Metabolic HealthHow to keep muscle and bone while losing weight on semaglutide or tirzepatide
GLP-1 drugs like semaglutide and tirzepatide produce large weight loss, so attention is shifting from how much weight is lost to what kind of tissue is lost. This review concludes that these drugs mostly reduce fat, including harmful visceral fat, with smaller but consistent drops in lean mass. A drop in scanner-measured lean mass is not the same as losing working muscle or strength. The authors recommend a food-first approach with adequate protein, structured resistance exercise, management of nausea and constipation, and checks for nutrient shortfalls. Protein shakes or complete meal replacements can help when eating is low. Creatine, leucine, HMB, fiber, probiotics and omega-3s are optional extras with thin evidence. Better tracking of muscle, function and bone is needed.
