From the Guidelines
GLP-1 analogs can cause muscle loss, but this effect can be minimized with proper exercise and nutrition strategies, and their use is generally recommended for weight loss in individuals with HIV, as seen in a recent study published in JAMA 1. When using GLP-1 analogs for weight loss, it is essential to incorporate regular resistance training at least 2-3 times weekly, focusing on major muscle groups with progressive overload, to minimize muscle loss.
- Consume adequate protein (1.6-2.2g per kg of body weight daily), spread throughout the day in 20-30g portions, to help preserve lean mass.
- Maintain a moderate calorie deficit (no more than 500-750 calories below maintenance) rather than severe restriction, as this can help reduce the percentage of weight loss coming from lean mass.
- Additionally, adequate sleep (7-9 hours) and stress management can also help minimize muscle catabolism during weight loss, as supported by the recommendation to emphasize lifestyle changes, including diet and exercise, especially for those at increased likelihood of weight gain with use of InSTI- and tenofovir alafenamide–based regimens 1. The efficacy of glucagon-like peptide-1 receptor agonists for weight loss among people with HIV is similar to that seen in the general population, and a randomized clinical trial found that once-weekly semaglutide is associated with decreased abdominal visceral and subcutaneous adipose tissue, and overall body fat, compared with placebo 1.
- It is crucial to weigh the benefits of using GLP-1 analogs for weight loss against the potential risk of muscle loss, particularly in older individuals at risk for sarcopenia.
- However, with proper exercise and nutrition strategies, the benefits of using GLP-1 analogs for weight loss can outweigh the risks, and their use is generally recommended, as seen in the recent study published in JAMA 1.
From the Research
Glp Analogue and Muscle Loss
- There is no direct evidence in the provided studies to suggest a link between GLP-1 analogues and muscle loss 2, 3, 4, 5, 6.
- The studies primarily focus on the effects of GLP-1 receptor agonists, such as liraglutide and semaglutide, on cardiovascular and renal outcomes in patients with type 2 diabetes 2, 3, 4.
- Some studies discuss the potential benefits of GLP-1 receptor agonists in reducing cardiovascular risk factors and improving kidney outcomes in patients with type 2 diabetes 3, 5, 6.
- However, none of the studies mention muscle loss as a potential outcome or side effect of GLP-1 analogue treatment.
- Therefore, there is limited evidence to support a conclusion about the relationship between GLP-1 analogues and muscle loss, and further research may be needed to fully understand this potential association.