Ozempic is nice for weight reduction — however dropping muscle is a aspect impact to be careful for

[ad_1] We’re used to seeing Serena Williams on our TVs, muscle tissue flexing, smashing a tennis ball previous her opponent. However in a current 30-second industrial, Williams traded the racket for a GLP-1 drug injector pen.

Williams, whose most up-to-date youngster was born in 2023, has change into a spokeswoman in her post-retirement days for Ro, one of many many boutique well being care companies to get in on the GLP-1 craze. “They are saying GLP-1s for weight reduction is a shortcut — it’s not. It’s science,” she says throughout the spot. “After children, it’s the medication my physique wanted.”

• Sufferers must be consuming a protein-rich, balanced weight-reduction plan and doing a little form of power coaching when on an GLP-1 remedy.

• Some sufferers taking GLP-1 medication have skilled important muscle loss and weak spot.

• Consultants fear that too many sufferers could also be making an attempt to make use of GLP-1 medication as a shortcut as a substitute of bettering their weight-reduction plan and train to drop pounds.

Right here is without doubt one of the world’s best athletes, giving voice — in commercials working throughout primetime TV, on the Today show , and on social media — to a frustration that many individuals have felt. She gained weight after she had children. And although, in her words , she was “doing every part proper” after the being pregnant, she couldn’t lower as a lot weight as she favored. That’s the place the GLP-1 drug got here in and delivered outcomes: Williams misplaced 31 kilos.

However there’s only one drawback with the pitch: GLP-1 medication like Ozempic and Wegovy are , in some methods, a shortcut.

“People at all times need the fucking capsule,” Dr. Robert Lustig, a metabolic scientist on the College of California-San Francisco, informed me. “I view GLP-1s like a Band-Help. … There’s nothing unsuitable with a Band-Help. However what for those who didn’t clear your wound and also you simply put the Band-Help on? The Band-Help is critical, nevertheless it’s not enough.”

The implications of sufferers slapping on the Band-Help — taking a GLP-1 — with out treating the underlying problem with the form of wholesome consuming and train which can be nonetheless essential even with these medication is turning into clear. Scientists have found that some GLP-1 sufferers can lose important muscle mass, in addition to a lack of purposeful power, resulting from a scarcity of vitality. Fairly than really feel fitter and able to exit on this planet or onto the tennis court docket, these are sufferers who find walking up the stairs to be almost debilitating .

For this story, I sought to grasp how that is enjoying out in American tradition. In looking Reddit communities devoted to GLP-1 medication, I discovered plenty of regular individuals whose expertise backed up that analysis: That they had lengthy tried to drop pounds however may by no means fairly meet their objectives — till they went on a GLP-1 drug.

However whilst they misplaced weight, they didn’t really feel higher. A few of them felt worse, weaker . There are dozens of posts of GLP-1 sufferers coming to their peers , asking for advice about workouts they might do to stem the muscle loss . A number of hope to find the right diet that can permit them to really feel energetic and keep away from muscle loss whereas dropping the burden — however with out having to decide to power coaching that should go together with it.

Whereas the time period “power coaching” might conjure photos of ripped bodybuilders, medical doctors more and more emphasize the significance of muscle coaching for all of their sufferers, from the 30-year-old marathon runner to the 65-year-old retiree. That’s as a result of analysis has proven that extra lean muscle helps you age better and protects against hazards, such as falls, that pose a greater and greater threat as you get older .

These medication are already wildly popular , and their use is more likely to continue to grow. In November, the Trump administration struck deals with Lilly and Novo Nordisk to decrease the money value of their medication in trade for expanded Medicare protection. These value modifications, which is able to start to take impact subsequent 12 months, may additional develop the variety of People taking these drugs, together with amongst seniors for whom any loss of muscle mass is a serious health concern . One quarter of GLP-1 prescriptions dispensed in 2024 had been for individuals older than 65.

Falls are already one of the most potent killers of older adults ; greater than 40,000 People over 65 died from falls in 2023, and the demise fee has tripled since 1990. If extra sufferers begin taking semaglutide for its results on cognition, for instance, and fail to eat and train correctly, they might expertise malnourishment and important muscle loss; each may put their long-term well being in danger.

That doesn’t imply GLP-1 medication are a foul deal for public well being. On the inhabitants degree, weight problems is associated with a host of major ills , and People have lengthy been determined to drop pounds. The category of medication that features Ozempic, Wegovy, Mounjaro, and now numerous others — Zepbound, compound GLP-1s, and so forth. — are probably the most spectacular weight-loss instruments we’ve ever seen. They work as a result of they gradual digestion and inform your mind you’re full, which makes it simpler for individuals to eat much less. Whereas these therapies are nonetheless pretty new, observational research have found that sufferers who keep on these medication for a 12 months or extra can lose 10 % of their physique weight on common. And on the inhabitants degree, weight problems charges are already starting to decline .

Scientists are additionally discovering that these medication have wonderful potential to deal with a breadth of points: from addressing substance-abuse disorders , decreasing your risk for heart disease , and even probably stopping dementia and Alzheimer’s disease . Current research have found that taking a GLP-1 like Wegovy or Ozempic is even related to decrease most cancers deaths.

However to stem the chance of muscle-mass loss, you should even be prepared to decide to bettering your weight-reduction plan and adopting a severe exercise routine over the long run. GLP-1 medication could also be magical on the subject of weight reduction, however they aren't magic capsules. Which signifies that together with the rise of Ozempic and different GLP-1s is a coming reckoning over America’s shortcut tradition.

“Is that this only a essential evil to weight reduction?”

Loads of athletes who should not world-famous see the identical attraction in GLP-1 medication that Serena Williams did.

One particular person specifically stood out to me. A self-identified weight lifter, CrossFit fanatic, and horse rider, who I’ll name Sam, shared their expertise on Reddit. They defined they'd at all times struggled to drop pounds regardless of strict meal preparation and consuming lots of protein.

And so, Sam began taking Wegovy. ”I’m pleased with the outcomes,” they stated — earlier than attending to a reasonably large caveat for any person who’s at all times had an lively life.

Regardless of aiming to eat 100 grams of protein daily, they stated they had been feeling weak. “I swear I can really feel my muscle being damaged down. Is that this a factor??” Sam requested within the on-line discussion board. “I really really feel much less agency, extra wobbly and flabby. I appear to have much less definition,“ they stated. “Is that this only a essential evil to weight reduction?”

Why I reported this story

GLP-1 medication are undeniably thrilling, and they're being extensively adopted. I lately came upon a member of the family of my very own had began taking them, they usually’re not the form of one that’s vulnerable to weight-reduction plan fads both. As a reporter, that makes me nervous: Something that sounds too good to be true in all probability is.

It could be great if GLP-1 medication may treatment Alzheimer’s, however we in all probability must suppose by the trade-offs. And I began to select up from different reporting and social media feeds I comply with that some individuals had been experiencing this surprising muscle loss. I believed it will be worthwhile to unpack the science to clarify why this occurs to some individuals and clarify what they'll do to keep away from it.

The web is stuffed with examples identical to this. “Anybody else having a tough time figuring out on Wegovy?” asked one Reddit poster final 12 months. They even felt their arms had been weaker whereas bowling. One other particular person realized one thing was unsuitable after they may now not do yard work round the home. Different individuals have noticed leg weak spot after mild strolling or climbing the steps: “I really battle to go up a staircase and I’m solely 32,” stated one GLP-1 affected person.

“I do know lots of people are figuring out, and I do want to start exercising on prime of the wegovy, however I’m simply questioning if anybody else is experiencing excessive weak spot or if it’s simply me and my un-toned self,” they requested.

Sam’s submit specifically had lots of feedback, with one respondent even urging the affected person to rethink: You're “a powerful, succesful goddess. You don’t must drop pounds.” Settle for who you might be. In response, Sam laid out the dilemma that so many individuals who've sought to drop pounds through the years face: “Sadly, a few of us simply do NOT drop pounds with weight-reduction plan and train.”

It’s true: Weight reduction isn't assured from weight-reduction plan and train. Some individuals have a genetic disposition to turning into overweight. And never everyone who's overweight is unhealthy; the physique mass index is an imperfect measurement, and a few people who find themselves technically overweight can nonetheless be wholesome if a lot of their weight is muscle. Nonetheless, the belief that weight problems is a illness to be handled, slightly than a private failure that may solely be remedied by private progress, has been essential in decreasing the prejudices that obese individuals have lengthy confronted.

However on the identical time, it's a slippery slope from acknowledging weight-reduction plan and train might not be enough on their very own to considering a drug like Ozempic could make them pointless. Some individuals, like Sam, have at all times exercised and seen GLP-1s as an additional push to assist them attain their weight objectives. However I additionally encountered different individuals who didn't essentially have wholesome habits earlier than however had been in a position with the medication to chop weight for the primary time. One affected person on Reddit acknowledged that they don’t work out they usually don’t adhere to a specific weight-reduction plan. They've been shedding weight, however they're “scared” about dropping an excessive amount of weight — so that they ask if they'll simply eat extra hen or drink a protein shake and regain the muscle “with out figuring out.”

They've purpose for concern: The identical medical trials which have proven how efficient GLP-1 medication are with weight reduction have additionally constantly reported muscle loss or weak spot amongst sufferers. When one group of researchers evaluated the kind of physique mass that sufferers on semaglutide medication had been dropping, they found that about 40 % was essential muscle.

The GLP-1 market is just going to develop because the medication show helpful for a big selection of therapies. Folks, together with those that should not obese, might take them preventively to stave off heart problems or dementia. For them, people who find themselves already at a wholesome weight, muscle loss is an much more severe concern. If GLP-1 medication do show to be promising for treating age-related cognitive decline, for instance, then applicable weight-reduction plan and train will probably be much more paramount for that affected person inhabitants. The very last thing we would like is extra seniors struggling catastrophic accidents throughout a fall due to misplaced muscle mass.

However understanding what precisely is inflicting the muscle loss is essential. Scientists are nonetheless figuring that out, however early indications are that the trigger isn't the medication themselves however a number of the life-style modifications the medication can result in.

One examine from researchers on the College of Utah suggests the lack of power is basically the results of not consuming sufficient energy. Of their analysis on mice, they found much less muscle mass loss than anticipated. As a substitute, after taking a GLP-1, mice had been dropping their purposeful power — how a lot they might carry or transfer round — even when muscle dimension stayed the identical. In different phrases, the mice appeared weaker although their muscle mass hadn’t modified.

“Power is not only an element of how a lot muscle you have got, however whether or not you'll be able to transfer that muscle successfully. There’s an brisk element to it,” lead creator Katsu Funai informed me. The animals on a GLP-1 drug might have had much less vitality as a result of they had been consuming much less — and subsequently they wouldn’t have the ability to exert as a lot drive with their muscle tissue. It’s not the GLP-1s per se; it’s what the GLP-1s result in with out intervention.

The findings may inform how we prescribe Ozempic, Funai stated: Smaller doses may assist to mitigate the lack of purposeful power. In any other case, shedding weight too shortly goes to imply dropping vitality shortly — and subsequently feeling weaker. Within the pleasure over Ozempic, and the potential to lose lots of weight and quick, individuals appear to have forgotten a elementary reality about weight reduction: “Extra isn't essentially higher,” Funai stated.

Earlier than GLP-1 medication existed in any respect, dieticians urged their sufferers to tempo weight reduction — not more than 1-2 kilos per week — for precisely this purpose: You don’t need to find yourself malnourished and weakened. With a standard weight-reduction plan, that may typically result in you consuming extra, which in flip eliminates the burden loss. However when your urge for food is suppressed by GLP-1s, the burden loss can proceed, and with it, power and vitality loss.

“With these GLP-1s, that dialog [about diet and exercise] has been sidelined,” Funai stated. “There are nuances to those issues that I believe are being missed not simply from the general public, but additionally from scientists,”

Learn how to take advantage of GLP-1s

Mockingly, the very drawback that GLP-1s had been meant to beat — that many People merely battle to eat proper and train sufficient — stays simply as central even with the medication.

And most of the individuals taking GLP-1s are beginning at a drawback: Solely 49 % of People say they're extraordinarily or very assured that they know what a nutritious diet appears to be like like, and about twice as many say they need to get extra train.

In case your sole objective is to drop pounds, a GLP-1 alone may get you there — however not within the healthiest manner. Except you modify what you eat, you’re nonetheless placing the identical junk in your physique — albeit much less of it — with the identical or extra unfavourable results in your vitality and stamina.

“For those who don’t change your conduct, for those who don’t change your habits, it's possible you'll be wanting good, it's possible you'll be shedding weight, however metabolically, your physique is in turmoil,” stated Nayan Patel, a pharmacist who works with sufferers taking the medication. “We’ve received to make use of these medication in the precise method.”

So what ought to individuals on GLP-1s intention to eat? A high-protein weight-reduction plan delivering lots of amino acids is essential, Patel stated: Eggs, nuts, lentils, poultry, and fish are all good sources. You'll be able to lower down on the carbs and sugars; your physique gained’t want them to supply vitality since you’ll be chopping fats. Consuming protein and power coaching permits your physique to be more practical at trimming the fats, with out compromising your core power.

Like something arduous however value doing, there’s loads to beat. Many People have change into intimidated by health club tradition, so they may desire to work out in privateness, at residence — however they don’t understand how. One particular person I encountered posted on-line to crowdsource recommendation on residence gear and routines. They stated they didn’t need to go to a health club, however “I do know I’m off form,” the poster confessed to their fellow Redditors .

The thread flooded with recommendation from easy exercise routines to attempt to position fashions they might comply with on social media. The recommendation included some very approachable methods — one thing so simple as sitting in a chair together with your legs outstretched and utilizing your stomach muscle tissue to carry them back and forth over a water bottle. Some commenters really useful incorporating a resistance band and a exercise ball. Well being care suppliers have developed basic suggestions for sufferers taking a GLP-1 drug: Mass Common, for instance, advises a combination of 150 minutes every week of average train — actions like strolling or driving a motorcycle — or about 75 minutes of vigorous cardio train like jogging or swimming laps along with two days of weight coaching and a gradual dose of stretching and adaptability exercises.

Whereas I discovered loads of individuals involved with surprising muscle loss, there have been additionally examples of sufferers proudly exhibiting off their lean and muscular new physiques. It may be finished.

However on this imaginative and prescient, GLP-1s are a jumpstart, not a shortcut. “Losing a few pounds is everyone’s objective. Utilizing a drug to jumpstart is a superb method to do the method,” Patel stated. “However for those who’re not taking the primary two steps, you’ll stumble till you fall flat in your face.”

This story was initially revealed in The Highlight , Vox’s member-exclusive journal. To get early entry to member-exclusive tales each month, join the Vox Membership program today .