Is Weight Loss–Induced Muscle Mass Loss Clinically Relevant?

Conte, Caterina; Hall, Kevin D.; Klein, Samuel

doi:10.1001/jama.2024.6586

JAMA

2024

DOI: 10.1001/jama.2024.6586

|View full text |Cite

Is Weight Loss–Induced Muscle Mass Loss Clinically Relevant?

Caterina Conte,

Kevin D. Hall,

Samuel Klein

Abstract: This Viewpoint explores the effects of weight loss achieved through GLP-1–based antiobesity medications on weight regain, fat-free mass, and skeletal muscle mass in people with obesity.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2024

Publication Types

Select...

Article5

Relationship

Self Cite0

Independent5

Authors

Journals

Cited by 25 publications

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Weight Loss–Induced Muscle Mass Loss

Evans,

Cummings

2024

JAMA

View full text Add to dashboard Cite

To the Editor Dr Conte and colleagues 1 assert that concern about marked weight loss induced by glucagon-like peptide-1 (GLP-1)-based antiobesity medications causing physical frailty or sarcopenia is not supported by data. We believe that reassurance is premature. The loss of skeletal muscle mass (SMM) during weight loss is poorly described and has not been directly measured for weight loss resulting from GLP-1 agonists. The figure in Conte's Viewpoint assumes that SMM is a constant 50% of fat-free mass (FFM). This assumption is not based on actual accurate measurement of SMM. The proportion of FFM that is SMM is highly variable and decreases with advancing age and, as a result, FFM is not a surrogate measurement of SMM. The loss of SMM in older patients with obesity is a particular concern. Previous studies have demonstrated an exaggerated loss of FFM in older men and women during weight loss and regain of fat and very little FFM or muscle. Loss of excessive muscle during weight loss in older people is associated with increased mortality risk. 2 This is particularly important for older people, as decreased muscle mass (but not FFM) is associated with increased risk of disability, hip fracture, and mortality. 3 There is an urgent need for studies that accurately measure muscle mass, strength, and mobility during GLP-1 agonist-induced weight loss and regain of weight after they are stopped, especially in older people. Until then, clinicians and patients should take measures to maintain muscle mass and strength during treatment and cessation of these potent agents.

show abstract

Weight Loss–Induced Muscle Mass Loss

Evans,

Cummings

2024

JAMA

View full text Add to dashboard Cite

show abstract

Weight Loss–Induced Muscle Mass Loss—Reply

Conte,

Hall,

Klein

2024

JAMA

View full text Add to dashboard Cite

show abstract

Malnutrition in patients with obesity: An overview perspective

Cristancho,

Mogensen,

Robinson

2024

Nut in Clin Prac

View full text Add to dashboard Cite

Malnutrition in patients with obesity presents a complex and often overlooked clinical challenge. Although obesity is traditionally associated with overnutrition and excessive caloric intake, it can also coincide with varying degrees of malnutrition. The etiopathogenesis of obesity is multifaceted and may arise from several factors such as poor diet quality, nutrient deficiencies despite excess calorie consumption, genetics, and metabolic abnormalities affecting nutrient absorption and utilization. Moreover, a chronic low‐grade inflammatory state resulting from excess adipose tissue, commonly observed in obesity, can further exacerbate malnutrition by altering nutrient metabolism and increasing metabolic demands. The dual burden of obesity and malnutrition poses significant risks, including immune dysfunction, delayed wound healing, anemia, metabolic disturbances, and deficiencies in micronutrients such as vitamin D, iron, magnesium, and zinc, among others. Malnutrition is often neglected or not given enough attention in individuals with obesity undergoing rapid weight loss through aggressive caloric restriction, pharmacological therapies, and/or surgical interventions. These factors often exacerbate vulnerability to nutrition deficiencies. We advocate for healthcare practitioners to prioritize nutrition assessment and initiate medical intervention strategies tailored to address both excessive caloric intake and insufficient consumption of essential nutrients. Raising awareness among healthcare professionals and the general population about the critical role of adequate nutrition in caring for patients with obesity is vital for mitigating the adverse health effects associated with malnutrition in this population.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Is Weight Loss–Induced Muscle Mass Loss Clinically Relevant?

Abstract: This Viewpoint explores the effects of weight loss achieved through GLP-1–based antiobesity medications on weight regain, fat-free mass, and skeletal muscle mass in people with obesity.

Cited by 25 publications

References 11 publications

Weight Loss–Induced Muscle Mass Loss

Weight Loss–Induced Muscle Mass Loss

Weight Loss–Induced Muscle Mass Loss—Reply

Malnutrition in patients with obesity: An overview perspective

Contact Info

Product

Resources

About