Hormonal
GLP-1 and GIP/GLP-1 receptor agonists (semaglutide, tirzepatide) cause a significant reduction in skeletal muscle mass (30-40% of total weight loss), posing a risk for sarcopenia, particularly in elderly patients and those with type 2 diabetes.
If you are taking semaglutide or tirzepatide, expect to lose some muscle along with fat. To protect your strength, you must eat more protein (at least 1.2g/kg/day) and perform resistance training 2-3 times per week. This is especially critical if you are older or already have low muscle mass.
Numerous studies indicate that, in addition to gastrointestinal adverse events, these medications may contribute to a reduction in muscle mass, potentially worsening the metabolic status of patients... some studies report decreases in lean mass of 40% to 60% of total weight loss... This is particularly relevant for elderly patients and those with sarcopenic obesity, for whom additional loss of muscle tissue can pose a serious risk.
Why this rating
Based on a review of multiple randomized clinical trials (STEP, SURPASS, SURMOUNT) and a meta-analysis of 38 studies.
Source
The impact of semaglutide and tirzepatide on skeletal muscle: Significant benefit or substantial risk?
В. В. Салухов et al. · Meditsinskiy sovet = Medical Council · 2025
DOI 10.21518/ms2025-467
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