Addressing Muscle Loss in Patients Using GLP-1 Medications

Recent studies presented at the American Diabetes Association's annual meeting in Chicago have highlighted a significant concern regarding the use of GLP-1 receptor agonists, such as Ozempic and Zepbound, which are widely prescribed for weight loss and diabetes management. While these medications effectively promote weight reduction, they are also associated with unintended muscle loss, with estimates indicating that up to 40% of weight lost during treatment may come from muscle mass depletion.

This muscle loss poses serious health risks, as lean muscle tissue plays a crucial role in stabilizing blood sugar levels, strengthening the immune system, protecting bones and joints, and increasing metabolic rate. The decline in muscle mass can undermine the overall health benefits of weight loss therapies.

To counteract this issue, researchers are exploring combined treatment approaches. One promising strategy involves using bimagrumab, an experimental drug that inhibits activin type II receptors involved in muscle regulation. When administered alongside semaglutide (the active ingredient in Ozempic and Wegovy), clinical trials involving over 500 participants showed that nearly 93% of the weight loss was attributable to fat reduction, compared to 72% with semaglutide alone. Moreover, the combination therapy not only preserved muscle mass but also led to an overall greater weight loss of 22%, compared to 11% with bimagrumab alone and 16% with semaglutide alone.

Lead researcher Dr. Steven Heymsfield explained that these findings demonstrate the potential to achieve significant fat loss while simultaneously maintaining or even increasing lean muscle mass. Currently, further testing of this combination is underway, including studies with Zepbound.

Another advancement in managing muscle health involves a biosensor developed to monitor phenylalanine levels — an amino acid released during muscle breakdown or protein digestion. Elevated phenylalanine levels, especially those exceeding 1500 uM/L, could indicate ongoing muscle loss. This innovative sensor aims to provide real-time feedback, allowing patients and clinicians to better manage nutritional intake, particularly in individuals on GLP-1 therapies, older adults, or those with sarcopenia.

As GLP-1 medications become increasingly common, understanding and mitigating their side effects on muscle mass is essential for optimizing long-term health outcomes. Continued research and technological innovations like biosensors could foster more holistic approaches to obesity and diabetes treatment, emphasizing both fat reduction and muscle preservation.