A recently developed drug named apitegromab could help people using obesity medications prevent significant muscle loss, according to studies appearing in the journal Nature Medicine. The medication works by inhibiting a protein responsible for muscle breakdown, allowing patients to lose fat whilst preserving lean mass. In a six-month trial including 102 adults, mostly women, those who received apitegromab alongside the weight-loss drug Mounjaro maintained approximately 55 per cent more muscle versus those on the obesity medication alone. The findings offer potential relief for users of widely-used GLP-1 drugs such as Wegovy and Mounjaro, who can shed as much as a third of their weight through muscle rather than fat—a phenomenon some have dubbed “Ozempic butt” due to the visual changes that result.
Understanding the muscular deterioration issue
Obesity medications referred to as GLP-1 drugs function by suppressing appetite and making patients feel fuller for longer, allowing them to consume significantly fewer calories and lose weight rapidly. However, this swift weight loss comes at a cost. Research indicates that roughly a third of the weight lost by patients using drugs like Ozempic, Wegovy and Mounjaro originates from muscle tissue rather than fat. This unwanted side effect occurs because the body breaks down muscle along with fat during rapid weight loss, a process that is difficult to reverse quickly through diet and exercise alone.
The aesthetic and physical implications of this loss of muscle mass have become more noticeable amongst users of GLP-1 drugs. Some people describe noticeable changes to their body shape, including loose skin and a deflated appearance, particularly around the buttocks—a phenomenon colloquially termed “Ozempic butt.” Whilst not a formal medical condition, the complaint has become common enough that plastic surgeons across the US report a marked increase in consultations about the issue. Health experts currently advise patients on GLP-1 medications to follow a nutritious diet and undertake regular exercise, including strength training, to help preserve muscle mass during their weight-loss journey.
- GLP-1 drugs reduce hunger and promote rapid weight loss
- Up to one-third of weight loss can result from muscle tissue
- Loss of muscle causes visible body shape changes and sagging
- Existing recommendations stresses strength training and exercise for muscle preservation
How apitegromab works and what studies revealed
Apitegromab constitutes a new treatment method to combating muscle wasting in people taking obesity medications. The drug functions by blocking a protein that plays a crucial role in muscle breakdown, thus assisting in maintaining muscle tissue during weight loss. Currently, apitegromab is available solely in clinical trials and must be administered via intravenous infusion. Nevertheless, the drug manufacturer, that financed the study, is exploring whether individuals might eventually self-inject apitegromab with a specialised injection device—comparable to the easy administration of GLP-1 obesity medications themselves.
Beyond its potential application in obesity treatment, apitegromab is being investigated for other health disorders that affect muscle health, including spinal muscular atrophy. The drug’s mechanism of action—targeting the protein that causes muscle degradation—makes it a promising candidate for various conditions involving muscle loss. Researchers suggest that by blocking this metabolic process, apitegromab could provide patients a way to maintain muscle integrity whilst experiencing rapid weight loss, addressing a notable drawback of current obesity medications that has troubled many users and prompted cosmetic surgery consultations.
Study findings and preservation of muscle
The six-month research study included 102 participants, mostly female, who were given the obesity medication Mounjaro alongside either apitegromab or a dummy therapy. Results published in the publication Nature Medicine demonstrated striking contrasts between the two groups. Those given apitegromab retained approximately 1.9 kilogrammes additional muscle mass, representing a 55 per cent improved retention of lean mass compared to those receiving only Mounjaro. These results were assessed via body scans, providing objective evidence of the medication’s muscle-sparing effects during weight loss.
The difference between the two groups became particularly notable when examining the composition of total weight loss. In the apitegromab group, muscle comprised just 14.6 per cent of total weight loss, whereas in the placebo group, muscle accounted for 30.2 per cent of weight lost. This substantial reduction in muscle loss whilst preserving fat loss suggests apitegromab could significantly alter the weight-loss profile for obesity medication users, thereby avoiding the unwanted aesthetic and physical consequences associated with rapid muscle depletion.
Professional insights and forthcoming considerations
Dr Marie Spreckley, a muscle health specialist from the University of Cambridge who was not involved in the research, has called for careful consideration in interpreting the findings. Whilst she recognised the results as promising initial findings, she stressed that bigger and extended investigations are necessary before reaching firm conclusions about therapeutic advantage. Her assessment reflects the scientific community’s careful consideration to new therapeutic approaches, particularly when early-stage trials involve comparatively limited sample sizes. Spreckley has specifically advocated for investigations into whether maintained muscle mass results in greater strength capacity, better overall wellbeing, and better long-term health outcomes for users.
The path towards apitegromab becoming a standard therapeutic option is unclear, with official clearance and additional assessment required before it should be suggested for broad application. Experts emphasise that obesity medications like Mounjaro and Wegovy were not designed as rapid remedies for appearance-related weight reduction, and users are currently encouraged to pair drugs with healthy eating and weight training to preserve muscle naturally. Nevertheless, the drug’s potential to address the muscle-loss problem represents a significant development in obesity treatment, offering hope to those worried regarding the physical changes accompanying swift weight loss on GLP-1 medications.
- Apitegromab presently accessible only in clinical trials through IV infusion
- Manufacturers exploring self-injection pen delivery method comparable to GLP-1 jabs
- Further research needed to establish long-term health benefits and safety profile
Creating and preserving muscle through natural methods
Whilst apitegromab offers a medical strategy to maintaining muscle during weight loss, healthcare experts stress that conventional methods continue to be the foundation of preserving lean mass. Individuals taking GLP-1 weight-loss drugs are already recommended to pair their therapy with consistent exercise and balanced nutrition. Strength training and sufficient protein consumption have been well-documented as proven methods for reducing muscle deterioration during caloric restriction, and experts advise these approaches be given priority alongside any new drug-based treatments to optimise overall wellbeing results.
Powerful resistance exercise options
- Strength training with weights two to three times per week
- Bodyweight exercises including push-ups, squats, and lunges
- Resistance bands for portable and adjustable muscle conditioning
- Swimming and water-based exercises for low-impact muscle engagement
- Core-strengthening and Pilates sessions for practical strength and mobility
- High-intensity interval workouts combining cardio with muscle work
- Expert personal training for individualised, progressive workout plans
- Regular training and steady progression essential for long-term muscle growth
Nutritional support for muscle strength
Consuming protein plays a critical role in maintaining muscle mass during weight loss, especially when using GLP-1 medications that decrease appetite. Nutritionists suggest distributing protein intake throughout the day rather than loading it in one meal, as this strategy optimises muscle protein synthesis. Adequate calories from unprocessed foods—including lean meats, fish, eggs, legumes, dairy products and nuts—provide key amino acids required for muscle recovery and development throughout resistance training.
Beyond proteins, micronutrients such as vitamin D, magnesium and iron assist with muscle function and recuperation. People on obesity medications ought to work with healthcare providers or registered dietitians to ensure their reduced caloric intake still meets nutritional requirements for preserving muscle health. Fluid intake also remains crucial, as muscles require adequate fluid for maximum performance and recovery from exercise, particularly when weight loss accelerates metabolic requirements.