Do GLP-1 Medications Have To Be Continued Indefinitely?
Several months back, an article came out discussing how GLP-1 (glucagon-like peptide-1) medications are more likely to cause muscle loss. More recently in the media, there is much discussion on what happens after coming off of a GLP-1 if it is used for weight loss.
The GLP-1 medications, Saxenda® and Wegovy™, are FDA-approved for weight loss. GLP-1 medications stimulate the secretion of insulin and slow the release of glucagon in your body, influencing blood sugar control. They also slow gastric emptying and are powerful appetite suppressants. With this being said, there are potential side effects, and these medications are not magic bullets. What I mean by this is that anyone on a GLP-1 has to combine it with lifestyle (nutrition, exercise, mindset, stress management work, and sleep) to allow it to be most effective.
For example, if someone was on a GLP-1 and did not make any lifestyle changes, the medication may provide a weight loss result, but it would be suboptimal and there is a high probability that some of the weight loss would include lean muscle mass.
Before I continue, I want to be clear that I use my knowledge as an obesity medicine board certified physician in my coaching practice, but I do not prescribe medications to my clients. With that being said, I do have many clients on GLP-1 medications that they have prescribed through their physician, and they utilize my health programming to optimize the effect of their medication.
I also want to be clear that we MUST remove the stigma of the use of GLP-1 medications. They can be life-changing for some, and anyone who is getting optimal weight loss results on GLP-1 medications is working for it. The medication is often just leveling the playing field to allow their results to happen.
Optimal weight loss is muscle maintenance with fat loss. So, I loop back around to my original point regarding GLP-1 medications and muscle loss. You see, it is not the medication that causes the muscle loss. It is the decrease in appetite that makes many not want to eat AND if they are not aware of their proper nutrition needs (especially protein), then yes - they will lose muscle mass. To top it off, if individuals on GLP-1 medications are not strength training, they will also be more predisposed to lose muscle mass. Without adequate protein and strength training, for every pound on the scale lost, we could lose up to 25% lean mass.
To answer the question.
GLP-1s do not directly cause muscle loss, but they do indirectly because of the lack of appetite that they bring about. And, if individuals on GLP-1s are not being guided in their nutrition, then this is going to put them more at risk for muscle loss.
All of this information, I give to discuss the next question, which I get all the time. If I start a GLP-1 medication for weight loss, will I have to continue it forever? The answer is maybe. And here is the reason.
First, if an individual is already prediabetic or diabetic, then using a GLP-1 will benefit them for the control of their diabetes and also their weight. There is a good chance that this medication will be needed indefinitely, especially if it is tolerated well. The recommendation for optimal health will have to include nutrition and exercise principles.
Let’s discuss if a GLP-1 is used outside of the diabetic individual.
If individuals on a GLP-1 (not prediabetic or diabetic) lose weight without optimizing nutrition or exercise, then they will lose muscle mass. If they stop the medication and their appetite comes back even slightly, they now have a lower basal metabolic rate and could regain weight, even with only consuming a few extra calories. So, if lifestyle changes such as nutrition and exercise are not willing to be made, then most likely this individual will need a GLP-1 long term.
NOW - I HAVE GREAT NEWS, TOO!!!!
Individuals who use GLP-1 medication and implement proper nutrition, exercise, sleep, stress management, and mindset changes can lose weight without sacrificing ANY muscle mass. My clients who use GLP-1 medications DO NOT LOSE MUSCLE MASS.
Keep in mind, It is not a requirement that my clients disclose GLP-1 use, but if they share this information with me, then we prioritize monitoring their InBody scans.
When individuals optimize their body composition by maintaining lean mass and losing just body fat, then their basal metabolic rate stays consistent and there is a possibility that they can come off of the GLP-1 and maintain their fat loss simply by continuing their lifestyle modifications.
In our programming, we offer strategies to make sure you are keeping your lean mass, preserving your basal metabolic rate, and if you are losing anything, it is body fat.
Enrollment for Jump Start™ and Transform® opens on Friday, March 31st, AND we are having an amazing MERCH MADNESS swag-a-thon. To earn all of the gear, you will want to enroll by April 2nd!!