8 ms·

Is the muscle loss a side effect of the drug or of the weight loss?

Dma54rhs 2y ago
eating less calories always has that side effect, you can train and eat protein to minimize it tho just like with regular diet
Bluescreenbuddy 2y ago
The loss. You eat less so you're probably eating less protein. And if you used to be heavy then it's safe to say you probably had some muscle mass and you're going to lose that with the caloric deficit especially if you're not exercising.
borgdefenser 2y ago
Lean mass is just non-fat mass. That includes much more than just muscle. I can't find any evidence that GLP-1 are catabolic to muscle mass. There is no evidence I can find that GLP-1s do anything above what calorie restriction does. There is a linear relationship between calorie restriction and fat loss down to under 10% body fat. There is so much wrong information on calorie restriction from studies done on people who were literally starving with already very low body fat %. Then apply that to people with 25% body fat is just wrong. Westerners trying to lose weight don't have this problem. I think part of the obesity epidemic is this insane idea that calorie restriction is bad. Everyone kind of understands the thermodynamics of calories in / calories out. Everyone even kind of understands the benefits of fasting. At the same time though there is this nonsense that if you restrict calories too much you start burning all this muscle mass. It is patently absurd. Add up the calories of what a 250lb bodybuilder is eating for contest prep to lose fat and you will see they are "starving" too.
- MrMcCall 2y ago
  YOU ARE ABSOLUTELY CORRECT. READ ^THIS^, FRIENDS. In the end, it really is just metabolic math. As a former wrestler who did some insane weight-losing in my youth, the muscle mass loss is due to extreme calorie restriction. Besides, just sitting around starving is not a good way to become healthier in the long run, and that's where the muscle loss will be worst. To be a true journey towards better health, dieting should be accompied by at least a lot of walking and some light weight training, in the minimum. And don't forget your supplements, kids (addressing general readership), because our foods are less nutrient dense in 2025, so find out if some supplements help energy levels on the downslope. Me and my teenagers have taken a sip / mini-gulp of a product called 'Orgain' daily for a month or so, and I have found my energy better, while having less cravings. An entire little 11oz single-size drink is way too much for me (too many vitamins, makes me sleepy), having 'just a little bit' is not at all scientific, but we seem to be thriving on that little bit of supplementation. And, as always, avoid those processed sugars, kids! Whole sugar cane is very, very good for us, but only in moderate doses. Processed sugar is the crack cocaine of sugar cane, as opposed to just chewing a leaf of the coca plant.
  - borgdefenser 2y ago
    I only wrestled for 2 weeks in 8th grade but have ASICS MATCONTROL 3 on right now. My gym shoes :) High school wrestling though might push things too far.Many of those guys under heavyweight do not have the bodyfat % to be restricting so much so are actually losing muscle mass. I know Jordan Burroughs diet that I have seen seemed like maximum micro nutrients for the calorie because how else can you eat to be a 4 time world champion at 74kg? I am probably half an inch taller than Burroughs and 163lbs is impossible. It is too far. Way too far.
- hombre_fatal 2y ago
  Yeah, I just went down a rabbit hole re-looking this up myself. It seems that there's nothing unique about semaglutide, and %FFM loss is just a function of how rapidly you lose weight. The most rapid losers on semaglutide have the same %FFM loss (30%) as bariatric patients, for example. And if you don't want to lose weight that fast, you can just temper the dose (unlike with bariatric surgery).
  - s1artibartfast 2y ago
    Or eat protein and exercise. I think it's extremely probable that the most rapid losers are running the largest calorie deficit and also the largest protein deficit.
    - borgdefenser 2y ago
      There is an age/hormone variable too. I would have said just eat protein and work out when I was in my teens, 20s and early 30s too. I am 48 and not on testosterone, yet. I actually can't recover at this point from workouts that burn enough calories vs working out less but more calorie restriction in terms of fat loss. Even 60 minute walks cause me to be more hungry to be able to recover from than what I can restrict without walking. I am at the final death throws of natural and not being on TRT basically. I have been pushing TRT out since my late 30s but have gone way too far. I think the TRT threshold probably be when you can't outrun calorie restriction by working out. For me, that has probably been since 43 or 44. By 46 for sure. Personally, I don't need GLP-1s. So many people though do.
  - borgdefenser 2y ago
    Keep in mind I am not using GLP-1s myself because I am unsure of the long term risks. What worries me is if what if in 20 years of use, something with insulin gets blown out? There is a chance it could be a drug for life like testosterone. We know though how devastating obesity is on health so it is really going to be up to the individual to take the risk. Not really my business at that level.
lores 2y ago
The drug does not directly affect muscle mass (unless you are already very lean), but heavy people are doing resistance training against their own body weight all the time, so they are strong in the absolute, even if not relatively. Weigh less and your muscles have it easier, so weaken, unless you keep them strong with exercise.
- wincy 2y ago
  I’m not sure that’s exactly what’s happening with GLP-1 drugs. I lost 40 pounds very quickly on them and hurt my hip then my shoulder then my wrist. Felt like I was constantly getting muscle strains and random injuries. I started drinking a protein shake once a day and the random mysterious injuries stopped.
  - lores 2y ago
    I'm on them too, and after being seriously grumpy for a while it dawned on me that not being hungry doesn't mean my body doesn't need satisfying food. I think it's easy to fall into 'don't need to eat, won't eat' and then get some form of malnutrition. I force myself to make good food and just eat less of it, so far it worked *fingers crossed*
  - droopyEyelids 2y ago
    What you described doesn’t seem to be in conflict with what he described
    - wincy 2y ago
      If the muscles had been reducing in concert with the reduced musculature needs of my body I wouldn’t be injuring myself.
  - aaronblohowiak 2y ago
    the caloric restriction that these drugs engender can indeed lead to various forms of under-nourishment. as you point out, your protein needs (as a proportion of calorie sources) go UP when you are in caloric restriction; see PSMF.
znpy 2y ago
Both. Muscle loss is due to not eating enough proteins to maintain muscle mass. You can lose muscle mass without drugs just by eating poorly (and not doing adequate movement)
pajamasam 2y ago
According to this article, it's a side effect of Ozempic itself. The article goes on to say that the newly discovered molecule can side-step the side-effect and metnioned that "obese mice treated with daily injections of BRP for 14 days lost an average of 3 grams—due almost entirely to fat loss..."
- stavros 2y ago
  We don't know yet whether the muscle loss is caused by the drug itself or due to the weight loss, there are some studies but I haven't seen any conclusion yet one way or the other. Anecdotally, a friend of mine was on a diet and exercise regime, then at some point he switched to Mounjaro to reduce cravings, while keeping the same diet and exercise regime (he's a data geek so he documented things pretty well), and his muscle gain maybe slowed a tiny bit, but didn't reverse on Mounjaro. Sample size of one, but at least it's not zero.
  - malfist 2y ago
    Also sample size of one, but with the weight loss from semaglutide, I've gotten back in the gym and I can now lift more weight than I ever have. It feels fantastic (both the weight loss and being strong)
    - stavros 2y ago
      I envy you. I tried three times and got bad side effects each time, so I've given up :(
      - MrMcCall 2y ago
        I feel for you, friend. The safest way, however, is to make hunger your friend, and walk an hour or two a day. That may not work well with your work schedule, but you can override your body with your mind, unless your mind suffers because of our tech work's energy needs. And, it takes me a day or two to get past a processed sugar addiction. After those couple of days, the body starts getting used to not having that "crack" energy source be a part of its desire-base. Good luck, stavros, you can do it! And the sooner you start, the quicker you can get over the initial hump of resistence. Perhaps you can carrot yourself along by knowing that you WILL feel much, much better as the pounds start coming off and your body starts being able to walk a bit further or lift a few more weights. Fight the food inertia, my brother. If you really want extra help, contact the Creator of the universe in the morning and evening, and ask It for help. If you do that with an intention to be able to better help others, you will find that the universe, itself, will become your ally.
crazygringo 2y ago
It's nearly always a side effect of weight loss, and it's a good thing. It's confusing how people act like it's bad. If you're obese, your legs are enormously strong with crazy amounts of muscle. Have you ever seen someone obese do leg presses at the gym? They can handle tons of weight. When you lose weight, you don't need all that extra muscle. If you're carrying around 180 lbs instead of 300 lbs on your frame, all that extra muscle goes away because there's no point in keeping it. This is a good thing. Even if you go from 200 lbs to 180 lbs, there's a level of muscle you don't need anymore. Losing muscle as you lose weight is natural and good. Now, obviously you don't want to lose so much that you become weak for your size, but that won't happen if you continue to be physically active. Your body is exceptionally good at maintaining the exact right level of muscle to meet the regular stresses it undergoes. (Provided you are eating enough protein, but that's easy.)
- ch4s3 2y ago
  I think the downside is that you don't just lose muscle in your legs and core, but rather you lose muscle mass all over. Yes, this is the expected result of calorie restriction but the issue is that when people lose a lot of weight without taking action to build and maintain muscle the amount of muscle loss they experience can cause other problems. Someone relying on a GLP-1 drug is often someone who isn't very active at all.
  - crazygringo 2y ago
    > but rather you lose muscle mass all over. Well, you lose weight all over. You lose fat in your arms and your shoulders don't need to be quite as strong. You lose weight on your face and your neck muscles don't need to be quite as strong. You lose more in your legs, but you're supposed to lose muscle mass all over. > Someone relying on a GLP-1 drug is often someone who isn't very active at all. Sure, but that's a completely separate issue. It doesn't have anything to do with weight loss. Being in good strong physical shape is great, but nobody should expect weight loss to magically result in strength. That's like thinking you can stop going to the gym but won't lose any of the muscle you'd previously built up. It's got nothing to do with weight loss though. It's got to do with the fact that you're not working out.

eating less calories always has that side effect, you can train and eat protein to minimize it tho just like with regular diet

Bluescreenbuddy 2y ago

The loss. You eat less so you're probably eating less protein. And if you used to be heavy then it's safe to say you probably had some muscle mass and you're going to lose that with the caloric deficit especially if you're not exercising.

borgdefenser 2y ago

Lean mass is just non-fat mass. That includes much more than just muscle. I can't find any evidence that GLP-1 are catabolic to muscle mass. There is no evidence I can find that GLP-1s do anything above what calorie restriction does. There is a linear relationship between calorie restriction and fat loss down to under 10% body fat. There is so much wrong information on calorie restriction from studies done on people who were literally starving with already very low body fat %. Then apply that to people with 25% body fat is just wrong. Westerners trying to lose weight don't have this problem. I think part of the obesity epidemic is this insane idea that calorie restriction is bad. Everyone kind of understands the thermodynamics of calories in / calories out. Everyone even kind of understands the benefits of fasting. At the same time though there is this nonsense that if you restrict calories too much you start burning all this muscle mass. It is patently absurd. Add up the calories of what a 250lb bodybuilder is eating for contest prep to lose fat and you will see they are "starving" too.

MrMcCall 2y ago
YOU ARE ABSOLUTELY CORRECT. READ ^THIS^, FRIENDS. In the end, it really is just metabolic math. As a former wrestler who did some insane weight-losing in my youth, the muscle mass loss is due to extreme calorie restriction. Besides, just sitting around starving is not a good way to become healthier in the long run, and that's where the muscle loss will be worst. To be a true journey towards better health, dieting should be accompied by at least a lot of walking and some light weight training, in the minimum. And don't forget your supplements, kids (addressing general readership), because our foods are less nutrient dense in 2025, so find out if some supplements help energy levels on the downslope. Me and my teenagers have taken a sip / mini-gulp of a product called 'Orgain' daily for a month or so, and I have found my energy better, while having less cravings. An entire little 11oz single-size drink is way too much for me (too many vitamins, makes me sleepy), having 'just a little bit' is not at all scientific, but we seem to be thriving on that little bit of supplementation. And, as always, avoid those processed sugars, kids! Whole sugar cane is very, very good for us, but only in moderate doses. Processed sugar is the crack cocaine of sugar cane, as opposed to just chewing a leaf of the coca plant.
- borgdefenser 2y ago
  I only wrestled for 2 weeks in 8th grade but have ASICS MATCONTROL 3 on right now. My gym shoes :) High school wrestling though might push things too far.Many of those guys under heavyweight do not have the bodyfat % to be restricting so much so are actually losing muscle mass. I know Jordan Burroughs diet that I have seen seemed like maximum micro nutrients for the calorie because how else can you eat to be a 4 time world champion at 74kg? I am probably half an inch taller than Burroughs and 163lbs is impossible. It is too far. Way too far.
hombre_fatal 2y ago
Yeah, I just went down a rabbit hole re-looking this up myself. It seems that there's nothing unique about semaglutide, and %FFM loss is just a function of how rapidly you lose weight. The most rapid losers on semaglutide have the same %FFM loss (30%) as bariatric patients, for example. And if you don't want to lose weight that fast, you can just temper the dose (unlike with bariatric surgery).
- s1artibartfast 2y ago
  Or eat protein and exercise. I think it's extremely probable that the most rapid losers are running the largest calorie deficit and also the largest protein deficit.
  - borgdefenser 2y ago
    There is an age/hormone variable too. I would have said just eat protein and work out when I was in my teens, 20s and early 30s too. I am 48 and not on testosterone, yet. I actually can't recover at this point from workouts that burn enough calories vs working out less but more calorie restriction in terms of fat loss. Even 60 minute walks cause me to be more hungry to be able to recover from than what I can restrict without walking. I am at the final death throws of natural and not being on TRT basically. I have been pushing TRT out since my late 30s but have gone way too far. I think the TRT threshold probably be when you can't outrun calorie restriction by working out. For me, that has probably been since 43 or 44. By 46 for sure. Personally, I don't need GLP-1s. So many people though do.
- borgdefenser 2y ago
  Keep in mind I am not using GLP-1s myself because I am unsure of the long term risks. What worries me is if what if in 20 years of use, something with insulin gets blown out? There is a chance it could be a drug for life like testosterone. We know though how devastating obesity is on health so it is really going to be up to the individual to take the risk. Not really my business at that level.

lores 2y ago

The drug does not directly affect muscle mass (unless you are already very lean), but heavy people are doing resistance training against their own body weight all the time, so they are strong in the absolute, even if not relatively. Weigh less and your muscles have it easier, so weaken, unless you keep them strong with exercise.

wincy 2y ago
I’m not sure that’s exactly what’s happening with GLP-1 drugs. I lost 40 pounds very quickly on them and hurt my hip then my shoulder then my wrist. Felt like I was constantly getting muscle strains and random injuries. I started drinking a protein shake once a day and the random mysterious injuries stopped.
- lores 2y ago
  I'm on them too, and after being seriously grumpy for a while it dawned on me that not being hungry doesn't mean my body doesn't need satisfying food. I think it's easy to fall into 'don't need to eat, won't eat' and then get some form of malnutrition. I force myself to make good food and just eat less of it, so far it worked *fingers crossed*
- droopyEyelids 2y ago
  What you described doesn’t seem to be in conflict with what he described
  - wincy 2y ago
    If the muscles had been reducing in concert with the reduced musculature needs of my body I wouldn’t be injuring myself.
- aaronblohowiak 2y ago
  the caloric restriction that these drugs engender can indeed lead to various forms of under-nourishment. as you point out, your protein needs (as a proportion of calorie sources) go UP when you are in caloric restriction; see PSMF.

znpy 2y ago

Both. Muscle loss is due to not eating enough proteins to maintain muscle mass. You can lose muscle mass without drugs just by eating poorly (and not doing adequate movement)

pajamasam 2y ago

According to this article, it's a side effect of Ozempic itself. The article goes on to say that the newly discovered molecule can side-step the side-effect and metnioned that "obese mice treated with daily injections of BRP for 14 days lost an average of 3 grams—due almost entirely to fat loss..."

stavros 2y ago
We don't know yet whether the muscle loss is caused by the drug itself or due to the weight loss, there are some studies but I haven't seen any conclusion yet one way or the other. Anecdotally, a friend of mine was on a diet and exercise regime, then at some point he switched to Mounjaro to reduce cravings, while keeping the same diet and exercise regime (he's a data geek so he documented things pretty well), and his muscle gain maybe slowed a tiny bit, but didn't reverse on Mounjaro. Sample size of one, but at least it's not zero.
- malfist 2y ago
  Also sample size of one, but with the weight loss from semaglutide, I've gotten back in the gym and I can now lift more weight than I ever have. It feels fantastic (both the weight loss and being strong)
  - stavros 2y ago
    I envy you. I tried three times and got bad side effects each time, so I've given up :(
    - MrMcCall 2y ago
      I feel for you, friend. The safest way, however, is to make hunger your friend, and walk an hour or two a day. That may not work well with your work schedule, but you can override your body with your mind, unless your mind suffers because of our tech work's energy needs. And, it takes me a day or two to get past a processed sugar addiction. After those couple of days, the body starts getting used to not having that "crack" energy source be a part of its desire-base. Good luck, stavros, you can do it! And the sooner you start, the quicker you can get over the initial hump of resistence. Perhaps you can carrot yourself along by knowing that you WILL feel much, much better as the pounds start coming off and your body starts being able to walk a bit further or lift a few more weights. Fight the food inertia, my brother. If you really want extra help, contact the Creator of the universe in the morning and evening, and ask It for help. If you do that with an intention to be able to better help others, you will find that the universe, itself, will become your ally.

crazygringo 2y ago

It's nearly always a side effect of weight loss, and it's a good thing. It's confusing how people act like it's bad. If you're obese, your legs are enormously strong with crazy amounts of muscle. Have you ever seen someone obese do leg presses at the gym? They can handle tons of weight. When you lose weight, you don't need all that extra muscle. If you're carrying around 180 lbs instead of 300 lbs on your frame, all that extra muscle goes away because there's no point in keeping it. This is a good thing. Even if you go from 200 lbs to 180 lbs, there's a level of muscle you don't need anymore. Losing muscle as you lose weight is natural and good. Now, obviously you don't want to lose so much that you become weak for your size, but that won't happen if you continue to be physically active. Your body is exceptionally good at maintaining the exact right level of muscle to meet the regular stresses it undergoes. (Provided you are eating enough protein, but that's easy.)

ch4s3 2y ago
I think the downside is that you don't just lose muscle in your legs and core, but rather you lose muscle mass all over. Yes, this is the expected result of calorie restriction but the issue is that when people lose a lot of weight without taking action to build and maintain muscle the amount of muscle loss they experience can cause other problems. Someone relying on a GLP-1 drug is often someone who isn't very active at all.
- crazygringo 2y ago
  > but rather you lose muscle mass all over. Well, you lose weight all over. You lose fat in your arms and your shoulders don't need to be quite as strong. You lose weight on your face and your neck muscles don't need to be quite as strong. You lose more in your legs, but you're supposed to lose muscle mass all over. > Someone relying on a GLP-1 drug is often someone who isn't very active at all. Sure, but that's a completely separate issue. It doesn't have anything to do with weight loss. Being in good strong physical shape is great, but nobody should expect weight loss to magically result in strength. That's like thinking you can stop going to the gym but won't lose any of the muscle you'd previously built up. It's got nothing to do with weight loss though. It's got to do with the fact that you're not working out.