Macro partitioning
SGLT2 inhibitors (dapagliflozin, empagliflozin, ipragliflozin) significantly reduce body weight in older adults with type 2 diabetes primarily through substantial fat mass loss, while causing only a modest, likely non-clinically meaningful reduction in skeletal muscle mass.
If you are an older adult with Type 2 Diabetes, SGLT2 inhibitors (like Jardiance or Farxiga) are effective for weight loss. Expect significant fat loss. You may lose a small amount of muscle, but it is not the primary driver of weight loss and is likely not clinically concerning for most. Monitor your strength if you are already frail, but the metabolic benefits of fat loss generally outweigh the modest muscle loss.
SGLT2 inhibitors significantly reduced body weight (standardized mean difference (SMD) = −0.85, p < 0.001; I2 = 0%) and fat mass (SMD = −0.53, p < 0.001; I2 = 51.1%). A small reduction in muscle mass was observed (SMD = −0.35, p < 0.001; I2 = 22.9%), though substantially smaller than fat loss.
Why this rating
Meta-analysis of 8 RCTs with high quality scores (CASP), though limited to Asian populations.
Source
The Effects of <scp>SGLT</scp> 2 Inhibitors on Muscle Health in Older Adults: A Systematic Review and Meta‐Analysis
Weena Joongpan et al. · Pharmacology Research & Perspectives · 2026
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →