GLP-1s for Fat Loss: But Where Are Our Muscles Going?

GLP-1 receptor agonists, like Ozempic and Wegovy, are taking the weight-loss world by storm, touted as game-changers in the fight against obesity. These medications work by mimicking the hormone glucagon-like peptide-1, which helps regulate blood sugar levels, slow gastric emptying, and reduce appetite. [1] In addition to curbing hunger, GLP-1s can quiet the voice of emotional eating and help disrupt addictive food patterns, allowing users to break free from cycles of overeating.

But while these medications can help shed pounds, an important question remains: what’s happening to our muscle in the process? Beneath the excitement lies a hidden concern about how these drugs impact muscle mass and long-term health. If fat is the villain, muscles are the unsung heroes of longevity—and preserving them is far more crucial than many realize.

Why a Healthy Weight Matters for Longevity

Maintaining a healthy weight plays a foundational role in promoting health and preventing chronic diseases. Excess body fat, particularly visceral fat (around our organs like the heart, lungs, and liver) increases the risk of metabolic diseases such as type 2 diabetes, cardiovascular disease, and certain cancers. Studies show that obesity is associated with reduced life expectancy, cutting an average of 6 to 7 years off one’s lifespan in severe cases. [2] Moreover, being overweight is linked to inflammation, impaired immunity, and decreased mobility—all of which contribute to premature aging and a diminished quality of life.

Just as important as achieving a healthy weight is maintaining balanced insulin regulation. Insulin resistance—a hallmark of conditions like obesity and type 2 diabetes—not only accelerates aging but also increases the risk of cardiovascular disease, kidney damage, and neurodegenerative conditions. Stable insulin levels help regulate energy, reduce inflammation, and prevent metabolic dysfunction, all of which are key to living longer, healthier lives.

Muscles: The True Organs of Longevity

While weight management and insulin regulation are critical, one of the most overlooked aspects of longevity is muscle mass. Muscles are not just about physical strength or aesthetics; they are metabolic powerhouses that regulate glucose metabolism, store amino acids, and support overall health. Research consistently shows that higher muscle mass is associated with better health outcomes and a longer life expectancy. [3]

Muscle Mass and Disease Prevention

• A study published in the PLOS ONE examined the association between low skeletal muscle mass index (SMI) and all-cause mortality risk. The findings indicated that individuals with lower SMI had a higher risk of mortality, underscoring the importance of maintaining muscle mass for longevity. [4]

• For women, higher muscle mass is associated with a reduced risk of osteoporosis and sarcopenia (age-related muscle loss), which significantly impact quality of life. [5]

• For men, greater muscle mass has been linked to improved cardiovascular health and reduced risk of metabolic syndrome. [6]

• Muscle mass plays a critical role in hormone regulation for both men and women, as it is closely linked to increased levels of testosterone, growth hormone, and insulin-like growth factor-1 (IGF-1), all of which are essential for metabolic health. [7]

Muscle Mass and Cognitive Health

Muscle mass is also strongly correlated with brain health. Studies reveal that individuals with higher levels of muscle mass have a lower risk of dementia and cognitive decline. A 2024 study presented at the Radiological Society of North America's annual meeting revealed that older adults with reduced skeletal muscle mass, particularly in the temporalis muscle (a fan-shaped muscle in the head that helps you bite and chew), faced a 60% higher risk of developing dementia. This finding highlights the critical role of muscle mass in cognitive health, suggesting that preserving muscle may serve as a protective factor against cognitive decline and age-related neurodegeneration. [8]

GLP-1s and Muscle Loss: A Hidden Concern

While GLP-1s are highly effective for weight loss, they come with an important caveat: they may lead to muscle loss in addition to fat loss. As these medications suppress appetite and promote calorie deficits, the body may begin breaking down muscle tissue for energy, especially if protein intake or resistance training is insufficient. Over time, this loss of muscle mass can negatively impact metabolism, strength, and overall health.

How to Preserve and Build Muscle While Using GLP-1s

If you’re using GLP-1s, it’s essential to implement strategies to protect and build muscle mass:

1. Engage in Hypertrophic Muscle Training
   Resistance training is key to preserving and building muscle. Focus on hypertrophy-specific exercises, such as lifting heavier weights with moderate repetitions (e.g., 8-12 reps per set). Compound movements like squats, deadlifts, and bench presses are especially effective at targeting multiple muscle groups. Incorporating functional fitness movements, such as kettlebell swings or farmer’s carries, can further enhance strength and stability by mimicking real-world movements. Adding a mix of both functional exercises and traditional weight training provides a well-rounded approach to building resilience, improving coordination, and reducing injury risk.
   

2. Prioritize Protein Intake
   To support muscle preservation, aim for a daily protein intake of at least 1.2 to 2.0 grams per kilogram of body weight. Include high-quality protein sources such as lean meats, eggs, fish, legumes, and dairy products. For plant-based eaters, combine complementary proteins like rice and beans to ensure adequate amino acid intake. My favorite clean, sustainable, and easy to digest, protein powder is Paleo Pro.
   If you’re finding it challenging to hit your protein intake goals with food, opt for protein smoothies. Keep them balanced with greens or banana, berries, and dates.
   

3. Stay Hydrated!
   Hydration is essential for muscle mass preservation because water is crucial for protein synthesis, nutrient delivery, and muscle repair. Proper hydration helps maintain electrolyte balance, which supports muscle contraction and prevents cramping. Dehydration can impair muscle recovery, reduce performance, and increase the risk of muscle breakdown due to elevated stress hormones like cortisol. Drinking enough water ensures optimal metabolic function and promotes the maintenance of lean muscle tissue.
   

4. Incorporate Muscle-Supportive Supplements

   • Creatine: Enhances muscle strength and recovery while promoting lean muscle mass. It’s also good for your brain function!
     My fave: ProMix Creatine Micronized Monohydrate

   • Branched-Chain Amino Acids (BCAAs): Helps reduce muscle breakdown during calorie deficits.
     My Fave: Thorne

   • Essential Amino Acids (EAAs): Supports protein synthesis and muscle repair.
     My faves: AFA Algae from Saluz (discount code: stephk), Momentus, or Pure
     AFA Algae is also a great supplement to include in your daily regimen, as it has a very high vitamin and mineral profile, boasting over 100 nutrients complete with vitamins; over 70 minerals, 20 amino acids, Omega 3, antioxidants, enzymes Chlorophyll, phycocyanin, and more. Why this matters? Because if you are consuming less food, you are also likely not hitting your required daily mineral and vitamin intake. This isnt just important for healthy muscles and bones, but also for your gut health!

   • Collagen Peptides: Beneficial for connective tissue and joint health, which can improve performance during resistance training. My fave: Vital Proteins Collagen Peptides

   • Fiber: Psyllium husk. Now Foods makes capsules or powder that can be added to water, juice, or smoothies.

   • Bonus Supplement: Good Livin’ Performance (discount code STEPHK)
     
     

5. Monitor Body Composition
   Use tools like DEXA scans or bioelectrical impedance analysis to ensure you’re losing fat, not muscle, during weight loss. This can help you adjust your diet and exercise routine as needed.
   
   And remember, if you’re unsure how to eat in a supportive way to your GLP-1 protocol, or even how to reverse out of this diet once you’re no longer using a GLP-1, get support from a registered dietitian! The nutrition experts at ModMeds can help!

If you struggle to maintain muscle mass during your weight loss journey, focus on building lean muscle once you’ve reached your goal. The strategies mentioned earlier are just as relevant here. After completing a GLP-1 regimen, your appetite will likely increase, making it crucial to gradually raise your caloric intake. Pay close attention to the quality of the foods you consume—prioritize protein to support muscle repair and growth, and include a healthy balance of fats and carbohydrates to fuel your body, brain, and hormone function effectively.

The Role of Peptides in Muscle and Tissue Health

GLP-1s like Ozempic and Wegovy are peptides, which opens the door to discussing the advancements in other injectable peptide therapies. Emerging peptides such as BPC-157, Thymosin Beta-4 (TB-500), CJC-1295, and Ipamorelin are gaining attention for their potential in tissue repair, muscle growth, and overall healing. While much of the evidence is anecdotal, here’s what we know so far:

• BPC-157: Can promotes wound healing and tissue repair by enhancing angiogenesis (formation of new blood vessels) and collagen production.

• Thymosin Beta-4 (TB-500): May support cellular regeneration, particularly in soft tissue, by modulating actin-binding proteins and promoting healing.

• CJC-1295 and Ipamorelin: Can stimulate the release of human growth hormone (HGH), which supports muscle repair, increases lean muscle mass, and enhances fat metabolism.

Potential Benefits

• Muscle Growth: Peptides that increase growth hormone release can improve muscle mass and strength, particularly when combined with resistance training.

• Recovery and Repair: BPC-157 and TB-500 are particularly useful for athletes or individuals recovering from injuries, as they accelerate healing and reduce inflammation.
  

• Anti-Aging: By supporting collagen production and tissue repair, these peptides may also have anti-aging benefits for skin, joints, and muscles.

Peptide therapies are still an emerging field, and their potential for supporting health, longevity, and muscle preservation is increasingly being studied. Currently, the FDA has not approved injectable peptides for human use. This hasn’t stopped retailers from selling them, so as always, it’s crucial to work with knowledgeable healthcare providers to ensure safe and effective use.

A Reminder About Weight Loss and Longevity

Beyond shedding pounds, it’s about preserving the very structures that sustain life: muscle mass, metabolic health, and resilience.

While GLP-1s can be a supportive and efficien

t tool for weight loss, they are not a magic cure. Without building healthy, sustainable habits—such as regular exercise, balanced nutrition, and stress management—you risk returning to where you started. True wellness comes from consistent efforts that support both your immediate goals and your long-term health. By combining resistance training, optimal nutrition, and prioritizing your mental wellbeing, we can ensure that the pursuit of weight loss doesn’t come at the cost of long-term vitality.

After all, the goal isn’t just to be lighter on the scale—it’s to be stronger, sharper, and ready to live life to its fullest potential.

For questions regarding the research, nutrition, peptides, longevity protocols, and more, get in touch via the Contact page!

Sources

1. Hinnen, D. (2017). Glucagon-like peptide 1 receptor agonists for type 2 diabetes. Diabetes Spectrum, 30(3), 202–210. https://doi.org/10.2337/ds16-0026

2. National Institutes of Health. (2014, July 8). NIH study finds extreme obesity may shorten life expectancy up to 14 years. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-study-finds-extreme-obesity-may-shorten-life-expectancy-14-years

3. Momma, H., Kawakami, R., Honda, T., Sawada, S. S., & Gando, Y. (2022). Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: A systematic review and meta-analysis of cohort studies. British Journal of Sports Medicine, 56(13), 755–763. https://doi.org/10.1136/bjsports-2021-105061

4. He, H., Chen, S., Yu, X., Huang, W., Chen, D., & Xie, W. (2022). Association between skeletal muscle mass index and all-cause mortality: A systematic review and meta-analysis. PLOS ONE, 17(6), e0267458. https://doi.org/10.1371/journal.pone.0267458

5. Lee, J. H., Kim, D. K., Kim, K. M., & Park, K. H. (2021). Low grip strength and muscle mass increase the prevalence of osteopenia and osteoporosis in elderly Korean women. Healthcare, 9(4), 476. https://doi.org/10.3390/healthcare9040476

6. Kim, G., Lee, S.-E., Jun, J. E., Lee, Y.-B., Ahn, J., Bae, J. C., Jin, S.-M., Hur, K. Y., Jee, J. H., Lee, M.-K., & Kim, J. H. (2018). Increase in relative skeletal muscle mass over time and its inverse association with metabolic syndrome development: A 7-year retrospective cohort study. Cardiovascular Diabetology, 17(1), 23.

7. Schroeder, E. T., Vallejo, A. F., Zheng, L., Stewart, Y., Flores, C., Nakao, S., & Martinez, C. (2013). Hormonal and metabolic effects of resistance training in men and women aged 60 to 75 years. Journal of Gerontology: Biological Sciences and Medical Sciences, 68(6), 631-638. https://doi.org/10.1093/gerona/glt012

8. Moradi, K., Albert, M., & Demehri, S. (2024, December 3). Skeletal muscle loss as a risk factor for developing dementia. Paper presented at the annual meeting of the Radiological Society of North America, Chicago, IL.

9. Huberman Episode on Peptides:
   https://www.youtube.com/watch?v=zU5EYw06wtw
   https://open.spotify.com/episode/1oz4IcumV721UdkeOgWLrL