Background

The use of GLP-1 Receptor Agonist (GLP-1RA) are effective for the management of Type II Diabetes, and now used in patients without diabetes and BMI's as low as 28kg/m2. Recent studies have reported body weight loss and changes in body composition, but changes in muscle mass (sarcopenia) has not been a focus. Specific effects of GLP-1RA on sarcopenia vs Medical Nutrition Therapy (MNT) have not been reported.

Methods

A critical review of the literature selected relevant published articles from January 2015 to August 2023; selection was made if randomized control human studies. Key metrics of Fat Mass (FM), Fat Free Mass (FFM), Skeletal Muscle Mass (SMM), Total Bodyweight Change (BW) were assessed. In total, 5 GLP1-RA and 4 MNT studies were included.

Results

Patients were Type II Diabetics and BMI's > 30 studied over 12 to 26 weeks. In GLP-1RA studies average weight loss was 20% (range of 6 to 25%) and an average 12% of muscle mass loss (range of 5 to 20%). Muscle mass loss as a percent of total body weight loss ranged from 15 to as high as 40%. MNT in 12 weeks averaged 10% of total body weight (range of 5 to 15% weight) with no loss in muscle mass.

Conclusions

These data suggest that sarcopenia occurs in patients receiving GLP-1RA and larger than that with MNT. While GLP-1RA's support significant total weight and fat mass loss, MNT should be considered for co-therapy to minimize sarcopenia. Current co-therapy studies are underway.