What is the clinical evidence for creatine's role in healthy weight loss?

From the Guidelines

Creatine supplementation is not a primary strategy for healthy weight loss, and its role is more focused on preserving lean muscle mass during caloric restriction, rather than directly promoting fat loss. When considering the clinical evidence for creatine's role in healthy weight loss, it's essential to prioritize the most recent and highest quality studies. According to the 2023 standards of care in diabetes, there is no clear evidence that nutrition supplements, including creatine, are effective for weight loss 1.

The most effective approach to weight loss, as supported by clinical evidence, is achieving a 500–750 kcal/day energy deficit, which can be attained through lifestyle programs that promote a caloric intake of approximately 1,200–1,500 kcal/day for women and 1,500–1,800 kcal/day for men, adjusted for the individual’s baseline body weight 1. Clinical benefits typically begin upon achieving 3–5% weight loss, and more intensive weight loss goals may be pursued if needed to achieve further health improvements 1.

Some key points to consider when evaluating the role of creatine in weight loss include:

• The importance of creating an energy deficit to promote weight loss
• The benefits of resistance training and preserving lean muscle mass during caloric restriction
• The need for a comprehensive lifestyle intervention that includes dietary changes and increased physical activity
• The lack of clear evidence supporting the use of nutrition supplements, including creatine, for weight loss

In terms of specific recommendations, the 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults emphasizes the importance of lifestyle changes, including dietary modifications and increased physical activity, for achieving and maintaining weight loss 1. While creatine supplementation may have some benefits in preserving lean muscle mass during caloric restriction, it should not be relied upon as a primary strategy for weight loss. Instead, individuals should focus on achieving a sustainable energy deficit through a combination of dietary changes and increased physical activity, with a goal of achieving a weight loss of 3-5% to realize clinical benefits 1.

From the Research

Clinical Evidence for Creatine's Role in Healthy Weight Loss

• The current evidence suggests that creatine supplementation can increase lean body mass and muscle strength, which may be beneficial for weight loss 2, 3, 4.
• However, there is limited research on the direct effects of creatine supplementation on weight loss, and the existing studies do not provide conclusive evidence 2, 3, 4, 5, 6.
• Some studies suggest that creatine supplementation may increase body mass, which could potentially offset the benefits of weight loss 5.
• Creatine supplementation has been shown to improve exercise performance and increase fat-free mass, which may be beneficial for weight loss 3, 6.
• The evidence suggests that creatine supplementation is safe and well-tolerated in healthy individuals, but more research is needed to fully understand its effects on weight loss 2, 3, 4, 5, 6.

Mechanisms of Creatine Supplementation

• Creatine supplementation increases skeletal muscle phosphocreatine stores, facilitating a greater capacity to rapidly resynthesize ATP and buffer hydrogen ion accumulation 5.
• Creatine supplementation may enhance glycogen resynthesis and content, an important fuel to support high-intensity aerobic exercise 5.
• Creatine supplementation has anti-inflammatory and antioxidant effects, which may be beneficial for overall health and weight loss 5.

Limitations and Future Directions

• More research is needed to fully understand the effects of creatine supplementation on weight loss and to determine the optimal dosage and duration of supplementation 2, 3, 4, 5, 6.
• The existing studies have methodological limitations, and more high-quality research is needed to provide conclusive evidence 2, 3, 4, 5, 6.