By Dr Mohgah Elsheikh: For a long time, diet and exercise were the only options for people wanting to lose weight but weight loss medications such as Semaglutide (Wegovy) and Tirzepatide (Mounjaro) are now available. These medications are based on natural gut hormones, particularly GLP-1, that help reduce appetite, making it easier to eat less and lose weight.
How Effective Are These New Weight Loss Medications?
Clinical studies show that these medications can help people lose up to 20% of their body weight. That’s a significant achievement for those struggling with excess weight. However, it is important to understand that weight loss, regardless of how that is achieved, can sometimes include a reduction in both fat and lean tissue like muscle and bone. Research suggests that up to one-third of weight lost with the help of weight loss medications may come from lean mass.
Why Is Preserving Muscle and Bone Important?
Losing lean mass can impact your overall health and well-being. As you age, muscle loss becomes particularly challenging. You naturally lose muscle mass as you get older, a process called sarcopenia, a significant contributor to increased frailty.
Maintaining muscle mass is crucial for several health benefits, including burning calories and preventing weight regain, as metabolism is directly linked to muscle mass. Muscles also provide essential strength and stamina for daily activities like climbing stairs and carrying shopping, while helping to maintain balance and reduce the risk of falls. Additionally, preserving muscle mass is important for bone health, as losing bone mass can lead to weakened bones and increased fracture risk. Furthermore, a healthy muscle mass enhances insulin effectiveness, lowering the risk of developing type 2 diabetes and other metabolic diseases.
Why Do We Lose Lean Mass After Weight Loss?
The long-term effects of GLP-1 medications on muscle and bone are still being studied, leaving it uncertain how and to what extent these medications contribute to lean mass loss. However, it is thought that when the body loses weight, particularly if that weight loss is rapid, it breaks down muscle proteins to be used as fuel, which can lead to a reduction in lean muscle mass. The loss of muscle can also decrease the dynamic load on bones, which is typically created by muscle contractions during movement. Consequently, the body may not produce as much new bone tissue as before, potentially resulting in a decrease in bone mineral density.
How to Protect Your Muscle and Bone During Weight Loss
If you are worried about losing muscle mass while taking weight-loss medications, there’s some good news: you can slow down the loss by making a few key lifestyle changes:
1. Eat Enough Protein
Protein is crucial for maintaining and building muscle. The current recommended daily allowance of protein is 0.8 g per kg of body weight daily. However, it is thought that more protein is needed to maintain muscle, particularly if you are over the age of 65 years. Try to consume at least 1 g of protein for every kg of your body weight daily, divided into three meals. Good sources of protein include eggs, Greek and protein yogurts, lean meats, fish, tofu and lentils. Supplement with protein shakes if needed.
2. Strength Training is Key
One of the best ways to preserve muscle mass is to do resistance (weight) training. Research shows that even short workouts can make a difference. Just 11 minutes of resistance training, three times a week, can lead to noticeable improvements.
You don’t need a gym to start strength training. Try these simple exercises at home:
– Body weight exercises such as squats, push-ups, planks and lunges
– Use resistance bands, dumbbells or even household items such as water bottles or backpacks filled with books as weights.
To achieve success in exercise, start slowly by engaging in bodyweight moves before incorporating resistance, especially if you are new to it. Ensure you work all major muscle groups, including legs, back, chest, shoulders, arms and core. Prioritise proper form by moving slowly and with control to prevent injuries. Finally, gradually increase reps or add weight over time.
3. Stay Active in Everyday Life
Aim to be physically active every day. The more the better. Try to avoid sitting for long periods. Try to take regular breaks every 15-20 minutes to walk around and stretch your legs. If structured workouts don’t fit your schedule, try these simple ways to stay active:
A Balanced Approach to Weight Loss
Weight loss medications can be life-changing, but they work best when combined with strength training, a protein-rich diet and an active lifestyle. This approach helps protect muscle and bone mass, keeps your metabolism strong and improves energy levels.
The primary objective of taking these medications isn’t just weight loss—it is to enhance your overall health. Achieving optimal health requires the right combination of fitness and nutrition. By focusing on muscle preservation and overall well-being, you will maximise the benefits of weight loss medications and maintain your health for years to come.