Combating Muscle Loss Associated with Weight Loss Drugs
There’s a downside to the fat loss associated with weight loss drugs like Ozempic; muscle loss. To be clear, I have no opinion on Ozempic (this is beyond my scope of practice). However, emerging research on weight loss drugs indicates that patients are losing weight (a good thing) but a high percentage of this weight loss is muscle (a bad thing). Of course, this is an undesirable consequence as muscle is our most important ally in maintaining fat loss as muscle influences our metabolic rate (and our daily calorie expenditure). More broadly, muscle is an endocrine organ and a key index of both health and longevity.
In a normal fat loss progression, approximately one-third of the weight that is lost is muscle. If you lose 15 pounds of weight, for example, we can expect that five pounds of this weight loss is muscle (this percentage is probably higher for adults over 50 years of age). Thus, for decades, we’ve taught clients who are interested in weight loss to combine a sensible eating plan (the key to weight loss) with an intense strength training program. The goal is to increase or at least maintain as much muscle tissue as possible. A realistic outcome might be 15 pounds of weight loss with 1 pound of lean muscle increase (thus, 16 pounds of actual fat loss).
Early research on weight loss drugs indicates that muscle loss might be exacerbated with early trials showing that over 50% of total weight loss is muscle loss. Additionally, when weight is regained, the weight is regained almost entirely as fat (patients don’t regain the muscle). In some cases, patients have lost weight but actually become fatter.
Of course, the remedy to this is intense strength training.
The simple checklist for maintaining or increasing lean muscle while on a fat-loss drug:
Strength training twice per week.
Continue each set to the point of momentary muscle failure.
Perform total body workouts – legs, midsection, and upper body.
Increase protein intake to 0.7-1.0 grams per pound of body weight.
Consider supplementing with creatine.
Avoid an intermittent fasting approach to eating.
