Ozempic can cause a significant loss of muscle mass and reduce bone density.

May 16, 2023

Weight loss is common in people who take GLP-1-containing drugs such as OzempicSemaglutide, and Mounjaro.

According to a trial of Ozempic, after 68 weeks on the medication, 86.4 percent of participants lost at least 5% of their weight, and 69.1 percent lost more than 10%.

Weight loss benefits your health, but losing weight quickly can cause muscle loss, decrease bone density and reduce your metabolic rate at rest, leading to Sarcopenia, the loss of strength and muscle function over time.

Sarcopenia is a common condition that affects older people and is often associated with aging. But rapid weight loss with GLP-1s such as Ozempic and Wegovy, without proper diet and exercise, can cause Sarcopenia at any age. This negatively affects a person’s life quality by reducing stamina and their ability to do daily activities like quickly walking upstairs,” said Dr. Rekha Kumar, a practicing NYC endocrinologist, and the Chief Medical Officer at Found.

She said sarcopenic obesity is similar to obesity and occurs when the person’s BMITrusted source falls into the normal range or lower. Still, lean muscle levels are so low that only fat and bones remain metabolically active tissues.

It is important to remember that a lower weight does not necessarily mean a healthier person. Evaluating body composition after a person has reached a plateau and achieved some weight loss is essential.

What science says about Sarcopenia, GLP-1 drugs such as Ozempic, and Sarcopenia

The data that raises concern about Sarcopenia about GLP-1 drugs comes from a small group of participants who have undergone DEXA (dual-energy X-ray absorptiometry), a method for measuring bone mineral density by using spectral images, according to Dr. Karl Nadolsky, is an endocrinologist at the American Board of Obesity Medicine and a diplomate.

He told Healthline that the 5 kg of lean mass reported by Healthline was 38% higher than expected. DEXA can be inaccurate in measuring the changes to body composition. Adipose tissue, including many poor groups, is a big part of the mass.

Nadolsky noted that rapid weight loss would generally reduce the resting metabolic rate.

metaanalysisTrusted Source revealed that patients who had undergone bariatric surgeries lost over 8kg in fat-free mass and over 22% of their total body weight within a year after the surgery.

The faster you lose weight, the more likely you will lose muscle. “While a 20% loss in muscle mass may seem normal when someone loses weight, it is the period in which the muscle loss occurs that causes the problem,” said Kumar.

She said that because the weight loss on GLP-1s occurs so quickly, people should be extra vigilant about their nutrition and increase their protein intake to prevent sarcopenic obesity.

Lifestyle changes that can prevent bone and muscle density loss when taking GLP-1s

Following lifestyle changes will help you maintain muscle mass and bone strength while losing weight quickly if you take GLP-1 medications such as Ozempic or Wegovy.

Increase protein intake

The systematic review, meta-analysis, and Trusted Source concluded that higher protein diets resulted in a lower loss of lean mass and a more significant loss of fat mass than lower protein intake.

Nadolsky said, “Nutrition should optimize proteins on a personal basis.”

Kumar advised that to maximize muscle preservation, you should consume 25-30 grams of Protein at each meal.

If you still feel hungry, you can switch to carbs.

She suggests using low-fat Greek Yogurt instead of sour cream, and prepping meals with lean proteins, like air-fried breasts, to make them more accessible. You can also get more Protein by adding beans to your salad, using quinoa instead of rice or pasta, and adding powders to drinks and foods.

Strength and resistance training

According to a Meta-analysisTrustedSource, resistance training can mitigate all muscle loss during caloric restrictions.

Nadolsky said it is essential to include some resistance training for all people undergoing weight loss therapies.

Kumar explained the benefits of strength and resistance training.

  • Maintain muscle mass during weight loss to ensure that you lose fat, not muscle mass.
  • It increases your metabolism and helps you burn more calories, even at rest.
  • Increases lifespan, “healthspan” (the period of good health), and mobility.

She recommends starting with two strength exercises per week.

“Fit in as much as you can,” Kumar suggested keeping dumbbells by your desk to do some reps during breaks, lunging down the hall, or holding a plank in the commercials of your favorite show.

Prioritize quality rest

Kumar said that healthy, refreshing, and consistent sleep patterns impact hormones such as growth hormone and cortisol, which regulate body weight.

She said that optimal circadian patterns can lead to a healthier body composition. Sleep deprivation, however, can increase your hunger hormone and cause more food cravings.

When losing weight while taking medication, consult a health professional.

Kumar said that the risk of muscle loss or sarcopenic weight gain while taking GLP-1s was one of the reasons people should take these medications under medical supervision and with nutrition support from a nutritionist. “A registered dietitian can help ensure you are getting enough protein and avoiding any health risks,” Kumar explained.

Nadolsky says physicians should be aware of the adverse effects of treating obese patients and work with them to mitigate this by incorporating resistance training and optimizing protein intake.

He also noted that research showed that despite any lean mass loss associated with weight loss when taking GLP-1s, the individual’s overall health improved.

Nadolsky said that the improved health included cardiometabolic health, such as type two diabetes, physical functions, and quality of life. “We shouldn’t use obesity pharmacotherapy and surgery on those who don’t have obesity. When used in the indicated patient populations, the benefits will outweigh those risks.”

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