Muscle mass plays a crucial role in mobility and other health paradigms, especially for older adults. The use of GLP-1 receptor agonists for obesity management is revolutionary for weight loss, but their use may, for some patients, lead to issues. While these drugs are highly effective in promoting weight loss, studies suggest that a significant portion of this weight loss includes muscle mass. For example, data indicates that up to 39% of weight lost on GLP-1 treatments like semaglutide and liraglutide may come from lean mass (some of which will be muscle), not fat. This is particularly concerning for older adults, who are already at risk for age-related muscle loss (sarcopenia).
Why does muscle matter in this context? Muscle mass isn’t just about physical strength; it plays a critical role in metabolic health, supporting functions like glucose regulation and immune response. It is also a functional reserve, and its mass is associated with better prognoses in cancer and many other situations. Loss of muscle mass can compromise these functions.
Compounding the issue, many people don’t adhere to GLP-1 treatments as prescribed (despite the statement that people will stay on these drugs for life). Real-world studies show that up to two-thirds of patients discontinue GLP-1 therapies within the first year. When people stop these medications, they often experience a rapid regain of weight—almost assuredly as fat rather than any muscle. This rebound can set older adults up for sarcopenic obesity, a dangerous combination of low muscle mass and higher fat mass.
Given these issues, it’s vital to consider strategies that preserve muscle mass during weight loss, such as incorporating resistance training and ensuring adequate protein intake. For older adults, maintaining muscle is not just about looking fit—it’s about supporting overall metabolic health and reducing the long-term risks of sarcopenic obesity.
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