The Muscle Mass Dilemma: How Ozempic and Wegovy Affect Lean Body Mass and What You Can Do About It

Introduction

GLP-1 receptor agonists like Ozempic and Wegovy have changed how people manage weight loss and diabetes. These medications help people lose weight by reducing hunger and slowing digestion, but one major downside is that a significant portion of the weight loss includes muscle, not just fat. Research shows that up to 40% of the total weight lost on GLP-1 therapy comes from lean body mass (LBM), which includes muscle. Losing muscle can slow metabolism, reduce strength, and make long-term weight maintenance harder.

This article explains how GLP-1 medications affect muscle mass, what recent studies say about the risks, and how to prevent muscle loss while taking these medications.

Based on findings from the study "Changes in Lean Body Mass with Glucagon‐Like Peptide‐1-Based Therapies and Mitigation Strategies" by Ian J. Neeland MD et al., affiliated with the Case Western Reserve University School of Medicine in Cleveland, Ohio, USA, published in Diabetes, Obesity & Metabolism (2024).

How Do GLP-1 Medications Affect Muscle Mass?

GLP-1 medications work by reducing appetite and making people eat less. As a result, the body burns stored fat for energy, but it may also break down muscle. The study found that 37-40% of weight lost on GLP-1 therapy came from muscle (Ian J. Neeland MD et al., 2024). This is a problem because muscle is essential for staying strong, keeping a fast metabolism, and preventing frailty, especially as people age.

Why Does Muscle Loss Happen?

• Eating Less Overall: A big calorie deficit can cause the body to break down muscle along with fat.

• Not Enough Protein: Since GLP-1 medications reduce appetite, some people don’t eat enough protein necessary to maintain muscle.

• Less Physical Activity: Some people on these medications feel tired or don’t work out as much, which leads to muscle loss.

• Hormone Changes: Weight loss can affect hormones like insulin and testosterone, which help maintain muscle.

• Aging: Older people naturally lose muscle over time, so rapid weight loss can make the problem worse.

How to Keep Muscle While Losing Weight

If you’re using GLP-1 medications, here are some ways to lose fat while keeping your muscle mass:

1. Eat More Protein

People on GLP-1 therapy often eat 20-30% fewer calories per day, which may mean they don’t get enough protein (Ian J. Neeland MD et al., 2024). Experts recommend eating 1.2–2.0 grams of protein per kilogram of body weight (or 0.54–0.91 grams per pound) to help preserve muscle. Good protein sources include:

• Lean meats like chicken, turkey, and fish

• Eggs and dairy

• Plant-based proteins like tofu, beans, and lentils

• Protein powders like whey, casein, or plant-based options

2. Strength Training is Key

Strength training, including lifting weights, is one of the best ways to protect muscles. Studies show that people who do resistance training while taking GLP-1 medications can reduce muscle loss by up to 30% (Ian J. Neeland MD et al., 2024). Aim for 2–3 strength workouts per week, focusing on exercises like:

• Squats and lunges (for legs and glutes)

• Deadlifts and rows (for back and core strength)

• Push-ups and presses (for chest and shoulders)

• Core workouts like planks and twists

3. Try EMS Training

EMS training, like Katalyst, is a great alternative to traditional workouts, especially for people who feel tired on GLP-1 medications. EMS can activate up to 90% of muscle fibers during a session, helping to preserve muscle even with a lower activity level. EMS training:

• Stimulates muscles without heavy lifting

• Helps improve strength while cutting fat

• Supports recovery and reduces joint stress

4. Track Your Body Composition

Instead of just focusing on weight loss, incorporate strength training and check your body fat percentage and muscle mass using tools like DEXA scans or bioelectrical impedance scales. The study found that people who tracked their body composition while following a structured diet and workout plan were able to keep 70-75% of their muscle mass while losing weight (Ian J. Neeland MD et al., 2024).

5. Stay Active Beyond Workouts

Moving throughout the day and incorporating strength training can help keep your muscles engaged. Try:

• Walking 8,000–10,000 steps per day

• Doing light bodyweight exercises like squats and push-ups

• Stretching and mobility exercises

• Yoga or recreational sports

6. Get Expert Guidance

A nutritionist or trainer can make a big difference in maintaining muscle. Research shows that people who worked with professionals kept up to 85% of their muscle mass while losing weight (Ian J. Neeland MD et al., 2024).

Conclusion: Losing Fat Without Losing Muscle

GLP-1 medications like Ozempic and Wegovy are powerful for weight loss, but they can also lead to muscle loss if you’re not careful. The key points to remember are:

• Up to 40% of weight lost on GLP-1 therapy may be muscle mass

• Eating enough protein, strength training, and EMS workouts can help prevent muscle loss

• Tracking body composition is more important than watching the scale

• A structured fitness plan can help you maintain 70-85% of your muscle while losing weight

To get the best results, focus on eating enough protein, doing traditional resistance training or Katalyst EMS, and tracking your muscle mass. You can healthily lose weight while staying strong and fit for the long run by taking the proper steps.