11/03/2025
claims that HALF of the weight loss on GLP1 medications like Ozempic is muscle mass! This is plain false.
Based on randomized controlled trials, these medications result in about 40% lean mass loss, which includes muscle mass AND “water weight” and other tissues. Only about half of that is muscle mass, so these medications, on average, result in about 60% fat loss, 20% muscle loss, and 20% loss of other mass (eg. “water weight”). This is similar to the muscle loss that occurs with significantly cutting calories WITHOUT medication. When you lose weight, some of it will be muscle loss, but the hope is that most of it is fat loss, which is the case with these medications.
However, those numbers I cited are WITHOUT resistance training. Engaging in weightlifting or bodyweight exercises can help to preserve muscle. Also, it’s worth noting that, even without advising for resistance training, the use of these medications can lower the risk of major cardiovascular events like heart attacks and strokes by 13%, kidney failure by 9%, and all-cause mortality, the risk of dying during the first ~2.4 years on these medications, by 12% based on a systematic review and meta-analysis of 21 trials and about 100,000 people.
Finally, we have now seen reductions in obesity prevalence in the USA 3 years in a row after what was almost year-after-year increases in obesity for the past few decades. These medications are working in a way that no diet trend ever did. Let’s celebrate the fact that we have such an amazing tool and not fear-monger over or exaggerate the muscle loss or other adverse effects.
References:
https://www.sciencedirect.com/science/article/pii/S0002916525002400?via%3Dihub
https://pubmed.ncbi.nlm.nih.gov/37807154/
https://pubmed.ncbi.nlm.nih.gov/40892610/
https://news.gallup.com/poll/696599/obesity-rate-declining.aspx