RECISATEC - REVISTA CIENTÍFICA SAÚDE E TECNOLOGIA · Nov 11, 2026
Impact of GLP-1 agonists on muscle mass: Pathophysiological mechanisms of lean mass loss during pharmacological weight loss
By Lopes TS, Lima MIA, Turbano MEN et al.
INTRODUCTION: Glucagon-like peptide-1 (GLP-1) receptor agonists and dual GLP-1/GIP agonists promote substantial weight loss and reduced adiposity in the treatment of obesity. However, some of this loss may occur at the expense of lean mass, raising questions about their musculoskeletal effects. The objective was to analyze the effects of these therapies on skeletal muscle mass and the mechanisms associated with lean mass loss during pharmacological weight loss. METHODS: This is an integrative literature review with a qualitative approach, conducted according to Whittemore and Knafl. The PubMed/MEDLINE, LILACS, SciELO, Scopus, and Web of Science databases were searched, considering studies published between 2018 and 2026. The last search was conducted on [FILL IN: date of last search]. Initially, 194 studies were identified, and after the selection stages, 25 were included in the synthesis. RESULTS: The studies demonstrated a reduction predominantly in fat mass, accompanied by variable lean mass loss. This reduction does not necessarily constitute pathological muscle loss or sarcopenia, especially when strength and function are preserved. The main associated mechanisms include an energy deficit, reduced protein intake, reduced mechanical stimulation, and changes in protein balance. CONCLUSIONS: GLP-1 and GLP-1/GIP agonists promote weight loss predominantly from fat, without sufficient evidence of a direct and generalized muscle catabolic effect. Individuals with greater musculoskeletal vulnerability require individualized follow-up, with adequate protein intake, resistance exercise, and monitoring of body composition and muscle function.