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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

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
    There’s negative cardiovascular effects from excess muscle just as with excess fat. Normally that’s offset by the health effects of the exercise required to gain and maintain them as well as the lack of medical conditions that prevent exercise etc. But a fat person losing weight should inherently lose muscle mass long term assuming no changes to lifestyle.
    - obvi8 2y ago
      I was looking for this comment! Not a doctor, but as I understand it muscle is roughly equivalent to fat as far as your heart’s workload is concerned. I thought I also read that muscle movement helps with blood return.
      - genewitch 2y ago
        Muscle movement is also necessary for the limbic system to function.
        Retric 2y ago
        Limbic system is unrelated to muscle movement. Movement is required for the lymphatic system to function, excess muscle volume doesn’t help.
    - cthalupa 2y ago
      This is one of those statements that is technically true but not particularly relevant. Obese people are almost never at a level of lean body mass that they would overall be at a good amount of muscle even for a healthy total weight, and rapid weight loss has consistently been shown in studies to reduce more lean body mass than slower weight loss. Getting to the same level of additional weight from muscles as there is from fat is also incredibly difficult. The average 5'8 person not utilizing AAS would take years of dedicated training, dialed in diet and recovery, etc., to get to 200lb at 15% bodyfat. People get there much faster and much easier putting on fat.
      - Retric 2y ago
  - deleted 2y ago
    [deleted]
- n4r9 2y ago
  > then they have "too much muscle" as typically needed for their body mass It's a leap to suggest that it's "good" to lose this muscle mass. If you're obese then it's good to lose fat. It's even better to do so while maintaining muscle mass.
  - hombre_fatal 2y ago
    Yeah, but whether you do resistance training while losing weight so that you have proportionally extra muscle mass than you had when you were overweight has nothing to do with the GLP-1 drug. Every time GLP-1 drugs come up, the convo splinters off into topics that have nothing to do with anything unique to the drug. Now we're just talking about general weight loss and that it's good to exercise. Which is a trivial claim.
  - IshKebab 2y ago
    Yeah that's obviously better. They really meant it's "not bad" rather than "good". When people read "muscle loss" they think "oh it's going to make me weak and feeble".
    - stavros 2y ago
      Well, no, but I like how muscular I look (even with the extra weight). I wouldn't want to look skinny and lose the weight lifting gains.
    - cthalupa 2y ago
      The problem is it is bad. People aren't just losing a proportional amount of muscle to fat mass to keep a good ratio - rapid weight loss is more catabolic towards lean body mass than it is with slower weight loss. And most obese people are below optimal levels of total lean body mass overall even before this - their leg muscles being larger than an untrained person of the same height and an average weight does not mean that their leg muscles are of optimal size, much less the rest of their body. Sarcopenia is a real risk for any obese person who is rapidly losing weight and GLP-1s are no exception.
JohnMakin 2y ago
Yea what you're replying to is just pure fat-logic that isn't really backed by science. You will lose muscle from calorie restriction - that isn't really in doubt by anyone. However, when cutting weight, you can do a routine that maintains/builds muscle as you cut, to reduce the effect. A body with more lean muscle mass will be able to keep weight off for longer - this has been known, settled, and accepted in weight loss and fitness science for decades now. I've never heard anyone, anywhere posit that muscle loss is good - and would love to see a source, so I can laugh at it. One insidious thing with these GLP1 drugs, is that they also seemingly affect muscles like the heart. I would not be willing to take one unless the risk of me carrying my weight far outweighed (no pun intended) the risk of the side effects. However, a lot of people seem to be treating it as some kind of miracle fad diet drug, which is concerning. It also has other side effects like reduced elasticity on skin, etc. I suspect we'll see longer term issues in the next decade from these drugs, and I'm glad alternatives are being explored.
- cma 2y ago
  Don't you also need a bigger heart when you gain weight and not need as big of one at less weight? Liposuction and amputations can also result in muscle loss in the heart from it having less work to do.
  - badosu 2y ago
    You don't want to have too much hypertrophy in the heart for sure. My understanding though is that it's very hard (almost impossible?) for it to be a problem without exogenous hormones, or some other condition that allows you to accrue an abnormal amount of muscle mass (e.g. myostatin defficiency). Edit: I mean someone with a healthy fat percentage body composition. Of course having to pump blood to a 300lb-140kg body is problematic for the heart, be it a mostly fat or mostly muscle body composition. My point is it's just much easier to be fat enough for it to be a problem than muscular enough without exogenous hormones or an abnormal condition.
    - cthalupa 2y ago
      Yeah, LVH is the big deal there in both cases. Telmisartan, an ARB generally used for BP management, can actually reverse LVH to a significant degree over time, though. Popular for bodybuilders on large quantities of AAS for that reason.
s1artibartfast 2y ago
There is a huge conflation of cause and effect with respect to muscle mass and longevity. Low muscle mass is associated a broad swath of illnesses, low activity, and generally poor health. Muscle mass's power as a predictor is not the same as it's utility as an intervention.
- naasking 2y ago
  As long as you're not using exogenous hormones, muscle mass can only be achieved with exercise that builds or preserves muscle. I'd say that's a pretty good predictor against frailty, which is strongly associated with mortality among the elderly.
  - s1artibartfast 2y ago
    Exactly my point! you have a chain of 3 associations right there. One is nearly tautological and another has backwards causality. Correlation =/= causation. Something being a good a good predicative indicator does not mean it is an effective intervention.
    - sn9 2y ago
      "Muscle" isn't an intervention. "Building muscle" is an intervention and has extremely well-documented mechanisms that have a causal role in improving health.
      - cthalupa 2y ago
        Muscle actually is an intervention for one of the biggest risk factors in metabolic syndrome - insulin resistance. Muscles use glycogen. They use more glycogen when you're doing the sort of thing that builds muscle, so of course it's even better there, but someone who just genetically puts on more muscle at the same level of activity as someone who puts on less will still use more blood sugar for their muscles, and thus be less likely to increase their insulin resistance.
inglor_cz 2y ago
"The idea that an overweight person has "too much muscle" is nonsense." Our bodies like to have a balance of everything. "Muscle mass is a huge predictor of mortality" In biology, most such predictors work only up to a point. Massively muscular people don't live to be 120. Bodies don't work in a straightforward fashion, and there are other effects to consider. For example, activation of the mTOR pathway, associated with tissue growth, is associated with shorter lifespan, and mTOR inhibitors like rapamycin seem to be modestly prolonging lives of many species.

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
  There’s negative cardiovascular effects from excess muscle just as with excess fat. Normally that’s offset by the health effects of the exercise required to gain and maintain them as well as the lack of medical conditions that prevent exercise etc. But a fat person losing weight should inherently lose muscle mass long term assuming no changes to lifestyle.
  - obvi8 2y ago
    I was looking for this comment! Not a doctor, but as I understand it muscle is roughly equivalent to fat as far as your heart’s workload is concerned. I thought I also read that muscle movement helps with blood return.
    - genewitch 2y ago
      Muscle movement is also necessary for the limbic system to function.
      - Retric 2y ago
        Limbic system is unrelated to muscle movement. Movement is required for the lymphatic system to function, excess muscle volume doesn’t help.
  - cthalupa 2y ago
    This is one of those statements that is technically true but not particularly relevant. Obese people are almost never at a level of lean body mass that they would overall be at a good amount of muscle even for a healthy total weight, and rapid weight loss has consistently been shown in studies to reduce more lean body mass than slower weight loss. Getting to the same level of additional weight from muscles as there is from fat is also incredibly difficult. The average 5'8 person not utilizing AAS would take years of dedicated training, dialed in diet and recovery, etc., to get to 200lb at 15% bodyfat. People get there much faster and much easier putting on fat.
    - Retric 2y ago
- deleted 2y ago
  [deleted]
n4r9 2y ago
> then they have "too much muscle" as typically needed for their body mass It's a leap to suggest that it's "good" to lose this muscle mass. If you're obese then it's good to lose fat. It's even better to do so while maintaining muscle mass.
- hombre_fatal 2y ago
  Yeah, but whether you do resistance training while losing weight so that you have proportionally extra muscle mass than you had when you were overweight has nothing to do with the GLP-1 drug. Every time GLP-1 drugs come up, the convo splinters off into topics that have nothing to do with anything unique to the drug. Now we're just talking about general weight loss and that it's good to exercise. Which is a trivial claim.
- IshKebab 2y ago
  Yeah that's obviously better. They really meant it's "not bad" rather than "good". When people read "muscle loss" they think "oh it's going to make me weak and feeble".
  - stavros 2y ago
    Well, no, but I like how muscular I look (even with the extra weight). I wouldn't want to look skinny and lose the weight lifting gains.
  - cthalupa 2y ago
    The problem is it is bad. People aren't just losing a proportional amount of muscle to fat mass to keep a good ratio - rapid weight loss is more catabolic towards lean body mass than it is with slower weight loss. And most obese people are below optimal levels of total lean body mass overall even before this - their leg muscles being larger than an untrained person of the same height and an average weight does not mean that their leg muscles are of optimal size, much less the rest of their body. Sarcopenia is a real risk for any obese person who is rapidly losing weight and GLP-1s are no exception.

JohnMakin 2y ago

Yea what you're replying to is just pure fat-logic that isn't really backed by science. You will lose muscle from calorie restriction - that isn't really in doubt by anyone. However, when cutting weight, you can do a routine that maintains/builds muscle as you cut, to reduce the effect. A body with more lean muscle mass will be able to keep weight off for longer - this has been known, settled, and accepted in weight loss and fitness science for decades now. I've never heard anyone, anywhere posit that muscle loss is good - and would love to see a source, so I can laugh at it. One insidious thing with these GLP1 drugs, is that they also seemingly affect muscles like the heart. I would not be willing to take one unless the risk of me carrying my weight far outweighed (no pun intended) the risk of the side effects. However, a lot of people seem to be treating it as some kind of miracle fad diet drug, which is concerning. It also has other side effects like reduced elasticity on skin, etc. I suspect we'll see longer term issues in the next decade from these drugs, and I'm glad alternatives are being explored.

cma 2y ago
Don't you also need a bigger heart when you gain weight and not need as big of one at less weight? Liposuction and amputations can also result in muscle loss in the heart from it having less work to do.
- badosu 2y ago
  You don't want to have too much hypertrophy in the heart for sure. My understanding though is that it's very hard (almost impossible?) for it to be a problem without exogenous hormones, or some other condition that allows you to accrue an abnormal amount of muscle mass (e.g. myostatin defficiency). Edit: I mean someone with a healthy fat percentage body composition. Of course having to pump blood to a 300lb-140kg body is problematic for the heart, be it a mostly fat or mostly muscle body composition. My point is it's just much easier to be fat enough for it to be a problem than muscular enough without exogenous hormones or an abnormal condition.
  - cthalupa 2y ago
    Yeah, LVH is the big deal there in both cases. Telmisartan, an ARB generally used for BP management, can actually reverse LVH to a significant degree over time, though. Popular for bodybuilders on large quantities of AAS for that reason.

s1artibartfast 2y ago

There is a huge conflation of cause and effect with respect to muscle mass and longevity. Low muscle mass is associated a broad swath of illnesses, low activity, and generally poor health. Muscle mass's power as a predictor is not the same as it's utility as an intervention.

naasking 2y ago
As long as you're not using exogenous hormones, muscle mass can only be achieved with exercise that builds or preserves muscle. I'd say that's a pretty good predictor against frailty, which is strongly associated with mortality among the elderly.
- s1artibartfast 2y ago
  Exactly my point! you have a chain of 3 associations right there. One is nearly tautological and another has backwards causality. Correlation =/= causation. Something being a good a good predicative indicator does not mean it is an effective intervention.
  - sn9 2y ago
    "Muscle" isn't an intervention. "Building muscle" is an intervention and has extremely well-documented mechanisms that have a causal role in improving health.
    - cthalupa 2y ago
      Muscle actually is an intervention for one of the biggest risk factors in metabolic syndrome - insulin resistance. Muscles use glycogen. They use more glycogen when you're doing the sort of thing that builds muscle, so of course it's even better there, but someone who just genetically puts on more muscle at the same level of activity as someone who puts on less will still use more blood sugar for their muscles, and thus be less likely to increase their insulin resistance.

inglor_cz 2y ago

"The idea that an overweight person has "too much muscle" is nonsense." Our bodies like to have a balance of everything. "Muscle mass is a huge predictor of mortality" In biology, most such predictors work only up to a point. Massively muscular people don't live to be 120. Bodies don't work in a straightforward fashion, and there are other effects to consider. For example, activation of the mTOR pathway, associated with tissue growth, is associated with shorter lifespan, and mTOR inhibitors like rapamycin seem to be modestly prolonging lives of many species.