roping, tennis, pickleball, Pilates, and resistance bands are all great options.
It is also important to stay hydrated, as water intake greatly impacts muscle function and recovery after exercise. Aim to drink half of your total body weight in ounces of water per day. For example, a 200-pound person should drink about 100 ounces of water each day.
While there is currently no drug approved to treat skeletal muscle atrophy, several clinical trials are underway to test potential treatments. For example, a trial is testing bimagrumab and semaglutide in adults with obesity. Additionally, drug companies such as Eli Lilly are working on combination treatments that may prevent muscle loss during weight loss.
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Frequently asked questions
Clinical trials have shown that Ozempic can lead to a 13.9% loss of lean muscle mass during treatment. However, this side effect is not listed in the FDA product labelling.
GLP-1 agonist drugs like Ozempic work like a hormone in the body called GLP-1 (glucagon-like peptide 1) that is secreted when we eat. They cause the pancreas to make insulin and slow down stomach emptying, increasing muscle uptake of glucose and reducing liver creation of glucose.
Studies have shown that patients can lose 10% or more of their muscle mass in 68- to 72-week-long clinical studies. A 200-pound person, for example, may lose 15 pounds of muscle.
To prevent muscle loss, it is recommended to include strength (resistance) training and adequate protein in your diet. It is also important to stay hydrated as muscle is 76% water.
Yes, Eli Lilly is currently testing a drug called bimagrumab, an antibody that promotes muscle growth, in combination with Ozempic.
