We’re used to seeing Serena Williams on our TVs, muscular tissues flexing, smashing a tennis ball previous her opponent. However in a latest 30-second industrial, Williams traded the racket for a GLP-1 drug injector pen.
Williams, whose most up-to-date youngster was born in 2023, has develop into a spokeswoman in her post-retirement days for Ro, one of many many boutique well being care companies to get in on the GLP-1 craze. “They are saying GLP-1s for weight reduction is a shortcut — it’s not. It’s science,” she says in the course of the spot. “After youngsters, it’s the drugs my physique wanted.”
• Sufferers needs to be consuming a protein-rich, balanced weight-reduction plan and doing a little type of energy coaching when on an GLP-1 remedy.
• Some sufferers taking GLP-1 medication have skilled important muscle loss and weak point.
• Specialists fear that too many sufferers could also be making an attempt to make use of GLP-1 medication as a shortcut as an alternative of enhancing their weight-reduction plan and train to shed some pounds.
Right here is among the world’s biggest athletes, giving voice — in commercials working throughout primetime TV, on the At present present, and on social media — to a frustration that many individuals have felt. She gained weight after she had youngsters. And despite the fact that, in her phrases, she was “doing every little thing proper” after the being pregnant, she couldn’t lower as a lot weight as she appreciated. That’s the place the GLP-1 drug got here in and delivered outcomes: Williams misplaced 31 kilos.
However there’s only one drawback with the pitch: GLP-1 medication like Ozempic and Wegovy are, in some methods, a shortcut.
“Individuals at all times need the fucking capsule,” Dr. Robert Lustig, a metabolic scientist on the College of California-San Francisco, informed me. “I view GLP-1s like a Band-Help. … There’s nothing mistaken with a Band-Help. However what when you didn’t clear your wound and also you simply put the Band-Help on? The Band-Help is important, nevertheless it’s not ample.”
The implications of sufferers slapping on the Band-Help — taking a GLP-1 — with out treating the underlying situation with the type of wholesome consuming and train which can be nonetheless essential even with these medication is turning into clear. Scientists have discovered that some GLP-1 sufferers can lose important muscle mass, in addition to a lack of practical energy, as a consequence of a scarcity of power. Quite than really feel fitter and able to exit on the earth or onto the tennis courtroom, these are sufferers who discover strolling up the steps to be virtually debilitating.
For this story, I sought to know how that is taking part in out in American tradition. In looking Reddit communities devoted to GLP-1 medication, I discovered a number of regular individuals whose expertise backed up that analysis: That they had lengthy tried to shed some pounds however might by no means fairly meet their objectives — till they went on a GLP-1 drug.
However at the same time as they misplaced weight, they didn’t really feel higher. A few of them felt worse, weaker. There are dozens of posts of GLP-1 sufferers coming to their friends, asking for recommendation about exercises they may do to stem the muscle loss. A number of hope to seek out the fitting weight-reduction plan that may enable them to really feel energetic and keep away from muscle loss whereas dropping the load — however with out having to decide to energy coaching that should go together with it.
Whereas the time period “energy coaching” might conjure pictures of ripped bodybuilders, medical doctors more and more emphasize the significance of muscle coaching for all of their sufferers, from the 30-year-old marathon runner to the 65-year-old retiree. That’s as a result of analysis has proven that extra lean muscle helps you age higher and protects towards hazards, reminiscent of falls, that pose a larger and larger risk as you grow old.
These medication are already wildly common, and their use is more likely to continue to grow. In November, the Trump administration struck offers with Lilly and Novo Nordisk to decrease the money value of their medication in trade for expanded Medicare protection. These value adjustments, which can start to take impact subsequent 12 months, might additional develop the variety of Individuals taking these drugs, together with amongst seniors for whom any lack of muscle mass is a severe well being concern. One quarter of GLP-1 prescriptions disbursed in 2024 had been for individuals older than 65.
Falls are already some of the potent killers of older adults; greater than 40,000 Individuals over 65 died from falls in 2023, and the dying fee has tripled since 1990. If extra sufferers begin taking semaglutide for its results on cognition, for instance, and fail to eat and train correctly, they may expertise malnourishment and important muscle loss; each might put their long-term well being in danger.
That doesn’t imply GLP-1 medication are a foul deal for public well being. On the inhabitants degree, weight problems is related to a bunch of main ills, and Individuals have lengthy been determined to shed some pounds. The category of medication that features Ozempic, Wegovy, Mounjaro, and now numerous others — Zepbound, compound GLP-1s, and so forth. — are essentially the most spectacular weight-loss instruments we’ve ever seen. They work as a result of they gradual digestion and inform your mind you’re full, which makes it simpler for individuals to eat much less. Whereas these therapies are nonetheless pretty new, observational research have discovered that sufferers who keep on these medication for a 12 months or extra can lose 10 p.c of their physique weight on common. And on the inhabitants degree, weight problems charges are already beginning to decline.
Scientists are additionally discovering that these medication have wonderful potential to deal with a breadth of points: from addressing substance-abuse problems, decreasing your danger for coronary heart illness, and even probably stopping dementia and Alzheimer’s illness. Latest research have discovered that taking a GLP-1 like Wegovy or Ozempic is even related to decrease most cancers deaths.
However to stem the chance of muscle-mass loss, you need to even be prepared to decide to enhancing your weight-reduction plan and adopting a severe exercise routine over the long run. GLP-1 medication could also be magical in the case of weight reduction, however they don’t seem to be magic tablets. Which implies that together with the rise of Ozempic and different GLP-1s is a coming reckoning over America’s shortcut tradition.
“Is that this only a essential evil to weight reduction?”
Loads of athletes who will not be world-famous see the identical attraction in GLP-1 medication that Serena Williams did.
One individual specifically stood out to me. A self-identified weight lifter, CrossFit fanatic, and horse rider, who I’ll name Sam, shared their expertise on Reddit. They defined that they had at all times struggled to shed some pounds regardless of strict meal preparation and consuming lots of protein.
And so, Sam began taking Wegovy. ”I’m pleased with the outcomes,” they stated — earlier than attending to a reasonably large caveat for any individual who’s at all times had an energetic life.
Regardless of aiming to eat 100 grams of protein daily, they stated they had been feeling weak. “I swear I can really feel my muscle being damaged down. Is that this a factor??” Sam requested within the on-line discussion board. “I really really feel much less agency, extra wobbly and flabby. I appear to have much less definition,“ they stated. “Is that this only a essential evil to weight reduction?”
Why I reported this story
GLP-1 medication are undeniably thrilling, and they’re being broadly adopted. I just lately came upon a member of the family of my very own had began taking them, they usually’re not the type of one that’s inclined to weight-reduction plan fads both. As a reporter, that makes me nervous: Something that sounds too good to be true most likely is.
It could be fantastic if GLP-1 medication might treatment Alzheimer’s, however we most likely have to suppose by the trade-offs. And I began to select up from different reporting and social media feeds I observe that some individuals had been experiencing this surprising muscle loss. I assumed it will be beneficial to unpack the science to elucidate why this occurs to some individuals and clarify what they’ll do to keep away from it.
The web is stuffed with examples identical to this. “Anybody else having a tough time figuring out on Wegovy?” requested one Reddit poster final 12 months. They even felt their arms had been weaker whereas bowling. One other individual realized one thing was mistaken once they might now not do yard work round the home. Different individuals have seen leg weak point after mild strolling or climbing the steps: “I really battle to go up a staircase and I’m solely 32,” stated one GLP-1 affected person.
“I do know lots of people are figuring out, and I do want to start exercising on prime of the wegovy, however I’m simply questioning if anybody else is experiencing excessive weak point or if it’s simply me and my un-toned self,” they requested.
Sam’s put up specifically had lots of feedback, with one respondent even urging the affected person to rethink: You might be “a powerful, succesful goddess. You don’t have to shed some pounds.” Settle for who you’re. In response, Sam laid out the dilemma that so many individuals who’ve sought to shed some pounds through the years face: “Sadly, a few of us simply do NOT shed some pounds with weight-reduction plan and train.”
It’s true: Weight reduction just isn’t assured from weight-reduction plan and train. Some individuals have a genetic disposition to turning into overweight. And never everyone who’s overweight is unhealthy; the physique mass index is an imperfect measurement, and a few people who find themselves technically overweight can nonetheless be wholesome if a lot of their weight is muscle. Nonetheless, the conclusion that weight problems is a illness to be handled, relatively than a private failure that may solely be remedied by private development, has been vital in lowering the prejudices that obese individuals have lengthy confronted.
However on the similar time, it’s a slippery slope from acknowledging weight-reduction plan and train will not be ample on their very own to considering a drug like Ozempic could make them pointless. Some individuals, like Sam, have at all times exercised and seen GLP-1s as an additional push to assist them attain their weight objectives. However I additionally encountered different individuals who didn’t essentially have wholesome habits earlier than however had been in a position with the medication to chop weight for the primary time. One affected person on Reddit acknowledged that they don’t work out they usually don’t adhere to a selected weight-reduction plan. They’ve been shedding weight, however they’re “scared” about dropping an excessive amount of weight — in order that they ask if they’ll simply eat extra hen or drink a protein shake and regain the muscle “with out figuring out.”
They’ve purpose for concern: The identical medical trials which have proven how efficient GLP-1 medication are with weight reduction have additionally persistently reported muscle loss or weak point amongst sufferers. When one group of researchers evaluated the kind of physique mass that sufferers on semaglutide medication had been dropping, they discovered that about 40 p.c was vital muscle.
The GLP-1 market is barely going to develop because the medication show helpful for a big selection of therapies. Individuals, together with those that will not be obese, might take them preventively to stave off heart problems or dementia. For them, people who find themselves already at a wholesome weight, muscle loss is an much more severe concern. If GLP-1 medication do show to be promising for treating age-related cognitive decline, for instance, then applicable weight-reduction plan and train will probably be much more paramount for that affected person inhabitants. The very last thing we wish is extra seniors struggling catastrophic accidents throughout a fall due to misplaced muscle mass.
However understanding what precisely is inflicting the muscle loss is vital. Scientists are nonetheless figuring that out, however early indications are that the trigger just isn’t the medication themselves however a few of the life-style adjustments the medication can result in.
One examine from researchers on the College of Utah suggests the lack of energy is essentially the results of not consuming sufficient energy. Of their analysis on mice, they discovered much less muscle mass loss than anticipated. As an alternative, after taking a GLP-1, mice had been dropping their practical energy — how a lot they may raise or transfer round — even when muscle measurement stayed the identical. In different phrases, the mice appeared weaker despite the fact that their muscle mass hadn’t modified.
“Power is not only an element of how a lot muscle you have got, however whether or not you may transfer that muscle successfully. There’s an brisk element to it,” lead creator Katsu Funai informed me. The animals on a GLP-1 drug might have had much less power as a result of they had been consuming much less — and due to this fact they wouldn’t be capable of exert as a lot power with their muscular tissues. It’s not the GLP-1s per se; it’s what the GLP-1s result in with out intervention.
The findings might inform how we prescribe Ozempic, Funai stated: Smaller doses may assist to mitigate the lack of practical energy. In any other case, shedding weight too shortly goes to imply dropping power shortly — and due to this fact feeling weaker. Within the pleasure over Ozempic, and the potential to lose lots of weight and quick, individuals appear to have forgotten a basic fact about weight reduction: “Extra just isn’t essentially higher,” Funai stated.
Earlier than GLP-1 medication existed in any respect, dieticians urged their sufferers to tempo weight reduction — not more than 1-2 kilos per week — for precisely this purpose: You don’t need to find yourself malnourished and weakened. With a traditional weight-reduction plan, that may usually result in you consuming extra, which in flip eliminates the load loss. However when your urge for food is suppressed by GLP-1s, the load loss can proceed, and with it, energy and power loss.
“With these GLP-1s, that dialog [about diet and exercise] has been sidelined,” Funai stated. “There are nuances to those issues that I believe are being missed not simply from the general public, but in addition from scientists,”
Learn how to profit from GLP-1s
Sarcastically, the very drawback that GLP-1s had been meant to beat — that many Individuals merely battle to eat proper and train sufficient — stays simply as central even with the medication.
And most of the individuals taking GLP-1s are beginning at a drawback: Solely 49 p.c of Individuals say they’re extraordinarily or very assured that they know what a nutritious diet seems to be like, and about twice as many say they need to get extra train.
In case your sole objective is to shed some pounds, a GLP-1 alone might get you there — however not within the healthiest means. Except you modify what you eat, you’re nonetheless placing the identical junk in your physique — albeit much less of it — with the identical or extra detrimental results in your power and stamina.
“In the event you don’t change your conduct, when you don’t change your habits, chances are you’ll be wanting good, chances are you’ll be shedding weight, however metabolically, your physique is in turmoil,” stated Nayan Patel, a pharmacist who works with sufferers taking the medication. “We’ve bought to make use of these medication in the fitting method.”
So what ought to individuals on GLP-1s goal to eat? A high-protein weight-reduction plan delivering lots of amino acids is vital, Patel stated: Eggs, nuts, lentils, poultry, and fish are all good sources. You possibly can lower down on the carbs and sugars; your physique gained’t want them to supply power since you’ll be reducing fats. Consuming protein and energy coaching permits your physique to be simpler at trimming the fats, with out compromising your core energy.
Like something onerous however value doing, there’s quite a bit to beat. Many Individuals have develop into intimidated by gymnasium tradition, so they could favor to work out in privateness, at residence — however they don’t understand how. One individual I encountered posted on-line to crowdsource recommendation on residence tools and routines. They stated they didn’t need to go to a gymnasium, however “I do know I’m off form,” the poster confessed to their fellow Redditors.
The thread flooded with recommendation from easy exercise routines to attempt to function fashions they may observe on social media. The recommendation included some very approachable methods — one thing so simple as sitting in a chair along with your legs outstretched and utilizing your stomach muscular tissues to raise them backward and forward over a water bottle. Some commenters advisable incorporating a resistance band and a exercise ball. Well being care suppliers have developed normal suggestions for sufferers taking a GLP-1 drug: Mass Normal, for instance, advises a combination of 150 minutes per week of average train — actions like strolling or using a motorbike — or about 75 minutes of vigorous cardio train like jogging or swimming laps along with two days of weight coaching and a gradual dose of stretching and adaptability exercises.
Whereas I discovered loads of individuals involved with surprising muscle loss, there have been additionally examples of sufferers proudly displaying off their lean and muscular new physiques. It may be completed.
However on this imaginative and prescient, GLP-1s are a jumpstart, not a shortcut. “Losing a few pounds is everyone’s objective. Utilizing a drug to jumpstart is a superb strategy to do the method,” Patel stated. “However when you’re not taking the primary two steps, you’ll stumble till you fall flat in your face.”
This story was initially revealed in The Spotlight, Vox’s member-exclusive journal. To get early entry to member-exclusive tales each month, be part of the Vox Membership program at present.
