Strategies for prevention and control of sarcopenia in obese patients undergoing treatment with GLP-1 agonists

Abstract

Sarcopenia is a condition characterized by the progressive loss of muscle mass and strength, which can be exacerbated by rapid weight-loss treatments such as GLP-1 agonists, including semaglutide and tirzepatide, commonly used in obesity treatment. While these medications have proven effective in weight reduction, they may also result in muscle mass loss, leading to sarcopenia. This study aimed to analyze strategies for the prevention and management of sarcopenia in obese patients treated with GLP-1 agonists like semaglutide and tirzepatide. A qualitative narrative literature review was conducted using databases such as PubMed, Google Scholar, and SciELO, selecting studies published between 2021 and 2025 that specifically addressed sarcopenia in obese patients treated with GLP-1 agonists, focusing on nutritional interventions, physical exercise programs, and pharmacological approaches. Studies that did not directly address the topic or lacked relevant clinical data were excluded. Although GLP-1 agonists are effective in weight loss, they may lead to significant muscle mass loss. The most effective prevention strategies include adequate protein intake, especially leucine and HMB, and resistance training exercises. These interventions are crucial for preserving muscle mass and improving functionality during weight loss. The findings emphasize the importance of a multidisciplinary approach to treating obesity with GLP-1 agonists, which should include appropriate nutritional interventions, physical exercise, and medical monitoring to ensure muscle preservation and enhance patients’ quality of life during weight reduction.