From the Guidelines
Ozempic (semaglutide) may contribute to muscle loss in some patients due to its weight loss effects, which can include both fat and lean muscle mass reduction. The medication works by reducing appetite and slowing gastric emptying, leading to weight loss [ 1 ]. To minimize muscle wasting while taking Ozempic, patients should incorporate regular resistance training (2-3 sessions weekly) and ensure adequate protein intake (1.2-1.6 grams per kilogram of body weight daily) [ 1 ].
Key Considerations for Minimizing Muscle Wasting
- Regular resistance training to maintain muscle mass
- Adequate protein intake spread throughout the day in 20-30 gram portions
- Staying physically active with both strength training and aerobic exercise
- Maintaining proper hydration and getting sufficient sleep (7-9 hours nightly)
The mechanism behind potential muscle loss relates to reduced caloric intake and the body's adaptation to this deficit, rather than a direct effect of the medication on muscle tissue [ 1 ]. If significant muscle weakness or loss occurs, patients should consult their healthcare provider, who might recommend adjusting the medication dosage or implementing additional nutritional strategies. According to the most recent consensus statement from the Association of Anaesthetists and other reputable medical societies [ 1 ], no dose change is necessary for semaglutide regarding its potential impact on muscle wasting, emphasizing the importance of overall lifestyle adjustments to mitigate this risk.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Muscle Wasting and Ozempic (Semaglutide)
- Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist used for the treatment of type 2 diabetes and weight management.
- Studies have shown that semaglutide can lead to a significant decrease in fat-free mass (FFM), which is an alternative index of muscle mass 2.
- A network meta-analysis of randomized controlled trials found that semaglutide, dapagliflozin, and canagliflozin showed a significant decrease in FFM compared to the placebo 2.
- Another study found that semaglutide decreased psoas muscle volume by 9.3% over 24 weeks, but did not significantly change physical function 3.
- Resistance training has been shown to increase lean weight, improve physical performance, and reduce fat weight, which may help mitigate muscle loss associated with semaglutide use 4.
- Semaglutide has been associated with various adverse effects, including acute pancreatitis, anesthetic risks, and acute kidney injury, but its effects on muscle mass and physical function are still being studied 5.
- An ongoing randomized controlled trial is investigating the effects of semaglutide on physical function, body composition, and biomarkers of aging in older adults with overweight and insulin resistance 6.
Key Findings
- Semaglutide can lead to a significant decrease in muscle mass, as measured by FFM and psoas muscle volume 2, 3.
- Resistance training may help mitigate muscle loss associated with semaglutide use 4.
- Semaglutide has various adverse effects, and its effects on muscle mass and physical function are still being studied 5, 6.
Studies on Semaglutide and Muscle Wasting
- A 2021 study found that semaglutide, dapagliflozin, and canagliflozin showed a significant decrease in FFM compared to the placebo 2.
- A 2025 study found that semaglutide decreased psoas muscle volume by 9.3% over 24 weeks, but did not significantly change physical function 3.
- A 2024 study is investigating the effects of semaglutide on physical function, body composition, and biomarkers of aging in older adults with overweight and insulin resistance 6.