Based on the observation that a large proportion of lean tissues lost during weight loss seems to be from our adipose tissue, and the proportion of total lean mass increased after weight loss in STEP 1 and SUSTAIN 8 trials, it’s unlikely that using semaglutide to support weight loss leads to clinically meaningful reductions in muscle and other lean tissues.
Additionally, recent research on patients taking oral semaglutide (Rybelsus) to help manage type 2 diabetes has shown that losing lean mass during weight loss with semaglutide isn’t always a certainty.
The results showed that the participants significantly reduced their BMI by 4.3% and lost 2.8kg of body fat after 24 weeks. However, their lean mass levels didn’t change.
This might be attributed to the attention the study paid to providing adequate diet and exercise advice to the participants. To quote the study:
‘The attending doctors asked the patients about changes in eating and exercise in every visit, and all patients answered to continue diet and exercise therapy with [the] same level according to advice and instructions from the attending doctors and medical staff.’
How do you prevent muscle loss on semaglutide?
You can prevent muscle loss on semaglutide (Wegovy/Ozempic) by eating enough calories and protein, performing strength training 1-2 times a week, and aiming for 7-9 hours of sleep a night.
You can read our article on how to lose fat without losing muscle if you want an in-depth review of this topic.
However, here’s a quick summary of how to lose fat without losing muscle on semaglutide:
1) Eat enough protein: The amount of protein you eat is critical to successful weight loss. Aim for 20-40 grams of protein in each of your main meals; this includes breakfast. Great sources include yoghurt, other dairy products, eggs, meat, fish, seafood, tofu, and tempeh.
2) Resistance (strength) training: If you want to try and join a gym, great, but you don’t need to and can get all the benefits of strength training from the comfort of your home. Try to snack on exercise throughout the day to kickstart your resistance training habit by doing push-ups while the kettle boils and squats whilst you cook.
3) Make sure you eat enough: Crash diets lead to a starvation response by your brain, which may see your body breaking down lean tissue to provide an energy source as it tries to protect your fat stores. A calorie deficit of around 10% and eating a diet based on whole foods can help you lose weight sustainably without losing excess lean tissue.
4) Get enough sleep: Aim for 7-9 hours a night. Have a regular sleep schedule, avoid caffeine after midday, and screen 30 minutes before bedtime.
Take home message
In this article, we’ve provided evidence that semaglutide doesn’t necessarily lead to a significant loss of lean body mass during weight loss.
However, this isn’t to say that losing muscle and lean tissues while losing weight on semaglutide isn’t a possibility.
It’s possible to lose muscle and lean tissue during any weight loss journey if we’re not approaching it in the right way. Be sure to consider our suggestions above on how to lose fat without losing muscle.
But, if you’re currently on semaglutide or considering semaglutide to support your weight loss journey, feel reassured that it’s unlikely to adversely affect your muscle and lean tissues if you approach weight loss in the right way.
Not a magic pill
Weight-loss injections are designed as additional tools for healthy lifestyle change and shouldn’t be considered as lifelong medications.
Instead, they should be used to help you kickstart your weight-loss journey whilst you focus on building new, healthy habits.
Consider the use of antidepressants for people living with depression. They’re not designed to cure the condition. Instead, they’re designed to allow room for therapy to treat the condition’s underlying cause.
Mounjaro and Wegovy are similar. These medications can help silence food-related thoughts and also give you a boost of confidence with more immediate weight-loss results.
This helps to buy you the time and headspace to understand why your body may have struggled to lose weight previously, and to build new long-term healthy habits.
The core focus of our medication programmes are to calm down the feeling of food noise, lower your cravings, and to allow you to build healthier habits to keep the weight off for good.
The ultimate goal is to make losing weight feel second nature.
Second Nature’s medication programme
Second Nature currently provides Mounjaro as part of our Mounjaro weight-loss programme.
Why should you choose Second Nature over other medication providers if you’ve decided to try Mounjaro (assuming you’re eligible)?
For peace of mind.
Second Nature has worked with the NHS for over 6 years providing weight-loss programmes across the UK.
While our Mounjaro weight-loss programme is private and not currently used by the NHS, we’ve built the programmes focusing on scientific evidence, patient safety, and data security.
We hope that our 6+ years of working with the NHS and building a track record of effective weight-loss results will give you peace of mind to give us a try.
