Preventive Strategies to Reduce Sarcopenia Risk During GLP-1-Based Anti-Obesity Therapy

Area of Science:

• Endocrinology
• Geriatrics
• Sports Medicine

Background:

• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for obesity treatment.
• Weight loss with GLP-1 RAs can lead to reductions in fat-free mass, risking sarcopenia.
• Sarcopenia, the loss of muscle mass and strength, is a concern in older adults and those with chronic conditions.

Purpose of the Study:

• To review evidence and strategies for preserving muscle health during GLP-1 RA therapy.
• To identify patients at higher risk for muscle loss.
• To provide practical, evidence-informed recommendations for clinicians.

Main Methods:

• Narrative review of current literature on GLP-1 RAs, obesity, sarcopenia, exercise, and nutrition.
• Identification of risk factors for sarcopenia in patients undergoing anti-obesity treatment.
• Synthesis of preventive and management strategies.

Main Results:

• Higher-risk patients include older adults, frail individuals, those with low muscle mass/strength, sarcopenic obesity, CKD, low activity, or rapid weight loss.
• Preventive strategies include baseline assessment, resistance/multicomponent exercise, adequate protein, nutritional support, and monitoring.
• Individualized treatment pacing and dose adjustment may be necessary for high-risk patients.

Conclusions:

• A risk-stratified, multidisciplinary approach is recommended to preserve muscle mass and function.
• Combining GLP-1 RA therapy with muscle-preserving strategies can maintain cardiometabolic benefits.
• Further research is needed, particularly GLP-1 RA-specific trials, to refine these recommendations.