Lose the Fat, Not the Muscle
February 19, 2025People struggling with obesity are excited to lose the fat and see the numbers go down on the scale. Studies show that any kind of weight loss medication, including dieting, medication, or bariatric surgery, can cause loss of muscle mass. Studies indicate that during weight loss, muscle loss can represent 20–40% while fat could be 60–80% (1). In this article, we will look at the role of GLP-1 agonists such as Semaglutide (Wegovy) and Tirzepatide (Zepbound) in contributing to muscle loss and subsequent problems associated with loss of muscle (2). One has to remember that GLP-1 agonists don’t target fat; they lead to loss that includes fat and muscle. We will conclude by looking at what can be done to decrease the amount of muscle loss.
What is the significance of muscle loss?
People with obesity have more muscle mass compared to a similar group of normal-weight individuals. When losing weight, people with significant obesity tend to lose a greater amount of muscle mass compared to their normal weight counterparts. Losing muscle mass is problematic since the clinical implications are significant for certain groups of people. When losing weight, research indicates that postmenopausal women, the elderly, athletes, and people with metabolic disease are at a greater risk of complications such as fractures, fatigue, and lower bone density(3). All forms of intentional weight loss cause fat loss and, to a lesser degree, muscle loss. Decreased muscle mass leads to a slower metabolism, partially explaining why people tend to put weight back on after successful weight loss.
What can be done to minimize muscle loss?
Research shows that a combination of resistance exercise and increased protein intake can decrease how muscle loss. In fact, the high-protein/resistance exercise group lost more fat and preserved muscle. Everything must be done in moderation. It is best to approach exercise in a safe and motivating way. If you haven’t done resistance training before, you would benefit from starting with an exercise expert who can guide you to achieve your goals and minimize the risk of injury. In regards to protein consumption, one has to be careful. Just like Goldilocks, not too cold, not too hot, but just right. Not enough protein leads to muscle loss, but taking too much protein can contribute to decreased insulin sensitivity and possibly overload the kidneys.
Conclusion:
Suffering from obesity is dangerous to your health. All forms of weight loss can improve your health, but you should be very careful not to ignore some of the detriments that can occur with weight loss. Staying healthy requires a certain amount of fat, carbohydrates, and protein. During weight loss, you will likely lose some muscle, but it doesn’t have to negatively affect your health. Working with a team such as a medical weight loss specialist, nutritionist, and sports specialist can help you get the best results in an attempt to lose the fat and stay healthy.
Good luck, Dr. Leon Katz
References
- Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies Ian J. Neeland MD1,2 | Jennifer Linge PhD3,4 | Andreas L. Birkenfeld MD5,6,7,8 . Diabetes Obes Metab. 2024;1–12. https://dom-pubs.onlinelibrary.wiley.com/doi/pdf/10.1111/dom.15728
- Weight Loss Strategies and the risk of skeletal mass loss. David McCarthy, Phd and Aloys Berg, Phd. Nutrients 2021, 13, 2473 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308821/pdf/nutrients-13-02473.pdf
- Does Rapid Weight Loss From GLP-1s Decrease Muscle Mass? Yoon Ji Ahn, MD; Vibha Singhal MD, MPH. Medscape Diabetes & Endocrinology July 14, 2023. https://www.medscape.com/viewarticle/994030
Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.
 | ABOUT THE AUTHOR Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. He focuses on patients seeking alternatives to surgery and those needing care after bariatric procedures. Dr. Katz was recently the director of a major medical weight loss program. With extensive experience in establishing successful weight management programs, he now concentrates exclusively on non-surgical weight loss solutions. Dr. Katz is a Diplomate of the American Board of Obesity Medicine and Fellow of American College of Surgeons. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center. |
