{"id":2730,"date":"2024-12-07T21:15:03","date_gmt":"2024-12-08T02:15:03","guid":{"rendered":"http:\/\/haidut.me\/?p=2730"},"modified":"2024-12-08T02:29:33","modified_gmt":"2024-12-08T07:29:33","slug":"almost-half-of-weight-loss-from-glp-1-drugs-ozempic-wegovy-mounjaro-etc-is-muscle-mass","status":"publish","type":"post","link":"https:\/\/haidut.me\/?p=2730","title":{"rendered":"Almost half of weight loss from GLP-1 drugs (Ozempic, Wegovy, Mounjaro, etc) is muscle mass"},"content":{"rendered":"<p>Just minutes after posting about the terrible effects of metformin on muscle mass, the study below pops up into my news feed (synchronicity again?) corroborating that blood glucose is not to be messed with on a whim. At least not if one cares about keeping their muscles &#8211; the primary factor determining one&#8217;s resting metabolic rate (RMR) and future risk of mortality\/morbidity. Yet another &#8220;success&#8221; story from Big Pharma turns out to be nothing, but potentially another global health disaster in the making. Those companies just can&#8217;t help but create the perfect &#8220;Trojan Horse&#8221; drug every time, Namely, a drug that seems to have a striking effect initially in ameliorating symptom(s) of a given disease &#8211; obesity\/diabetes in the case of metformin and GLP-1 agonists &#8211; yet in the background exacerbates systemic health so that the overall effects are profoundly negative, thus creating multiple secondary &#8220;opportunities&#8221; for the drugs that treat the side effects of the primary drug. Worse, in many cases the side effects of the primary drug are so terrible, it is arguably better to never take it in the first place. Some notable examples of such &#8220;blockbuster&#8221; stories from Big Pharma are the SSRI class of antidepressants, anxiolytic\u00a0 drugs (Klonopin anyone?), antipsychotics, proton pump inhibitors (PPI), statins, diabetes drugs such as metformin\/phenformin, estrogenic HRT, 5-alpha reductase (5-AR) inhibitors such as finasteride\/dutasteride, glucocorticoid therapy for inflammation, etc. This time, the new &#8220;blockbuster&#8221; disaster in the making seems to be the GLP-1 agonist class of drugs represented by flagship brand names such as Ozempic, Wegovy, Mounjaro, ZepBound, etc. Some of their side effects are already known and include apparently &#8220;acceptable&#8221; (according to whom?) increase in risk for conditions such as gastroparesis, blindness, and thyroid cancer. In addition, a recent study argues convincingly that <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3920789\/\">GLP-1 agonists may cause pancreatic cancer<\/a> when used long-term, and that cancer is lethal for the vast majority of people who get it. Yet, pharma companies can always fudge the stats to present the risk of such side effects as very low, thus convincing patients that the drug is worth it. However, what if the primary effect for which the drug is prescribed\/marketed &#8211; weight loss &#8211; is another disaster in disguise? Wouldn&#8217;t that directly largely invalidate the very use case for such drugs? Worst of all, not only is this sacropenic side effect of GLP-1 drugs apparently known to medicine, the study below now confirms that the sarcopenic effects are very pronounced even in the heart muscle, which one of the most resilient to muscle tissue loss due to its high concentrations of anti-catabolic steroids such as testosterone, pregnenolone, DHEA and (in children and women) progesterone. And the cherry in the cake about this study is the recognition by study authors that muscle mass is one of the primary factors in controlling blood glucose and preventing development of diabetes (see my comment above about RMR). So, <span style=\"text-decoration: underline;\"><strong>the current &#8220;blockbuster&#8221; drugs for preventing and treating obesity\/diabetes actually excel at destroying the primary protective factor we have against obesity\/diabetes<\/strong><\/span> (and CVD and mortality, and so on)!?!? Peak insanity, this can&#8217;t go on for much longer&#8230;<\/p>\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869\">https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869<\/a><\/p>\n<p>&#8220;&#8230;The significant reduction in body weight (BW) induced by glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as semaglutide, has led to recent clinical trials demonstrating benefit in certain forms of cardiovascular disease (CVD).<a class=\"anchor anchor-primary\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869#bib1\" name=\"bbib1\" data-sd-ui-side-panel-opener=\"true\" data-xocs-content-type=\"reference\" data-xocs-content-id=\"bib1\"><span class=\"anchor-text-container\"><span class=\"anchor-text\"><sup>1<\/sup><\/span><\/span><\/a>\u00a0While these findings are promising for CV patients, <span style=\"text-decoration: underline; color: #ff0000;\"><strong>a side-effect of GLP-1RAs use is the loss of skeletal muscle (lean BW) mass<\/strong><\/span>.<a class=\"anchor anchor-primary\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869#bib2\" name=\"bbib2\" data-sd-ui-side-panel-opener=\"true\" data-xocs-content-type=\"reference\" data-xocs-content-id=\"bib2\"><span class=\"anchor-text-container\"><span class=\"anchor-text\"><sup>2<\/sup><\/span><\/span><\/a>\u00a0Although it is likely that the metabolic benefits from weight loss may outweigh modest sarcopenia, <span style=\"text-decoration: underline;\"><strong>this loss of lean BW could potentially lead to exercise intolerance that may reduce the quality of life<\/strong><\/span> in individuals at risk for or with heart failure.<a class=\"anchor anchor-primary\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869#bib3\" name=\"bbib3\" data-sd-ui-side-panel-opener=\"true\" data-xocs-content-type=\"reference\" data-xocs-content-id=\"bib3\"><span class=\"anchor-text-container\"><span class=\"anchor-text\"><sup>3<\/sup><\/span><\/span><\/a>\u00a0Given this, intense research efforts are ongoing to try to understand how GLP-1RAs induce loss of skeletal muscle mass.<a class=\"anchor anchor-primary\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869#bib4\" name=\"bbib4\" data-sd-ui-side-panel-opener=\"true\" data-xocs-content-type=\"reference\" data-xocs-content-id=\"bib4\"><span class=\"anchor-text-container\"><span class=\"anchor-text\"><sup>4<\/sup><\/span><\/span><\/a>\u00a0However, little attention has been given to the potential that <span style=\"text-decoration: underline; color: #ff0000;\"><strong>other types of muscle, such as cardiac muscle, may also be lost in response to GLP-1RAs<\/strong><\/span>.&#8221;<\/p>\n<p><a href=\"https:\/\/www.thelancet.com\/journals\/landia\/article\/PIIS2213-8587(24)00272-9\/abstract\">https:\/\/www.thelancet.com\/journals\/landia\/article\/PIIS2213-8587(24)00272-9\/abstract<\/a><\/p>\n<p><a href=\"https:\/\/www.ualberta.ca\/en\/folio\/2024\/11\/weight-loss-drug-found-to-shrink-heart-muscle.html\">https:\/\/www.ualberta.ca\/en\/folio\/2024\/11\/weight-loss-drug-found-to-shrink-heart-muscle.html<\/a><\/p>\n<p>&#8220;&#8230;<span style=\"text-decoration: underline;\"><strong>Trendy weight-loss drugs making headlines for shrinking waistlines may also be shrinking the human heart and other muscles<\/strong><\/span>, according to a\u00a0<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2452302X24002869\">new University of Alberta study<\/a> whose authors say should serve as a \u201ccautionary tale\u201d about possible long-term health effects of these drugs&#8230;Dyck and his team set out to study why <span style=\"text-decoration: underline; color: #ff0000;\"><strong>a reported side-effect of the leading weight-loss drug Ozempic is the loss of skeletal muscle<\/strong><\/span>. Ozempic, known medically as semaglutide, was originally designed to help adult patients with type 2 diabetes control their blood sugar. However, this drug \u2014 and a host of others in this class of medication \u2014 are also being touted for their effectiveness as an anti-obesity medication. Using mice for the study, the <span style=\"text-decoration: underline;\"><strong>researchers found that heart muscle also decreased in both obese and lean mice. The systemic effect observed in mice was then confirmed in cultured human heart cells<\/strong><\/span>.&#8221;<\/p>\n<p>&#8220;&#8230;Dyck\u2019s study comes on the heels of a <a href=\"https:\/\/www.thelancet.com\/journals\/landia\/article\/PIIS2213-8587(24)00272-9\/abstract\">commentary published in the November issue of\u00a0<em>The Lancet<\/em><\/a>\u00a0by an international team of researchers from the U of A, McMaster and Louisiana State University who examined <span style=\"text-decoration: underline; color: #ff0000;\"><strong>emerging research showing that up to 40 per cent of the weight lost by people using weight-loss drugs is actually muscle<\/strong><\/span>. <a href=\"https:\/\/apps.ualberta.ca\/directory\/person\/cprado\">Carla Prado<\/a>, a nutrition researcher in the\u00a0<a href=\"https:\/\/www.ualberta.ca\/en\/agriculture-life-environment-sciences\/index.html\">Faculty of Agricultural, Life &amp; Environmental Sciences<\/a> and lead author on the commentary, explains <span style=\"text-decoration: underline;\"><strong><span style=\"color: #ff0000; text-decoration: underline;\">this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets or normal aging<\/span> and could lead to a host of long-term health issues<\/strong><\/span> \u2014 including decreased immunity, increased risk of infections and poor wound healing. \u201c<span style=\"text-decoration: underline;\"><strong>Muscle does much more than just help us move or lift things. It is a powerful organ that keeps us healthy in a number of ways<\/strong><\/span>,\u201d she says. For example, muscle stores important building blocks \u2014 amino acids \u2014 that the body uses when we\u2019re sick, stressed or injured to repair itself and stay strong. <span style=\"text-decoration: underline; color: #ff0000;\"><strong>It also plays a huge role in managing blood sugar, which helps prevent diabetes<\/strong><\/span>. As well, Prado notes <span style=\"text-decoration: underline;\"><strong>muscle releases special molecules called myokines that signal other parts of the body to help fight infections and support our immune system<\/strong><\/span>. \u201cThat\u2019s why <span style=\"text-decoration: underline; color: #ff0000;\"><strong>preserving muscle is so important, especially during weight-loss treatments<\/strong><\/span> \u2014 it\u2019s not just about staying strong, but about keeping our whole body resilient and healthy.\u201d In the commentary, the authors suggest that <span style=\"text-decoration: underline;\"><strong>muscle loss due to weight reduction may also exacerbate conditions<\/strong><\/span> like sarcopenic obesity \u2014 characterized by a combination of high body fat and low skeletal muscle mass \u2014 <span style=\"text-decoration: underline;\"><strong>which contributes to poorer health outcomes, <span style=\"color: #ff0000; text-decoration: underline;\">including<\/span> cardiovascular disease and <span style=\"color: #ff0000; text-decoration: underline;\">higher mortality rates<\/span><\/strong><\/span>.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Just minutes after posting about the terrible effects of metformin on muscle mass, the study below pops&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[912,285,2084,2087,778,319,2085,779,2086],"class_list":["post-2730","post","type-post","status-publish","format-standard","hentry","category-science","tag-atrophy","tag-diabetes","tag-glp-1","tag-mounjaro","tag-muscle","tag-obesity","tag-ozempic","tag-sarcopenia","tag-wegovy","wpcat-2-id"],"_links":{"self":[{"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/posts\/2730","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/haidut.me\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2730"}],"version-history":[{"count":2,"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/posts\/2730\/revisions"}],"predecessor-version":[{"id":2732,"href":"https:\/\/haidut.me\/index.php?rest_route=\/wp\/v2\/posts\/2730\/revisions\/2732"}],"wp:attachment":[{"href":"https:\/\/haidut.me\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2730"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/haidut.me\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2730"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/haidut.me\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2730"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}