Understanding GLP-1 Medications and Weight Loss (Free Article)

GLP-1 medications can be powerful weight loss tools, but lifestyle determines what kind of weight you lose.

By now most of us have heard of GLP-1 medications like Ozempic, Mounjaro, Wegovy, and Zepbound. They are helping millions of people lose weight, and 1 in 8 Americans have tried one of these medications, with the highest rates of use in women ages 50-64.

Fat Loss vs. Lean Mass Loss

But while these drugs have become valuable tools to help people lose weight, it’s the type of weight that many are not talking about. What do we mean? We’re talking about the difference between fat loss and lean mass loss.

What Is Lean Mass?

• Muscle
• Bones
• Organs
• Water

Recent studies have shown that up to 40% of the weight lost while taking these medications is lean body mass (aka not body fat). While this is a startling number to hear, there’s a little more to the story.

Much of that 40% actually comes from fat being cleared from inside the liver, which is a GOOD thing, considering almost 4 in 10 adults in the US have fatty liver. So yes, it’s not all doom and gloom.

That said, even after accounting for liver fat, up to 25% of our weight loss is coming from skeletal muscle. We want to protect our muscle at all costs, as it gets harder to build muscle as we age. Muscle loss leads to:

• Decreased strength
• Lower bone density
• Increased risk of fracture

How to Protect Muscle During GLP-1 Therapy

Resistance Training Is Essential

If you are on a GLP-1 medication, it should be non-negotiable️ that you are doing some form of resistance training. Cardio alone will not cut it to protect muscle. We need to be challenging our muscles, or we truly face a use it or lose it scenario.

Don’t Forget about Protein Intake

If you are trying to preserve or even build muscle mass, studies show that you need to be eating at least 0.5 grams of protein per pound of body weight per day. Example: If you weigh 160 lbs, that’s 80 grams of protein spread across a few meals.

A Worst-Case Scenario

1. Someone loses 50 lbs while taking a GLP-1 (Yay!)
2. At least 12.5 lbs of that is muscle (Booo!)
3. That person gains all 50 lbs back after stopping the medication (unfortunately this happens to many people)
4. All of the weight regained is fat, meaning they have traded 12.5 lbs of muscle for 12.5 lbs of fat and they are worse off than they were before.

Key Takeaways for Healthy Weight Loss

Lifestyle still matters while you are on these medications! The good news is, studies have shown that regular resistance training and adequate protein intake can reduce muscle loss from GLP-1’s. But it takes work.

GLP-1s are a powerful tool, and more potent versions are in development that could change the landscape of weight loss in the future. Without adequate protein and strength training though, these drugs can have some real downsides.

Weight loss is important, but we want to keep your muscle, protect your bones, and feel strong through the process.