I'm a Doctor and Here's What Ozempic Actually Does to Your Muscle Mass That Nobody Talks About

Prescription meds like Ozempic and Mounjaro seem to be "heroes" when it comes to weight loss these days. Once used to help treat type-2 diabetes, studies show that more than 86% of individuals taking semaglutide can lose 5% or more of their body weight in roughly 68 weeks. This amount of weight loss can—and has—led to a total transformation for a lot of people. But at what cost? We spoke with Dr. Bronwyn Holmes, M.D., Medical Advisory Board at metabolic health platform Eden, and learned what Ozempic actually does to your muscle mass that nobody ever talks about.

When taking Ozempic, weight isn't the only thing patients lose. As the number on the scale drops, so does lean muscle.

"Ozempic delivers meaningful fat loss, but that loss doesn't discriminate. Usually, about 30-40% of the weight that goes away on semaglutide can come from mass, including skeletal muscle," Dr. Holmes explains. "That's concerning because muscle protects metabolism. Muscle influences insulin sensitivity, resting metabolic rate, and the ability to stay independent. The result? A slower metabolism and increased vulnerability to weight regain over time if muscle isn't preserved."

Much of the talk surrounding GLP-1 medication focuses on dramatic weight loss. However, what most patients and providers overlook is that "weight loss doesn't equal fat loss," Dr. Holmes stresses.

"If you do not prioritize muscle preservation with nutrition and resistance training, you risk becoming smaller and weaker and metabolically compromised," she adds. "Because this side effect isn't as 'visible' as others like nausea, it's far too easily ignored."

Ozempic promotes a substantial reduction in fat mass when compared to lean mass. That said, when protein intake is low or exercise is lacking, the ratio of lean muscle mass loss increases.

"In clinical trials, patients without structured strength training or protein intake guidance saw muscle loss make up as much as 40% of total weight loss. The body will catabolize lean tissue as readily as fat during rapid calorie reduction unless it receives specific signals to preserve it," Dr. Holmes explains.

RELATED: 4 Morning Exercises That Trim Waist Bulge Better Than 30 Minutes of Cardio After 45

It's crucial to protect and build muscle while taking any weight-loss medication. Here's how to do it:

• Consume 100 to 120 grams of high-quality protein each day, modified according to body size and muscle mass.
• Perform two to four resistance workouts each week, emphasizing compound movements.
• Stay hydrated and maintain adequate electrolytes—especially when appetite is decreased.
• Regularly monitor muscle mass through body composition scans.

"My method is to teach patients that GLP-1 therapy should not be passive. To keep muscle, the patient needs a plan that makes GLP-1 therapy a collaboration, not a shortcut," Dr. Holmes says.

​​If you're curious about what else GLP-1s can do, check out 5 Surprising Health Benefits of GLP-1 Drugs That Have Nothing to Do With Weight Loss.