9 ms·

> emerging research showing that up to 40 per cent of the weight lost by people using weight-loss drugs is actually muscle That's the sort of headlines that sm

• taeric 2y ago
  Yeah, folks don't like thinking that obese people have a lot of muscle needed to move around. And losing weight is losing all weight.
• hnthrowaway0328 2y ago
  Just curious, does your appetite come back whence you cut off the meds? The only reason I want to lose weight is to eat more freely, won't be useful if I lose my appetite too.
  • 0xB31B1B 2y ago
    Appetite comes back yes
  • andreareina 2y ago
    It does.
  • xeromal 2y ago
    I saw someone mention that they craved heroin less on ozympic.
  • cm2187 2y ago
    You don't lose taste, you lose your appetite, which means you can resist the temptation to eat easily, and you feel full very quickly. That doesn't prevent you from eating what you like, but it does help you to not eat too much of it, which I hope is not what you mean by "more freely". The appetite comes back when you cut the meds, but it's an appetite based on your new weight. But if you then go on a some suggar rampage, you will regain weight and your appetite will grow too. Those drugs are merely a guard rail to complete a diet successfully, but if people do not change their eating habbits, the same causes will produce the same effects after they cut the meds.
    • hnthrowaway0328 2y ago
      Thanks, that's good enough. I have been going to weight loss for over 6 months but I'm stuck between 79 and 80kg. It's a bit difficult to add more weight lifting because I tended to hurt myself, so eat less is better.
      • andy_ppp 2y ago
        Add walking for 2h per day is the recommended I’ve seen.
        • hnthrowaway0328 2y ago
          Thanks, 2h is a bit too much for me, so what I do is about 3-4 10-12 mins walk-sprint walk reps. Basically half walk (3.5m/h) and half sprint-walk (4.4m/h). I wish I could do more but my joints are not really good.
          • theendisney 2y ago
            Just walking is better. You get a steady burn. If you do high intensity you burn calories for a good while afterwards. Mild intensity doesnt do much.
      • throwaway2037 2y ago
        > It's a bit difficult to add more weight lifting because I tended to hurt myself Did you try slightly lower weight and higher reps? It is worth trying as an experiment. Current scientific literature says that 5-30 reps is the ideal range for gaining muscle mass. And, as you said, the relative heaviness of weights to the person makes a big difference for injury risk.
  • vundercind 2y ago
    Experiences vary but I worried I’d, like, not enjoy food on it. Nope, not a problem. I just get full much faster and am even more prone to simply not eating when I’m busy, than I already was. Not as food-focused when idle, but I still snack a little or whatever.
• denkmoon 2y ago
  god... 133kg down to 88kg, that's like a dream to me. Years of trying to get under 100 by 'traditional' calorie restriction diet & exercise.
  • throwaway14356 2y ago
    some fun study sort of concluded that the ratio carbs vs fat and protine is the entire mechanic. fat people who eat almost nothing eat only carbs thin people who can eat huge amounts every day eat a lot of fat and protein. Both eat other things just not as much.
    • throwaway14356 2y ago
      I really eat a lot. When my gf cooked more and the potato meat ratio changed from 1:3 to 3:1 I immediately started to grow fat. I had her adjust it to 1:1 and started eating lots of sausages and chicken legs between meals. 500g to a kg per day worth of extra food. My body fat declined rapidly.
  • renewiltord 2y ago
    One of my friends has tried many fad diets, etc. and he finally just went and paid cash for a GLP-1 and he's lost a lot of weight and is feeling much better. If I were in that situation, I would just do the same.
    • twelve40 2y ago
      bringing it down is not even half the battle, it's what happens next is the more interesting part
      • turbojet1321 2y ago
        You keep taking the GLP1 agonist, otherwise you gain the weight you lost.
      • renewiltord 2y ago
        These drugs are like psychedelics. There are lots of non users talking about them like they know them but all they did is read stuff in popular media. My friend cut usage after he lost weight and finds maintenance easy.
• firecall 2y ago
  Interestingly, when I was part of a weight loss diet study at my local university I actually gained muscle whilst losing weight. I had multiple full body dexascans during the programme. I didn’t change my exercise routine at all. I wasn’t hitting the gym or doing weights, just my usual basic cardio. And I gained muscle and lost ~10kilos in weight. It wasn’t much muscle, but the amount of muscle was higher than before.
  • philipbjorge 2y ago
    The latest research I’ve pulled suggests that DEXA scans are fairly inaccurate and aren’t a reliable way to measure body composition even for the same person across time. MRI is the gold standard, everything else is pretty loosely goosey. Sorry, no references but this comes up pretty often in the science based lifting communities on Reddit and YouTube if you want to learn more.
    • cthalupa 2y ago
      https://macrofactorapp.com/body-composition/ https://macrofactorapp.com/body-composition/ Estimates in level of inaccuracy on the high end ranges from ~5% to ~10% If you see your lean mass going up in DEXA, your muscles are getting larger, and you're getting stronger, particularly across a wide variety of exercises where CNS adaptation can't explain the strength gains, they're likely broadly accurate. Mine have all tracked quite closely with what I'm seeing in the mirror and what is happening when it comes to the amount of weight I'm moving.
• throwup238 2y ago
  The next line of the article after that 40% quote: > Carla Prado, a nutrition researcher in the Faculty of Agricultural, Life & Environmental Sciences and lead author on the commentary, explains this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets or normal aging and could lead to a host of long-term health issues — including decreased immunity, increased risk of infections and poor wound healing. The rather obvious problem is that these GLP1 agonists don't improve your diet. If you continue to eat a protein and nutrient deficient diet (which is probably a majority of Americans) with caloric restriction on top of that, that leads to excessive muscle loss that you wouldn't see in a weight loss diet. This normally doesn't happen without GLP1 agonists, because these diets are too difficult to stick to for most people. Those who stick to them usually turn to nutritious high satiety whole foods that help combat the negative effects of caloric restriction. Losing weight without losing muscle mass is very hard. It requires extreme diets like a protein sparring modified fast where 80%+ of your calories are from lean protein while running a 50% caloric deficit. If this research is correct, then using GLP1 agonists shortcuts the feedback loops that make the diets hard to stick to, but they shift the tradeoffs from weight to overall nutrition. "When a measure becomes a target, it ceases to be a good measure" and all that.
  • chunky1994 2y ago
    I'd like to see the diets in the study that are specified as the "calorie-reduced diets". (Can't seem to find the paper). If it's the same as the Standard American Diet, this muscle loss is quite explainable. I think the mitigation is relatively easy though, if you want to shift the p-ratio, recommending a daily high protein shake would do a lot to stave off muscle loss (and even more if resistance training is applied of course). The exercise addition is probably the hardest to adhere to.
    • groby_b 2y ago
      I'd be surprised if either mice or human cells eat "the Standard American Diet"
  • loeg 2y ago
    I'm pretty skeptical of the "this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets" claim. I suspect we're comparing apples to oranges rather than doing like-for-like comparisons at equivalent calories.
• adrian_b 2y ago
  See the actual research article: https://www.sciencedirect.com/science/article/pii/S2452302X24002869 https://www.sciencedirect.com/science/article/pii/S2452302X2... This study on mice was suggested by a previous publication: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00272-9/abstract https://www.thelancet.com/journals/landia/article/PIIS2213-8... where it had been noticed that in humans "the muscle loss with these medications (as indicated by decreases in fat-free mass [FFM]) ranges from 25% to 39% of the total weight lost over 36–72 weeks", in comparison with muscle loss of only 10% to 30% when the weight is lost just by eating less, without semaglutide. So with semaglutide, a larger fraction of the weight loss affects muscles than when the same weight is lost by traditional means. While for other muscles the loss of mass may not be so important, the fact that at least in mice the loss also affects the heart is worrisome and it certainly warrants further studies.
  • petesergeant 2y ago
    > Studies suggest muscle loss with these medications (as indicated by decreases in fat-free mass [FFM]) ranges from 25% to 39% of the total weight lost over 36–72 weeks. This substantial muscle loss can be largely attributed to the magnitude of weight loss, rather than by an independent effect of GLP-1 receptor agonists, although this hypothesis must be tested. By comparison, non-pharmacological caloric restriction studies with smaller magnitudes of weight loss result in 10–30% FFM losses Emphasis my own. In short: no evidence this is anything other than due to rapid weight-loss.
    • adrian_b 2y ago
      The part highlighted by you was just an optimistic supposition made at the time when the first article has been published. That supposition only expressed wishful thinking that was not based on any data. The study on mice published in the second article has been made specifically to test this optimistic supposition and the results have shown that it had been false, i.e. the weight loss caused by semaglutide is different from the weight loss caused only by calorie restriction. More studies are needed to elucidate whether this effect of semaglutide is really harmful or maybe it can be reversed or avoided by combining the medication with a better diet, e.g. with a higher protein intake.
• makeitdouble 2y ago
  I don't have it at hand [edit: [0]] but there are a number of studies showing exercice had more health impact than weight loss (you can combine both of course, but just losing weight has less benefits) As you point out, losing muscle is common in a diet, and the researchers are well aware of it. Their point was that this aspect is not pushed enough and is drowned by the losing weight part. From the paper: > Dismissing the importance of muscle loss can create a disconnect between patients' increased awareness of muscle and the role it plays in health, and clinicians who downplay these concerns, affecting adherence to and the development of optimised treatment plans. [0] https://journals.lww.com/acsm-csmr/Fulltext/2019/08000/Effects_of_Physical_Activity,_Exercise,_and.5.aspx https://journals.lww.com/acsm-csmr/Fulltext/2019/08000/Effec... For the "Fitness Versus Fatness" part for instance
• colordrops 2y ago
  So it smells like bullshit because of your personal anecdote? Or because some scientific evidence or experience you have?
• jostmey 2y ago
  Biology is super complicated with lots of surprising dependencies between different biological pathways. So it is possible. That said, I am skeptical as well. For example, if the body sheds 15% of its weight, does the heart naturally shrink by 15% as well? With so many people taking these drugs, there is enough data to begin to profile the rare risks of these drugs in humans (the clinical trials would have found any of the obvious risks)
• NoPicklez 2y ago
  The article does dissect the difference between weight loss drugs and dieting in general. Where they found that muscle mass loss was higher in those that took the drug as opposed to those who followed a calorie restricted diet. To your point, the drug is absolutely to do with it if by taking the drug people need to be more mindful of the types of food they eat, if they have a smaller window to consume nutrients. It is most certainly a contributor and for some who may not exercise like you, or consume an appropriate level of protein this research may show that those taking the drug need to focus on a more protein right diet.