The Fact About Ozempic and Muscle Loss

It’s laborious to go a day with out listening to one thing new concerning the newest diabetes and weight problems medicines, semaglutide and tirzepatide. Normally, the excitement is constructive, however there was a persistent declare made about these medicine that will make any potential person cautious: They don’t solely allow you to shed extra pounds—they supposedly hole out your muscle mass on the similar time, making you weak and weak to all types of future well being issues down the road. However what does the present science say, and simply how nervous must you be about muscle loss if taking these medicine?

Semaglutide (bought as Ozempic and Wegovy) and tirzepatide (bought as Mounjaro and Zepbound) are the most recent additions to a category of medicine often known as incretins, which mimic hormones essential to our metabolism and sense of starvation, amongst different capabilities. Semaglutide mimics GLP-1, whereas the newer tirzepatide mimics GLP-1 and one other hormone, GIP. Each medicine have been discovered to assist individuals safely, reliably, and considerably lose extra weight on common than weight-reduction plan alone or other treatments, outdoors of bariatric surgical procedure. Research have additionally advised that these medicines can stave off coronary heart, kidney, and liver illness in overweight individuals weak to it and probably even assist deal with addiction and different circumstances not strictly tied to weight problems or diabetes.

As spectacular as these medicine appear to be, no remedy comes with out its potential negatives. Customers will generally expertise gastrointestinal points like vomiting and diarrhea, although these signs are likely to wane over time. They could additionally trigger uncommon however doubtlessly severe issues like gastroparesis, also known as abdomen paralysis.

Some critics have additionally alleged that GLP-1s can dangerously sap our muscle mass, however specialists interviewed by Gizmodo say this declare isn’t presently backed by the info or our understanding of how these medicine work.

The thin on muscle loss and GLP-1 use

For starters, the potential for muscle loss whereas taking these medicine isn’t stunning. Lengthy earlier than Ozempic appeared on the scene, medical doctors have recognized that this could occur with any type of weight reduction. After we slim down, we sometimes lose some mixture of fats and fat-free mass, also referred to as lean physique mass, which might embrace our muscle tissue. And whereas there is perhaps another features of GLP-1s that assist us shed extra pounds, they primarily scale back our urge for food and enhance our sense of fullness, main us to eat much less energy over time. In different phrases, there’s nothing significantly novel about how we shed extra pounds whereas taking them.

Research have discovered that when overweight individuals lose vital weight via weight-reduction plan alone or by way of bariatric surgical procedure, 20% to 30% of that weight is lean physique mass. And thus far, we’re not discovering that GLP-1 medicine are veering dramatically from this baseline. A 2024 review of medical trial knowledge on semaglutide, as an example, discovered that the proportion of lean physique mass misplaced whereas shedding pounds ranged from 0% to 40%. And enormous medical trials of tirzepatide have found that the share of lean physique mass misplaced is according to the share misplaced via weight-reduction plan or surgical procedure.

“So it truly is on par,” Michael Weintraub, an endocrinologist and medical weight problems researcher at New York College Langone Well being, advised Gizmodo over the cellphone. “And there’s no cause to suppose there’s some distinctive mechanism of those GLP-1 agonists that’s inflicting a sort of particular muscle mass loss.”

These numbers alone don’t inform the complete image both. Even with the best figures, overweight individuals are nonetheless shedding extra fats than lean physique mass and that’s undeniably a internet constructive, Weintraub says. One cause why muscle loss will be harmful is that it may well make us frail and fewer in a position to perform our day by day capabilities. However that’s completely not what the analysis is exhibiting. In comparison with placebo, individuals on these drugs have reported a greater high quality of life and improved bodily functioning. Some restricted knowledge have additionally suggested that these medicine may cause a lack of lean physique mass however with out really compromising the standard of our muscle tissue.

“Once I see my sufferers, they’ll say issues like: ‘Effectively, I simply really feel so significantly better, I’m in a position to perform so significantly better. I’m in a position to go up and down the subway with out having to cease,’” Weintraub stated. “These are the outcomes, I feel, that really matter.”

‘No knowledge to help the notion’

Samuel Klein is the director of the Middle for Human Diet at Washington College Faculty of Drugs in St. Louis. Earlier this month, he and different weight problems researchers wrote about this very subject for an article in JAMA and got here to the identical primary conclusion as above.

“We determined to evaluation the literature rigorously and really discovered that there’s simply no knowledge to help the notion that weight reduction with GLP-1 agonist remedy causes results on muscle mass, or fats free mass, that result in abnormalities in bodily perform,” Klein advised Gizmodo over the cellphone.

There are some potential ways in which incretin medicine might be riskier in relation to our muscle tissue. All the info talked about above pertains to people utilizing these medicines for both kind 2 diabetes or weight problems, however their success has additionally pushed a public demand that has commonly outmatched the out there provide. That, mixed with excessive record costs (upwards of $1,000 a month) and low insurance coverage protection, has fueled a gray and black market for the medicine, making it comparatively simple for anybody to get their fingers on it, even when they don’t essentially want it. So somebody who’s already pretty skinny and is taking semaglutide may probably turn into underweight or lose related quantities of muscle, although Klein notes that he hasn’t seen any case studies of this occurring but. Then once more, any drug’s dangers can outweigh the advantages when utilized by those that it’s not meant for.

Driving muscle loss worries

The shortage of information supporting huge muscle loss hasn’t stopped some drug firms from making an attempt to counteract the problem. A number of firms are testing a combination of GLP-1s with medicine designed to realize muscle or forestall muscle loss. It’s definitely attainable that these combos would possibly enhance individuals’s well being much more than taking a GLP-1 alone, particularly for older people who find themselves already at greater threat of shedding muscle as they age. However these trials shouldn’t be seen as an admission by Huge Pharma that we actually have one thing to fret about both, Klein argues.

“It’s a remedy in search of an issue,” he stated. “I feel step one could be is to reveal that weight reduction with these medicines in a subset of individuals causes hurt by extreme muscle mass loss and decreased bodily perform. And till you reveal that, it’s unclear that stopping the muscle loss can have therapeutic results which are value it.”

Actions to take care of muscle well being

In case you are nonetheless nervous about potential muscle loss from taking these medicine or shedding pounds one other approach, then right here’s some encouraging information: We already know tips on how to assist scale back or forestall it.

“I spend plenty of time within the clinic counseling sufferers on this, ensuring that they’re attaining ample protein consumption, after which ensuring that we’re spending effort on power, or resistance, coaching,” Weintraub stated. “As a result of we all know that [those two things] can actually mitigate the muscle mass loss that we’d see with anti-obesity medicines.”

For his or her half, specialists like Weintraub and Klein do endorse additional analysis wanting extra intently at muscle (and bone) loss whereas taking these medicine. However they’re additionally unequivocal about the place the proof stands in the interim.

“We simply must observe the info—it’s the yellow brick street—and never be wedded to any explicit viewpoint. However proper now, there aren’t any knowledge that I’m conscious of supporting that this can be a downside,” Klein says.