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Ozempic is a popular weight-loss drug that has been shown to cause muscle loss in patients. This condition is known as sarcopenia and can affect a person's stamina and ability to perform daily activities. While the long-term risks of muscle loss due to Ozempic are not yet fully understood, there are strategies to help prevent muscle loss, including regular strength training, aerobic exercise, and adequate protein, fluid, and nutrient intake. Some drug companies are also working on combination treatments that may prevent muscle loss.
| Characteristics | Values |
|---|---|
| Drugs | Ozempic, Wegovy, Mounjaro, Zepbound |
| Drug Type | GLP-1 agonist drugs, incretin mimetic treatments |
| Muscle Loss | 13.9% loss of lean muscle mass, 60% fat and 39% muscle mass, 25% muscle and 75% fat, 20% to 30% of the loss may be lean tissue |
| Side Effects | Sarcopenia, lower metabolic rate, reduced stamina and ability to perform daily activities, dehydration, fatigue, muscle cramps, sagging skin, wrinkly feet |
| Preventative Measures | Strength training, resistance training, aerobic exercise, adequate protein intake, optimal nutrition plan, weight-bearing and resistance training |
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What You'll Learn
Strategies to prevent muscle loss
Slow and steady weight loss
While most people want to lose weight as quickly as possible, it is better for your body, bones, and muscles to lose small amounts of weight over a longer period of time. Crash diets or low-calorie diets can lead to more rapid weight loss in the short term but can be harmful in the long run.
Resistance training
Resistance training is one of the most important factors in maintaining muscle mass when you are trying to lose weight. Studies have shown that patients who lose weight may also lose lean body mass, which includes muscle mass. Resistance training can be effective in maintaining muscle mass during weight loss in people with obesity or overweight.
Aerobic exercise
Incorporating aerobic (cardiovascular) exercises with resistance training may also benefit fat loss while preserving muscle mass. However, consider structuring your workouts to limit doing too much cardio before resistance training.
Prioritize protein
Making sure you are getting an adequate amount of protein will help preserve lean muscle. While taking a weight-loss medication, most people should consume 60–90 grams of high-quality protein each day.
Hydration
Water intake and proper hydration greatly impact muscle function, as well as recovery after exercise. Muscle is 76% water, so muscle loss can contribute to dehydration, fatigue, and muscle cramps. Try to drink half of your total body weight in ounces of water.
Nutrition and exercise plan
Engage with your doctor, nurse, and dietician to learn about the optimal nutrition plan for your weight-loss goals. Speak with your healthcare provider before you engage in a modified diet or exercise program.
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How muscle loss affects bone health
Muscle loss can have a significant impact on bone health, and this is especially true for older adults. The loss of muscle mass can lead to a decrease in bone density and an increased risk of osteoporosis, a condition characterised by weakened bones that are more susceptible to fractures. This is because bones adapt their morphology and strength in response to the long-term loads exerted by muscles during physical activities. Thus, when there is a decline in muscle mass, bone density also tends to decrease.
Several factors contribute to muscle loss, including age, diet, and physical activity levels. Age-related muscle loss, known as sarcopenia, typically begins in the 20s for men and 40s for women, with muscles shrinking and becoming less toned due to changes in muscle tissue and the nervous system. This loss of muscle tissue can be accelerated by a sedentary lifestyle and a lack of physical activity. Additionally, crash diets or low-calorie diets can contribute to rapid muscle loss, further affecting bone health.
To maintain muscle mass and support bone health, it is crucial to engage in regular exercise, including weight-bearing and resistance training. Exercise helps stimulate bone remodelling, improve posture, and enhance balance. Additionally, adequate protein intake is essential for preserving muscle mass and bone health. Protein supplementation has been found to slow sarcopenic muscle loss, and a well-balanced diet that includes sufficient protein can help protect bone and muscle health.
Furthermore, rapid weight loss, especially when achieved through the use of certain medications like Ozempic, can also contribute to muscle loss. Ozempic, a popular weight-loss drug, has been associated with a decrease in lean muscle mass, which can further impact bone density. However, it is important to note that the long-term risks of muscle loss associated with Ozempic are not yet fully understood. To mitigate these risks, healthcare providers recommend combining Ozempic with strength training and optimal protein intake to preserve muscle mass and support bone health.
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The role of diet and exercise
While Ozempic can be effective for weight loss, it can also lead to a decrease in muscle mass. However, there are ways to counteract this through diet and exercise.
Firstly, it is important to note that muscle loss is a common occurrence when losing a substantial amount of weight, regardless of the method used. Therefore, it is crucial to prioritise healthy weight loss over rapid weight loss. Crash diets and low-calorie diets can lead to more rapid weight loss in the short term but can be harmful in the long run. Instead, focus on losing small amounts of weight over a longer period. Eating a well-balanced diet that includes protein and incorporating exercise into your weekly routine can help protect muscle mass.
Secondly, adequate nutrition and protein intake are vital for maintaining muscle. Consuming an optimal level of protein, such as 60-90 grams of high-quality protein per day, can help preserve lean muscle. Supplements, including whey protein drinks, can be beneficial in reaching this goal, especially if nausea or decreased appetite makes eating challenging. It is recommended to consult a registered dietician to determine the ideal amount of protein for your specific needs. They can also provide guidance on highly nutritious foods and any necessary supplemental vitamins.
Thirdly, engaging in strength or resistance training can effectively maintain muscle mass during weight loss. Adding weight-bearing cardiovascular exercises, such as walking, lifting weights, or playing tennis, can increase weight loss, build muscle mass, and strengthen bones. Additionally, aerobic exercise can be beneficial. Consider seeking guidance from a personal trainer to help you safely and effectively achieve your exercise goals.
By implementing these dietary and exercise strategies, it is possible to help prevent muscle loss while taking Ozempic and promote overall health.
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The impact of muscle loss on metabolic rate
Muscle loss, or sarcopenia, is a condition characterised by a progressive and generalised loss of skeletal muscle mass, strength, and/or physical performance. Sarcopenia is typically associated with ageing, but it can also occur at any age if rapid weight loss is experienced without the proper diet and exercise. This can negatively affect a person's quality of life by reducing their stamina and ability to perform daily activities.
The loss of muscle mass can have a significant impact on an individual's metabolic rate, which refers to the rate at which the body burns energy while at rest. Muscle tissue is metabolically active, meaning it requires energy to be maintained. When muscle mass decreases, the body's energy demands decrease, resulting in a lower resting metabolic rate. This can lead to a plateau in weight loss, as the body adapts to a new, lower energy requirement. Additionally, muscle plays a crucial role in mobility and strength, and rapid weight loss can increase the risk of falls or injuries, especially in older adults.
Furthermore, muscle loss can negatively impact bone health, especially in individuals who are already at risk of osteoporosis. This is because muscle helps to support and protect bones, and the decreased mechanical load on the bones during movement can contribute to bone density loss. Additionally, muscle-derived secretory proteins, called myokines, mediate interactions between skeletal muscle mass and other organs, including the liver, adipose tissue, pancreas, bone, and the cardiovascular system. Therefore, muscle loss can have systemic effects on overall health and metabolism.
To mitigate the impact of muscle loss on metabolic rate, it is essential to prioritise protein intake, as this helps to preserve lean muscle mass. Additionally, including weight-bearing and resistance training in one's exercise routine can help build muscle mass and strengthen bones. A well-balanced diet and regular exercise can help protect muscle, bone health, and overall health. It is also important to stay hydrated, as water intake impacts muscle function and recovery after exercise. Muscle is composed of 76% water, and muscle loss can contribute to dehydration, fatigue, and muscle cramps.
While the long-term risks of muscle loss due to treatments like Ozempic are not yet fully understood, it is important for clinicians and patients to work together to assess the benefits of blood sugar control, weight loss, and heart protection against any potential risks associated with muscle loss. Strategies to prevent muscle loss during treatments like Ozempic include regular strength training, aerobic exercise, and adequate dietary protein, fluid, and nutrient intake.
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Clinical trials on muscle loss
Clinical trials have shown that GLP-1 agonist drugs like semaglutide (Ozempic) can lead to a 13.9% loss of lean muscle mass (equal to a 6.9 kg or 15 lb) during treatment. This is supported by obesity trials that showed participants using incretin mimetic agents like Ozempic lost 10% or more of their muscle mass in 68- to 72-week-long clinical studies. This equates to roughly 20 years of muscle loss due to aging, according to experts.
A small, retrospective review evaluated the clinical effectiveness of semaglutide (Ozempic) on weight loss, body composition, and muscle strength in a Chinese population with obesity. Participants were prescribed semaglutide and the results were compared to the baseline values after the patients had completed 24 weeks of treatment. Overall, weight was significantly reduced by 9.9 kg (21.8 lb) at 24 weeks. The proportion of patients with at least a 5% weight loss was 93%, and with at least a 10% weight loss was 54%. However, a significant amount of skeletal muscle mass was also lost (1.4 kg or 3 lb), but this was found to be significantly less than the loss of fat mass at 5.6 kg (12.3 lb). By percentage, the fat mass loss was 15.6 ± 10.1%, and the muscle mass loss was 4.8 ± 4.4%, which was statistically significant. Muscle strength (measured by grip strength) did not change significantly, nor did calf circumference.
Another systemic review evaluated the effects of semaglutide on lean body mass in obesity management in 6 studies with 1,541 overweight or obese adults. Lean mass reductions were found to range from 0% to 40% of total weight reductions, and this was especially evident in larger studies. Even though lean mass was reduced in these studies, the amount of lean mass lost when compared to total body mass increased, suggesting a positive overall effect. The authors conclude that semaglutide affects weight loss primarily through fat mass reduction, but the loss in lean mass is still a concern, especially from the perspective of larger clinical studies.
The long-term risks due to muscle loss when using incretin mimetic treatments like Ozempic are not fully known at this time. However, there are proven ways to help maintain muscle strength if you are at risk of muscle loss. Engaging in strength (resistance) training and maintaining optimal levels of protein in your diet may help with muscle loss during Ozempic treatment. Studies have shown that resistance training can be effective in maintaining muscle mass during weight loss in people with obesity or overweight. Adequate nutrition and protein intake is also important to maintain muscle. The loss of skeletal muscle mass has been associated with calorie-restricted diets and rapid weight loss in general, as well as with the use of incretin mimetic agents such as semaglutide (Ozempic).
Additionally, Eli Lilly, the company that makes Mounjaro and Zepbound, is looking to develop combination treatments that prevent muscle loss. A trial is also underway, testing bimagrumab and semaglutide, the substance in Ozempic, in adults with obesity. Later this year, the drugmaker Regeneron will begin a clinical trial testing semaglutide in combination with an antibody treatment that blocks receptors that regulate muscle growth.
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Frequently asked questions
Yes, clinical trials have shown that Ozempic can lead to a loss of lean muscle mass. However, the exact amount of muscle a person loses may vary.
The muscle wasting is caused by the rapid weight loss that occurs when taking Ozempic. This rapid weight loss can also cause a decrease in bone density and lower your resting metabolic rate.
Older adults are at an increased risk of muscle wasting from Ozempic due to the changes associated with aging. People with low lean muscle mass may also experience more muscle loss.
Strategies to prevent muscle wasting include regular strength training, aerobic exercise, and adequate dietary protein, fluid, and nutrient intake. Working with a trainer and a registered dietitian can be helpful.
Muscle wasting can negatively impact your stamina, strength, and ability to perform daily activities. It can also contribute to dehydration, fatigue, and muscle cramps.
