Do #weightloss medications lead to more muscle loss than other types of treatment?

You may have seen some of the press surrounding #Ozempic and #Wygovy (#semaglutide) causing a higher-than-expected amount of muscle loss when used for weight loss. In the STEP 1 semaglutide study, those research subjects selected to have DEXA scans (one of the best ways to determine body composition) lost an average of 38.6% of their weight from muscle mass.

This seems concerning since muscle loss lowers your metabolic rate more than fat loss. However, it is important to put this into context:

1) ANY weight loss, wether from surgery, through medications, a diet plan or lifestyle changes can lead to muscle loss. For example, in the look AHEAD study 1,019 people underwent intensive lifestyle changes alone that lead to about 33% of weight loss coming from muscle loss on DEXA scans.

2) And when you take a closer look at the data in the semaglutide study, it is interesting to note that those patients on a placebo actually lost 57% of their weight from muscle loss - which is more than those on the medication.

3) The number of participants tested with a DEXA was only 140 out of the total of 1,961 patients enrolled in the study and the small sample size likely affected the results in both groups.

4) In the SURMOUNT-1 study done with another diabetes/weight loss drug called #tirzepitide (#Monjouro), 24.3% of weight loss came from muscle mass loss in the medication group versus 24.1% in the placebo group. This study also did DEXA scans on a limited number of patients - 160 out of the 2,539 study participants. This medication works in a similar way as semaglutide so it is unusual to see such a different result.

Bottom line: If all 3,500+ patients in both studies were tested, we would have more accurate results - for both medication groups and both placebo groups.