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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

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.
  - ch4s3 2y ago
    The problem is that fat, sick people lose a lot of weight and muscle mass and then become skinny and frail. It just puts you at risk of other medical issues. In older individuals this can cause decreased mobility and raise the risk of falls. Its well documented in medical literature, that's why people worry about it.
    - crazygringo 2y ago
      But my point is that this is no different from being skinny and frail in the first place. It has nothing to do with losing weight. Yes, that puts you at risk. That's why you should exercise, even if it just means daily walks. The point is, you're not winding up with too little muscle because you lost weight. If you're winding up with too little muscle, it's because you're not being physically active enough. If you're physically active, you won't lose the muscle that you still need even as you lose weight.
      - im3w1l 2y ago
        > The point is, you're not winding up with too little muscle because you lost weight Imagine someone eating only candy and pastries, but because they eat so huge amounts, they actually get a half-decent amount of protein. Then they decrease portion size with the help of appetite suppresants.
        crazygringo 2y ago
        I explicitly made clear in my original comment: > Provided you are eating enough protein, but that's easy. If you're trying to lose weight eating only candy and pastries, then we're having an entirely different conversation...
      - ch4s3 2y ago
        If you were physically active enough and careful about your diet you likely wouldn't be on a GPL-1 drug. That's the point. People end up in bad shape for a lot of reasons, including injury. The search for a mechanism to burn fat without losing muscle is to help support people who are on GLP-1 drug because for whatever reason they were insufficiently active.
arrobbiato 2y ago
This is exactly why hand-to-hand combat instructors will tell you that fighting an obese person will go very differently than you might think it will.
mikenew 2y ago
That is absurd. Muscle mass is a huge predictor of mortality and anyone who isn't actively strength training and maintaining higher levels of muscle would see a health benefit by doing so. The idea that an overweight person has "too much muscle" is nonsense. The side affect of muscle loss from these glp-1 agonist drugs is a serious downside that everyone should be aware of and try to mitigate if they choose to take them.
- freedomben 2y ago
  > The idea that an overweight person has "too much muscle" is nonsense. I think you've misunderstood GP. He's not saying they have too much muscle when they're overweight. He's saying that take that exact same amount of muscle, subtract a ton of fat from their upper bodies, then they have "too much muscle" as typically needed for their body mass. I don't agree with their phrasing, but the point isn't "nonsense."
  - mikenew 2y ago
    I understand the point. Mine is that an ordinary untrained person will see health benefits and a statistically longer life from more muscle. An overweight person would have more muscle than their non-overweight counterparts (mostly localized to the legs, not upper body), and that is the one and only positive of being overweight. Willfully throwing that away will harm your health, full stop. The muscle loss problem with these drugs is talked about a lot because it is in fact a problem. Not because the medical field is mistaken in thinking it's a bad thing.
    - hombre_fatal 2y ago
      Your complaint doesn't make sense to me. The negative health impact of being obese isn't equalized by having a little more muscle mass. Also, if this is your stance, then GLP-1 is a red herring because you have the same issue with weight loss in general. Weight loss, without increasing resistance training, leads to muscle loss.
    - Retric 2y ago
solumunus 2y ago
Complete nonsense.
BSOhealth 2y ago
My read on past studies is that one area of muscle mass loss that is problematic is around the heart. Obviously it’s not a problem if an obese person’s quads shrinks 2x because they lift 2x weight every day.
- MetaWhirledPeas 2y ago
  I would think any drastic change to body composition would have its risks, and should be mitigated through healthy diet and exercise. I suspect the detractors are quick to overemphasize such risks because users of weight loss drugs aren't 'earning' it. My counterargument would be that it's better to be underexercised and normal weight than to be underexercised and overweight. And I suspect being normal weight makes exercise more pleasant.
naasking 2y ago
> Losing muscle as you lose weight is natural and good. It's natural but that doesn't make it good. In particular, muscle loss can cause heart problems because the heart is a muscle. The body's catabolic processes don't distinguish between different kinds of muscle.
- consteval 2y ago
  I don’t think this is true. My understanding is that the heart is a very unique muscle because it doesn’t grow. If your heart does grow, either by genetic defect or anabolic abuse, it works much worse. So you’ll live a shorter life.
  - naasking 2y ago
    Heart muscle can shrink in extreme calorie deficits which can lead to heart issues, therefore it must grow when leaving such calorie deficits, even if that growth has an upper bound.
  - sn9 2y ago
    Hypertrophy of the heart is a well-known and desired part of improving cardiovascular fitness. https://en.wikipedia.org/wiki/Aerobic_exercise#Health_effects https://en.wikipedia.org/wiki/Aerobic_exercise#Health_effect...
timewizard 2y ago
> Have you ever seen someone obese do leg presses at the gym? They can handle tons of weight. They can't handle reps. It's almost as if muscle has several different properties that are important beyond just "mass."
yellowapple 2y ago
> When you lose weight, you don't need all that extra muscle. Sure, but what if I want it? Maybe I want to jump extra high, or want to be able to lift things 120lbs heavier than I could before?
cthalupa 2y ago
This is silly. I'm a big proponent of GLP-1s (and on one!) but we can and do see people on these reaching sarcopenic levels of lean body mass. The overwhelming majority of people on these drugs should absolutely be doing everything they can to preserve their muscle mass. (The overwhelming majority of people losing weight in general should be doing everything they can to preserve their muscle mass.) Having slightly larger quads/hamstrings/calves than the average person doesn't mean they have an optimal amount of muscle mass in their legs to begin with, much less on the rest of their body. Leg presses are also an absolutely terrible exercise to measure strength and by proxy muscle mass. The angle reduces the weight - generally only 71% - and they are one of the most "cheated" exercises in existence, with people doing what could charitably be called half reps (and is often more like quarter reps.)

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.
- ch4s3 2y ago
  The problem is that fat, sick people lose a lot of weight and muscle mass and then become skinny and frail. It just puts you at risk of other medical issues. In older individuals this can cause decreased mobility and raise the risk of falls. Its well documented in medical literature, that's why people worry about it.
  - crazygringo 2y ago
    But my point is that this is no different from being skinny and frail in the first place. It has nothing to do with losing weight. Yes, that puts you at risk. That's why you should exercise, even if it just means daily walks. The point is, you're not winding up with too little muscle because you lost weight. If you're winding up with too little muscle, it's because you're not being physically active enough. If you're physically active, you won't lose the muscle that you still need even as you lose weight.
    - im3w1l 2y ago
      > The point is, you're not winding up with too little muscle because you lost weight Imagine someone eating only candy and pastries, but because they eat so huge amounts, they actually get a half-decent amount of protein. Then they decrease portion size with the help of appetite suppresants.
      - crazygringo 2y ago
        I explicitly made clear in my original comment: > Provided you are eating enough protein, but that's easy. If you're trying to lose weight eating only candy and pastries, then we're having an entirely different conversation...
    - ch4s3 2y ago
      If you were physically active enough and careful about your diet you likely wouldn't be on a GPL-1 drug. That's the point. People end up in bad shape for a lot of reasons, including injury. The search for a mechanism to burn fat without losing muscle is to help support people who are on GLP-1 drug because for whatever reason they were insufficiently active.

arrobbiato 2y ago

This is exactly why hand-to-hand combat instructors will tell you that fighting an obese person will go very differently than you might think it will.

mikenew 2y ago

That is absurd. Muscle mass is a huge predictor of mortality and anyone who isn't actively strength training and maintaining higher levels of muscle would see a health benefit by doing so. The idea that an overweight person has "too much muscle" is nonsense. The side affect of muscle loss from these glp-1 agonist drugs is a serious downside that everyone should be aware of and try to mitigate if they choose to take them.

freedomben 2y ago
> The idea that an overweight person has "too much muscle" is nonsense. I think you've misunderstood GP. He's not saying they have too much muscle when they're overweight. He's saying that take that exact same amount of muscle, subtract a ton of fat from their upper bodies, then they have "too much muscle" as typically needed for their body mass. I don't agree with their phrasing, but the point isn't "nonsense."
- mikenew 2y ago
  I understand the point. Mine is that an ordinary untrained person will see health benefits and a statistically longer life from more muscle. An overweight person would have more muscle than their non-overweight counterparts (mostly localized to the legs, not upper body), and that is the one and only positive of being overweight. Willfully throwing that away will harm your health, full stop. The muscle loss problem with these drugs is talked about a lot because it is in fact a problem. Not because the medical field is mistaken in thinking it's a bad thing.
  - hombre_fatal 2y ago
    Your complaint doesn't make sense to me. The negative health impact of being obese isn't equalized by having a little more muscle mass. Also, if this is your stance, then GLP-1 is a red herring because you have the same issue with weight loss in general. Weight loss, without increasing resistance training, leads to muscle loss.
  - Retric 2y ago

solumunus 2y ago

Complete nonsense.

BSOhealth 2y ago

My read on past studies is that one area of muscle mass loss that is problematic is around the heart. Obviously it’s not a problem if an obese person’s quads shrinks 2x because they lift 2x weight every day.

MetaWhirledPeas 2y ago
I would think any drastic change to body composition would have its risks, and should be mitigated through healthy diet and exercise. I suspect the detractors are quick to overemphasize such risks because users of weight loss drugs aren't 'earning' it. My counterargument would be that it's better to be underexercised and normal weight than to be underexercised and overweight. And I suspect being normal weight makes exercise more pleasant.

naasking 2y ago

> Losing muscle as you lose weight is natural and good. It's natural but that doesn't make it good. In particular, muscle loss can cause heart problems because the heart is a muscle. The body's catabolic processes don't distinguish between different kinds of muscle.

consteval 2y ago
I don’t think this is true. My understanding is that the heart is a very unique muscle because it doesn’t grow. If your heart does grow, either by genetic defect or anabolic abuse, it works much worse. So you’ll live a shorter life.
- naasking 2y ago
  Heart muscle can shrink in extreme calorie deficits which can lead to heart issues, therefore it must grow when leaving such calorie deficits, even if that growth has an upper bound.
- sn9 2y ago
  Hypertrophy of the heart is a well-known and desired part of improving cardiovascular fitness. https://en.wikipedia.org/wiki/Aerobic_exercise#Health_effects https://en.wikipedia.org/wiki/Aerobic_exercise#Health_effect...

timewizard 2y ago

> Have you ever seen someone obese do leg presses at the gym? They can handle tons of weight. They can't handle reps. It's almost as if muscle has several different properties that are important beyond just "mass."

yellowapple 2y ago

> When you lose weight, you don't need all that extra muscle. Sure, but what if I want it? Maybe I want to jump extra high, or want to be able to lift things 120lbs heavier than I could before?

cthalupa 2y ago

This is silly. I'm a big proponent of GLP-1s (and on one!) but we can and do see people on these reaching sarcopenic levels of lean body mass. The overwhelming majority of people on these drugs should absolutely be doing everything they can to preserve their muscle mass. (The overwhelming majority of people losing weight in general should be doing everything they can to preserve their muscle mass.) Having slightly larger quads/hamstrings/calves than the average person doesn't mean they have an optimal amount of muscle mass in their legs to begin with, much less on the rest of their body. Leg presses are also an absolutely terrible exercise to measure strength and by proxy muscle mass. The angle reduces the weight - generally only 71% - and they are one of the most "cheated" exercises in existence, with people doing what could charitably be called half reps (and is often more like quarter reps.)