Side Effects of Ozempic: Should You Worry About Muscle Loss?

Everyone just seems to be losing weight.

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As a trainer, I like to go around patting myself and my staff on the back for the job well done. Look at us helping EVERYONE lose a LOT of weight. 

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If it were only that magical. Unfortunately, we aren’t suddenly getting perfect adherence to a healthy diet and plenty of movement outside of the gym. What we are getting is the use of GLP-1s, a drug you are sure to have heard about and almost certainly know more than one person taking. 

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GLP-1s seem to have an almost magical effect on weight loss, though: people who have had 15 lbs of stubborn fat or 50 lbs to lose are suddenly losing it quite quickly. The short term side effects seem fairly minimal. What’s the catch?

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More on that later. In our role as trainers, we realize people are going to take these drugs, so how can we best help them realize how to make the most of it? The fact is, when you take a GLP-1, you are going to lose all kinds of weight: fat AND ALSO muscle. Losing muscle isn’t good for your long term health. Having a strength training plan will help you maintain as much of your existing muscle as possible while losing the fat. 

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Let’s explore more!

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How Ozempic And Other Appetite Suppressants Work

These medications work by mimicking a natural hormone that the body should be producing, GLP-1, that helps control your blood sugar and regulates your appetite. In individuals who have an excess of body fat, sometimes that hormone isn’t working the way it should be. 

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The impact on your appetite and thus, on your weight loss, is two fold: it slows digestion and reduces hunger. 

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This hormone literally slows down the movement of food through your stomach, causing you to feel fuller longer. Many clients report just simply not having an appetite. Not having an appetite leads to eating less calories, leading to overall weight loss. 

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Muscle Loss vs. Fat Loss

Weight loss = fat + muscle loss, unfortunately. It would be wonderful if it was just all fat, right? In fact, a recent study showed GLP-1 users can attribute up to 40% of their weight loss to muscle loss, which is a devastating number. Which means if you were to lose 10 lbs, a relatively small number for GLP-1 users, 4 lbs of that would be muscle. That could take a year or more to add back on.

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The goal of any healthy, sustainable weight loss program is to lose fat while maintaining almost all of your muscle mass. To be clear, any rapid weight loss can lead to a higher muscle loss. Our goal is to make sure you maintain as much muscle as possible while losing weight. This will mean your weight loss is a little slower, but significantly healthier. 

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What the Research Says About Side Effects of GLP-1s and Muscle Loss

Muscle loss, or what is termed sarcopenia, can lead to many issues both physically and even mentally. Overall, it is a major concern for anyone, but especially senior citizens. 

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Muscle loss will always make you weaker and less able to perform normal everyday activities like climbing the stairs, taking a walk, or performing household tasks. More importantly as you age, it opens you up to a much higher risk of fractures and falls. 

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Muscle loss leads to a host of chronic diseases, such as osteoporosis, heart disease, and diabetes. It can lead to cognitive decline and potentially even dementia. 

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Relating to weight loss, muscle loss can even lead to a lower metabolic rate, which again leads to weight gain. Devastating, right? It doesn’t have to be if you strength train, eat a diet high in protein, and protect your muscle as much as possible!

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How to Protect Muscle While on Ozempic

Strength train. It can be that simple. While there is no definitive study on preserving muscle while on a GLP-1, it is widely recommended to take up a strength training routine while taking the drug. While we wrote a whole blog post about gaining muscle, it can mostly be applied to preserve muscle during weight loss as well. https://www.evolvetrainingnj.com/post/5-ways-to-gain-5lbs-of-muscle

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The key takeaways:

Progressive overload: make some changes to your exercises each time you do them. That can be adding weight, adding reps, shortening your rest period, or taking a longer time to do the exercise.

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Compound movements: you should be performing some basic movements that require a lot of muscles at least twice per week. That includes the squat, deadlift, press, pull, and any variation of those movements. 

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Eat more protein: this is going to be the hard part when you’re taking a GLP-1. You have to be in the mood for the foods that contain protein. The general guideline is that adults should be consuming around 0.8g of protein per lb of bodyweight that they weight. For example, a 200 lb person should be eating 160g of protein every day. That’s not always easy, especially if you aren’t already a healthy eater. 

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Final Thoughts

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Does Ozempic cause muscle loss? It does. Does it help people who have tried to lose weight for years? Certainly. Is it healthy long term? We don’t really know yet. 

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A client of ours that takes Ozempic had this to say: “A few months after starting Ozempic it felt great losing the weight I always wanted to lose but I could tell my muscle mass was dwindling too. If I hadn’t kept up with strength training, I would not have been able to maintain the muscle mass I worked so hard to achieve in the past. It is so important to keep up with strength training while on the GLP-1 so that you really look and feel great while losing fat.” -M.S.

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The most important thing you can do is discuss your options with your doctor if you need to lose weight. And the most important thing you can do if you’re on Ozempic or another GLP-1 is strength train. It’ll make a world of difference on your long term health and success with keeping the fat off. 

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