Research
Adherence
Patients with baseline musculoskeletal pain (cervicalgia, knee pain) experience significantly greater lean body mass loss during GLP-1 therapy, suggesting mobility limitations exacerbate muscle catabolism.
If you have joint pain, you are at higher risk for losing muscle while losing weight on GLP-1s. This is because pain limits your movement. Try to maintain some level of gentle activity or resistance training that does not aggravate your pain to protect your muscle mass.
GoodQualifiesHIGH confidence
Among 3,746 examined EHR phenotypes, baseline musculoskeletal pain emerged as the most significant correlate of greater LBM loss (BH-adjusted q<0.001): cervicalgia (semaglutide, −4.1 percentage points; tirzepatide, −14.3 percentage points) and knee pain (semaglutide, −4.8 percentage points; tirzepatide, −13.4 percentage points)
Why this rating
Strong statistical association (q<0.001) in a large observational dataset.
Source
Greater lean-body-mass decline with tirzepatide than semaglutide in routine care, revealed by body-composition digital phenotyping
Karthik Murugadoss et al. · medRxiv · 2026
preprint · n=670422
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