Ozempic and Wegovy could help you shed unwanted pounds and keep obesity-related disease at bay — but you could lose some muscle in the process, some experts warn.
Rapid weight loss can result in a condition called sarcopenia, defined as “the gradual loss of muscle mass, strength and function,” according to Healthline — but there are steps you can take to reduce the risk while still maintaining a healthy weight.
Semaglutide medications such as Ozempic and Wegovy cause weight loss through a combination of mechanisms, including delayed gastric emptying and the GLP1 hormones that signal the stomach to feel full, noted Andrew Y. Sun, M.D., a board-certified urologist and chief medical advisor for Marius Pharmaceuticals in Dallas-Ft. Worth, Texas.
“Both of these result in a caloric restriction that causes weight loss,” he told Fox News Digital.
When people shed pounds, it results in a combination of both fat loss and muscle loss.
“In the clinical studies for drugs in the GLP1 class, the data indicated that 40% to 50% of the weight loss comes from lean muscle mass instead of fat,” Sun said. “When you lose muscle mass, your resting metabolic rate, or the rate the body burns calories, also declines.”
While all patients are susceptible to the loss in muscle mass, women tend to lose more than men, noted Dr. Brett Osborn, a Florida neurologist, longevity expert and bodybuilder.
“One of the primary factors has to do with circulating testosterone levels,” he told Fox News Digital.
“Women have lower levels naturally and have lesser muscle mass at base level. In a caloric deficit, testosterone levels further decrease, and there is potential for significant muscle loss (sarcopenia). This similarly occurs in the aged population.”
‘More susceptible to falls’
The health effects of losing muscle can be more dangerous for certain patients than others, Sun noted.
“When you lose muscle or when you have insufficient amounts of muscle tissue, you are more susceptible to falls and fractures,” he warned.
“It makes recovery from illness and injury more difficult and, in general, leads to frailty and a more sedentary lifestyle that can, in extreme cases, increase the likelihood of death.”
Older patients are particularly at risk, he said, but all adults start losing muscle mass as a natural part of the aging process.
“This begins as early as your 30s and 40s, picking up significantly as adults approach 65,” Sun said. “Some suggest that adults may lose up to 8% of muscle mass each decade.”
“When you lose muscle or when you have insufficient amounts of muscle tissue, you are more susceptible to falls and fractures.”
Then, “when you take a semaglutide drug like Ozempic, Wegovy or Mounjaro, you’re significantly increasing this muscle loss — and that can be concerning if you’re an at-risk patient.”
Osborn emphasized the importance of muscle as a protector from disease.
“Our muscle is our resilience,” he said. “In addition to being aesthetically pleasing, muscle tissue serves as a protein depot from which antibodies form, allowing us to fend off pathogens.”
Muscle also acts as a “glucose filter,” he noted, which helps to regulate blood sugar and reduces the risk of heart disease and diabetes.
“The less muscle you have, the more susceptible you are to these diseases — so, muscle is critical to your health.”
‘Pay close attention’
People can take certain steps to counter the risk of semaglutide-related muscle loss, experts agree.
“It starts with heightened surveillance from both the patient and the physician,” Osborn told Fox News Digital.
He recommends that physicians conduct regular body measurements of patients and adjust the medication dosage if benchmarks are not being met.
“Patients need to pay close attention to their waistlines and their muscle mass relative to their total body weight,” said Osborn. “A male’s body weight ideally should be comprised of 50% muscle and a female’s should be 45%.”
Achieving that ratio will help stave off age-related diseases such as coronary artery disease, type 2 diabetes, cancer and Alzheimer’s, the doctor said.
“It will also protect you from frailty and the associated lack of mobility that place you at a high fall risk, which is a major cause of morbidity and mortality in people over the age of 50,” he said.
It’s also critical that every patient attempts to meet their prescribed daily calories, Osborn said.
“The less muscle you have, the more susceptible you are to diseases — so, muscle is critical to your health.”
“In my clinic, we shoot for a caloric intake equal to one’s sedentary basal metabolic rate, or BMR,” he said. “We allow the medication to create a slight caloric deficit to assist in weight loss, but we do not recommend that patients starve themselves, as is often seen in the media.”
One way to stimulate appetite is through strength training, Osborn noted, which also helps to temper muscle loss.
Sun agreed that patients on semaglutide therapy should adopt strength and resistance training — combined with a high-protein diet — to offset the effects of muscle loss.
In some cases, Osborn also prescribes hormone replacement therapy to support an individual’s muscle mass.
“Using this protocol, we can maintain muscle despite Ozempic usage while driving fat loss, which is a double bonus — and truly the best of both worlds,” he said.
Looking ahead, Sun said he hopes that the next generation of weight-loss drugs will be more focused on balanced body composition rather than fat loss.
“Until then, there are circumstances where muscle loss should prompt conversations between the physician and patient about lifestyle changes and concomitant use of other drugs like testosterone to maintain muscle mass,” he added.
Fox News Digital reached out to Novo Nordisk, the manufacturer of Ozempic and Wegovy, requesting comment on the medication’s potential to increase muscle loss.