Hi {{first_name}} -
One of the biggest concerns I hear about GLP-1 medications is muscle loss. And honestly, this has been a major concern of mine too. Because are we all going to be skinny, weak people in our 80s? Are hip fractures going to increase due to muscle/bone loss? Are we just exchanging one problem for another?
But like most things, the answer is more nuanced than the headlines make it sound.
A recent article from Substance Over Noise looked at two new reviews on GLP-1s and body composition. One found that lean body mass loss is relatively minimal, around 1–4% over 3 to 12 months. The other found that when you look at lean mass as a percentage of total weight lost, muscle-related losses can look much higher, sometimes around 30–35%. And of course, the headlines grab onto that number.
So which one is right?
Actually both.
The difference comes down to how the data is measured. A smaller percentage drop in lean mass can still represent a larger share of total weight loss, especially when someone loses a significant amount of weight. It really just matters how you crunch the numbers.
But there is another important issue: most studies use DEXA scans, and DEXA cannot perfectly separate true skeletal muscle from other types of lean tissue. Some of what gets labeled as “lean mass loss” may actually be changes in liver fat, glycogen, water, or intramuscular fat, not necessarily loss of functional muscle. So our measurement systems are also imperfect.
But what really matters is not just a number on a scan. What is more important is strength, mobility, function, independence, and long-term health.
The early research looking at actual muscle function and mobility is more reassuring. Some studies show that even when muscle size decreases, grip strength, knee strength, gait speed, or physical function can be maintained or even improved. So maybe the “loss” isn’t having that much impact on actual movement ability.
But this doesn’t mean you can just stop the strength training or eating your protein.
GLP1 or not, all of us need to be thinking about our muscle health because muscle = longevity. So what do you do?
Continue to prioritize protein.
Strength train 2–3 times per week.
Include regular movement or cardio.
Track strength and function, not just weight.
Pay extra attention if you are older, have a lower starting body weight, have a history of weight cycling, or already have low muscle mass.
The takeaway: GLP-1s do not automatically destroy muscle, but weight loss without a plan can absolutely lead to unnecessary lean mass loss.
Recipe of the Week Sponsored by “I Can’t Believe It’s Not Butter”
Maple Mustard Chicken with Tangy Lemon Chili Broccolini is a flavorful, well-balanced dish that’s perfect for a wholesome dinner. The chicken is glazed with a sweet and zesty maple-Dijon sauce, paired with broccolini tossed in a bright lemon chili dressing and topped with slivered almonds. Serve over brown rice or quinoa for a satisfying blend of savory, spicy, and citrusy notes. Great for meal prep or a fresh weeknight meal.
What’s Happening This Week
This week on the podcast, I shared an episode about identifying the root cause of diabetes with functional medicine practitioner Jason Shumard. While his approach may not be traditional, I think he had an interesting POV. I like to speak to people who maybe don’t fit the “norm,” sometimes to get a different perspective on things. I hope you listen with an open mind.
I also interviewed Jeremy Shane, founder of Life for Health, about his unique point of view on financially encouraging people to STAY healthy, rather than just treating their illness when it comes to insurance. I love that there are so many people out there trying to make insurance and health coverage work better.
Over on YouTube, I posted a video about why a low carb diet is unnecessary on GLP1 and might even make certain side effects worse. And another video about replacing food addiction with healthy habits.
Thank you so much for being here! See you next week!
GLP1 Provider Recommendation
If you are looking for a GLP-1 provider who offers comprehensive care, check out Tyde Wellness. Tyde is built for long-term personalized support, with a care team you can message, GLP-1-specific nutrition guidance, and consultations where you can actually talk to a provider. They also offer microdose GLP-1 programs, hormone therapy, and longevity peptides.
Visit tydewellness.com/glp1hub and use code GLP1HUB50 for $50 off your first month.
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