How to Prevent Muscle Loss on Semaglutide

Many individuals turn to medications like semaglutide as a solution for weight loss. Its efficacy is proved over and over through various studies.

The SELECT study found that 67.8% achieved 5% of more weight loss and 44.2% achieved 10% weight loss with semaglutide. Another study found an average 15% weight loss with semaglutide compared to 2.4% with placebo.

It’s safe to say that individuals taking semaglutide can expect to lose weight. But, what they don’t expect to lose is muscle mass.

Muscle loss is a natural part of aging— about three to eight percent every decade starting at age 30— and can be exacerbated by weight loss. The concern, however, is when the muscle loss occurs too rapidly or excessively.

Does semaglutide cause muscle loss?

While semaglutide is FDA-approved for weight loss, it’s important to note that the studies supporting its approval did not specifically account for the type of weight lost, leaving muscle mass potentially at risk.

A spokesperson from Novo Nordisk even stated that the company “did not specifically study the medicine’s impact on muscle mass” in its clinical trials.

Unfortunately, semaglutide muscle loss is a concern.

While there is no dedicated semaglutide muscle loss study, some studies have noted the correlation between semaglutide and muscle loss. The STEP 1 study (the primary clinical trial on semaglutide for weight loss) did conduct scans on all participants which monitors body mass. They found that participants on semaglutide experienced an average loss of 10.4% fat mass and 6.9% lean body mass.

When it comes to semaglutide fat vs muscle loss, the loss of fat does seem to outweigh the loss of lean body mass. And, though the weight loss can result in a reduced risk of cardiovascular events as well as renal benefits, the muscle loss with semaglutide is still a concern.

Why does semaglutide cause muscle loss?

The truth is, semaglutide itself is not the cause of muscle loss. The rapid weight loss is.

Semaglutide and other GLP-1 agonists have shown to be highly effective in helping obese individuals reach a healthier weight. The weight loss is not the problem. The problem is how quickly the weight loss happens.

Some muscle loss is normal when you lose weight—approximately 25% of the total weight loss will be lean body mass on average. But, the faster you lose weight, the more muscle you’re likely to lose alongside the fat.

With semaglutide, muscle loss ranged between 20% and 50% according to a review of studies. Why is muscle loss with semaglutide so much more prevalent?

Rapid weight loss can decrease muscle mass, lower bone density, and lower the resting metabolic rate.

The loss of lean body mass that occurs with medications like semaglutide is so great that it can lead to sarcopenia—which is typically associated with aging. Studies published in Current Diabetes Reviews and Endocrinology and Metabolism found that the rapid weight loss combined with a lack of proper nutrition and exercise leads to sarcopenia.

So, while you may be losing a significant amount of weight, you would still be considered obese—even if your BMI falls under 30. How? Sarcopenic obesity.

Sarcopenic obesity, or “skinny fat” mimics obesity. This is because the percentage of body fat is still higher than the percentage of muscle.

How to prevent muscle loss on semaglutide?

Individuals at risk of sarcopenia and semaglutide muscle loss can take steps to counteract the loss of lean body mass. You will need to focus on two areas: diet and exercise.

We know that the semaglutide muscle loss that leads to sarcopenia is caused by a lack of proper nutrition and exercise. So, to combat the issue we need to ensure that these areas are not lacking.

Changing your diet to avoid semaglutide muscle loss

The first step is to make changes to your diet. This approach not only helps prevent semaglutide muscle loss but also supports your overall weight loss goals and helps you maintain your weight long-term.

Balance your diet. Ensure your meals include a variety of nutrients to support muscle maintenance and overall health. Try using the plate method, or MyPlate. MyPlate has replaced the food pyramid and is a visual representation of how you should balance your plate with each meal. USDA offers plenty of free resources to help you determine the best way to portion your nutrients for a balanced diet.
Watch your protein. Increase your intake of high-quality protein to help preserve muscle mass. Aim for lean meats, beans, legumes, and dairy products. Protein is considered the “king of muscle food.” Animal sources (meat, eggs, milk) are considered the best options.
Stay hydrated. Drinking plenty of water is crucial for muscle function and recovery. Aim for at least eight glasses a day, but adjust based on your own personal needs. An additional benefit: staying hydrated can help prevent renal issues as well as semaglutide muscle loss.

Exercising to prevent muscle loss on semaglutide

Incorporating regular exercise, especially resistance and strength training, can significantly help preserve muscle mass while using semaglutide.

Resistance and strength training. Engage in activities like weight lifting, resistance bands, or body-weight exercises at least two to three times a week. These exercises stimulate muscle growth and maintenance.
Other exercises. Other exercises can benefit your overall health and help to continue building your muscle mass, but the resistance training is key when trying to prevent semaglutide muscle loss.

What to do, if you are already experiencing semaglutide muscle loss?

If you’ve noticed signs of muscle loss while using semaglutide, it’s important to take proactive steps to address this issue. You won’t be able to immediately undo what’s already been done, but you can prevent further loss and take steps to regain what’s already been lost.

- Consult with a Healthcare Professional. Speak with your doctor or a dietitian about your concerns. They can provide personalized advice and potentially adjust your medication or supplement regimen.

Monitor your body composition. This can be done at home with a scale that checks your body composition as well as your weight. You can also use your current scale and measuring tape to monitor. If the number on the scale is dropping, but your measurements are staying the same, you may be losing more lean muscle mass than fat.

Increase protein intake. Focus on incorporating more high-quality protein into your diet. Remember, protein is the “king of muscle food.”
Incorporate nutrient-dense foods: Make sure your diet includes foods rich in vitamins and minerals that support muscle health, such as leafy greens, nuts, seeds, and whole grains.
Adjust your exercise routine: Shift your workout routine to focus more attention on resistance and strength training exercises. If you’re not currently exercising, it’s time to start.
Get enough rest: Muscle recovery happens during rest, so make sure you’re getting enough quality sleep and allowing time for muscle repair between workouts.
Increase water intake. Proper hydration is essential for muscle function and recovery. Make sure you’re drinking enough water throughout the day. Don’t just aim for the arbitrary eight cups per day. Instead adjust your daily intake based on your body weight. The general rule is one ounce of water for every two pounds of body weight.

Exercises to preserve muscle mass

We’ve already discussed the benefits of resistance training when mitigating semaglutide muscle loss. Now, let’s discuss why it’s so effective.

Resistance training has been found to prevent muscle loss in obese individuals. A meta-analysis conducted in 2018 found that combining caloric restriction (CR) and resistance training stopped the CR-induced lean body mass loss completely—without curbing the fat body mass reduction.

For beginners, starting with simple yet effective exercises can make all the difference when preventing muscle loss on semaglutide.

Here are some beginner-friendly resistance and strength training exercises to help preserve muscle mass:

Bodyweight Exercises

These exercises use your own body weight as resistance. This makes them easily accessible and an excellent starting point. Common bodyweight exercises you can do are:

Squats
Lunges
Push-Ups
Planks

Resistance Band Exercises

Resistance bands are another easily accessible option. These take things a bit further than simply bodyweight and allows for a wider range of movement options. Resistance bands are a considered low-cost workout equipment, with many costing under $20.

Dumbbell Exercises

If you have access to dumbbells, these exercises can add extra resistance to your routine. Since it is so important to increase the weight to continuously challenge your muscles and promote growth, you will eventually need to incorporate some kind of weight beyond bodyweight.

You can join a gym if that’s feasible, purchase a set of dumbbells or kettlebells within your budget, or use items around the house to add extra weight to your workout. The options are endless.

Consult a healthcare professional to prevent semaglutide weight loss

To ensure a safe and effective weight loss journey with semaglutide, it’s crucial you work closely with a healthcare professional. They can provide personalized guidance, helping you navigate the potential side effects, like semaglutide muscle loss.

By being aware of these risks and taking proactive measures, you can optimize your weight loss results while maintaining your muscle mass and overall health.

Start your weight loss journey with Heally. Schedule a consultation with a doctor who understands the ins and outs of semaglutide today.