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lee11/21/20244 repliesview on HN

From the article: "...explains this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets or normal aging and could lead to a host of long-term health issues..."

The warning isn't that you're losing muscle during weight-loss with these drugs. It's that the ratio of muscle vs fat loss is much greater with the drugs compared to traditional weight loss methods.

It's been well studied that if you exercise and eat enough protein while losing weight, you can retain more muscle.

Losing a lot of lean mass is incredibly detrimental to your longevity and quality of life.


Replies

beejiu11/21/2024

Even amongst traditional calorie deficits, rapid weight loss results in greater loss of muscle mass when compared to gradual weight loss, even if you lose the same amount of mass overall. I.e. you keep more muscle losing 0.5 lbs a week over 40 weeks than 2 lbs a week over 10 weeks.

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cactca11/21/2024

Can you provide a single high quality (randomized) study demonstrating GLP1 therapeutics are 'incredibly detrimental to [your] longevity and quality of life'?

Consider the type of confounding that occurs in studies of people losing a lot of lean mass: cachexia, restriction to bed, famine.

Traditional weight loss methods have not shown the magnitude of survival benefits wrt cardiovascular disease, joint pain, diabetic complications. Exercise is wonderful, but as a public health intervention it is not sufficient.

If anyone looks at the totality of the high quality GLP1 clinical evidence and concludes these drugs are going to cause a net reduction in longevity and quality of life, then they should step back and assess their process for evaluating information.

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IG_Semmelweiss11/21/2024

>>>Losing a lot of lean mass is incredibly detrimental to your longevity and quality of life.

While true, its also true that if you manage to lose substantial fat in the process, it leads to longer and better quality life

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crazygringo11/21/2024

If I'm reading the study [1] correctly, that conclusion is not warranted.

It appears that they fed the control group and treatment group of mice lots of food to get them fat, then gave them identical normal diets, and gave the treatment group semaglutide.

The semaglutide group lost significantly more weight (fig A.ii) than the control group, and also lost heart muscle.

So it does not seem that they compared to an equivalent amount of weight loss in mice, which is what I'd think you'd need to do to come to the conclusion from the article (actually, not just an equivalent amount of weight loss, but also at the same rate).

[1] https://www.sciencedirect.com/science/article/pii/S2452302X2...

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