Several GLP-1 drugs, like Ozempic, Wegovy, and Rybelsus (semaglutides), are transforming weight loss, but they are not improving other critical measures of health, such as cardiorespiratory fitness, according to a recent University of Virginia study published in The Journal of Clinical Endocrinology & Metabolism.
The study focused on the impact of GLP-1 drugs, like Ozempic, on cardiorespiratory fitness (CRF), a key indicator of heart, lung, and muscle efficiency during physical activity. These drugs did have certain measures of benefits for those with type 2 diabetes, obesity, and heart failure, for improving blood sugar control as well as short-term cardiorenal benefits and improvements in survival outcome. And while these drugs, including Ozempic, effectively reduced weight and improved some weight-related health issues, they did not translate to improvements in V02 Max to significantly improve cardiorespiratory fitness. This means that while patients were losing weight, they were also losing muscle mass, which could negate some of the benefits of weight loss.
Losing Lean Muscle
“Some patients literally told me that they felt that they were losing muscle or muscle was slipping away from them while they were on these medications,” said researcher Zhenqi Liu, MD, Professor of Medicine and James M. Moss Professor of Diabetes at the University of Virginia School of Medicine and former chief of UVA Health’s Division of Endocrinology and Metabolism. “This is a serious concern. Muscle, especially axial muscle, is essential for posture, physical function, and overall well-being. Losing lean body mass can increase the risk of cardiovascular disease, all-cause mortality, and diminished quality of life. We need to make sure that patients prescribed these medications aren’t already at risk for malnutrition or low muscle mass.”
“Cardiorespiratory fitness is an important predictor of mortality risk across a range of healthy and clinical populations, including obesity, diabetes, and heart failure,” said associate professor of kinesiology Siddhartha S. Angadi. “In fact, in a recent study involving roughly 400,000 individuals, we demonstrated that cardiorespiratory fitness was better than obesity in predicting the risk of death.” Then, going on to add that,” once CRF was factored in, body weight failed to predict the risk of mortality. This is why it’s so important to understand the effects of this new class of drugs on it.”
The researchers emphasize the need for strategies to mitigate muscle loss in patients taking GLP-1 drugs, like Ozempic. They suggest that combining these medications with exercise programs, nutrition supplements, or complementary medications could help patients maintain muscle mass and achieve the full benefits of weight loss. Further research is underway to explore these strategies and develop more comprehensive approaches to patient care.
Ensuring Healthy Weight Loss
GLP-1 drugs, like Ozempic, can help people lose fat, which comes with loss of fat-free mass, of which muscle makes up 40% to 50%. Fat-free mass loss accounts for 25-40% of the total pounds lost, while age-related declines in fat-free mass are only 8% per decade.
The researchers conclude that GLP-1 drugs, including Ozempic, “significantly reduce body weight and adiposity, along with a substantial FFM [fat-free mass] loss, but with no clear evidence of CRF enhancement.” The researchers expressed concern that this could take a toll on patients’ metabolic health, healthspan/frailty, and overall longevity. They are urging additional research to better understand the effects of the drugs, like Ozempic, and ensure patients get the best possible outcomes.
“This is an area of active research, and we are hopeful that better solutions are coming soon,” Liu said. “But for now, it is important that patients prescribed GLP-1 drugs have conversations with their health care providers about strategies to preserve muscle mass. The American Diabetes Association recommends screening for malnutrition and low muscle mass risk before starting these medications and promoting adequate protein intake and regular exercise throughout treatment.”
“Finally, exercise training during GLP1 therapy remains to be assessed in its ability to preserve or improve VO2max during GLP1 therapy,” Angadi added. “Future studies examining the singular and additive effects of exercise training and increased protein intake with regard to preserving muscle mass are urgently needed.”
This article was created at the WHN News Desk
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