A new study says that weight loss medications can be the cause of declining skeletal muscle health. In a recent commentary published in The Lancet journal, researchers from the US and Canada highlighted the critical importance of skeletal muscle mass in the context of medically induced weight loss, particularly with the widespread use of GLP-1 receptor agonists.

GLP-1 receptors are present in popular weight loss and diabetes drugs like Ozempic, Wegovy, Mounjaro and Zepbound. GLP-1 receptors are proteins found on cell surfaces and they play an important role in regulating blood sugar levels and metabolism. These receptors stimulate insulin secretion from the pancreas while inhibiting the release of glucagon which is a hormone that raises blood sugar levels. This helps to lower blood sugar after eating.

GLP-1 receptors also influence appetite control, thereby, improving feelings of fullness and potentially helping in weight management. Drugs that mimic GLP-1, known as GLP-1 receptor agonists, have been developed to help manage type 2 diabetes and obesity by improving these natural effects, thus helping in blood sugar control and supporting weight loss.

The researchers from Pennington Biomedical Research Center in the US, Universities of Alberta and McMaster in Canada argued that while the drugs have shown extreme potential in treating obesity which is a precursor for many diseases like diabetes, hypertension and cancer, they can also lead to substantial muscle loss as part of the weight loss process.

They noted that muscle loss which is measured by decreases in fat-free mass can account for 25 to 39 per cent of total weight lost through the 36 to 72 weeks. The role of skeletal muscle is not only for maintaining physical strength and function but it is also important for metabolic health and regulation of the body’s immune system.

The team found that GLP-1 receptor agonists lead to significantly larger muscle decline than with a non-pharmacological caloric restriction diet or normal ageing. This, the researchers said, “could lead to unintended negative health consequences”.

People with poor muscle mass have decreased immunity, and are at increased risk of infections, poor glucose regulation, and other health risks. Further, the researchers noted that muscle loss caused by weight reduction can also worsen sarcopenic obesity -- prevalent among individuals with obesity, and contributes to cardiovascular disease and higher mortality rates.

Dr Steven Heymsfield, professor of metabolism and body composition at Pennington, called on people going for weight loss drugs to be “mindful of the side effects”. He added that, while on the medications people are “eating less and not getting the appropriate amount of dietary vitamins and minerals”. The researchers suggest that an adequate amount of protein along with an optimum amount of exercise should be explored along with the medications.

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