GLP-1 weight loss drugs are popular for their short-term benefits. However, UVA researchers warn these medications might not improve long-term cardiorespiratory health and could impact muscle mass. Here’s what you need to know.
GLP-1 receptor agonists, popular for their significant weight loss effects, may not offer long-term enhancements in cardiorespiratory function. Researchers from the University of Virginia are urging caution and additional measures to ensure patients reaping the short-term benefits do not face adverse long-term consequences.
In collaboration with fellow UVA experts, Zhenqi Liu, a professor of medicine and James M. Moss Professor of Diabetes at University of Virginia School of Medicine, raised concerns in their recent paper published in the Journal of Clinical Endocrinology & Metabolism.
Among the benefits, GLP-1 drugs are known to improve blood sugar control and short-term cardiovascular health for those struggling with obesity, type 2 diabetes and heart failure. However, a critical improvement in heart and lung health, vital for long-term well-being, seems to be lacking.
“Some patients literally told me that they felt that they were losing muscle or muscle was slipping away from them while they were on these medications,” Liu said in a news release. “This is a serious concern. Muscle, especially axial muscle, is essential for posture, physical function and overall well-being. … We need to make sure that patients prescribed these medications aren’t already at risk for malnutrition or low muscle mass.”
Research indicates that while GLP-1 drugs are effective in fat loss, they also lead to a significant reduction in fat-free mass, notably muscle. This phenomenon is alarming since muscle comprises about 40-50% of fat-free mass, and its decline goes far beyond mere aesthetics.
Liu explains the gravity of this muscle loss, adding “Losing lean body mass can increase the risk of cardiovascular disease, all-cause mortality and diminished quality of life.”
Liu and fellow researchers — graduate student Nathan R. Weeldreyer and Siddhartha S. Angadi, an associate professor of kinesiology at UVA’s School of Education and Human Development — reviewed data on the impact of GLP-1 drugs on cardiorespiratory fitness (CRF).
CRF, or VO2max, is an essential marker that evaluates how efficiently the heart and lungs perform during exercise and is a potent predictor of mortality.
“Cardiorespiratory fitness is a potent predictor of all-cause and cardiovascular mortality risk across a range of populations, including obesity, diabetes and heart failure,” added Angadi. “In a recent study by our group that examined mortality outcomes from almost 400,000 individuals across the world, we found that CRF was far superior to overweight or obesity status for predicting the risk of death.”
Despite some heart function improvements, the study found that these enhancements do not translate into substantial improvements in VO2max.
To mitigate these concerns, the researchers suggest incorporating exercise programs and nutritional strategies to maintain muscle mass. These might include adequate protein intake and regular physical activity throughout the treatment.
They also point to promising developments in the field, such as monoclonal antibodies that may counteract muscle loss.
“This is an area of active research, and we are hopeful that better solutions are coming soon,” Liu added.
For now, patients and health care providers must discuss strategies to protect against muscle loss. Besides, the American Diabetes Association recommends screening for malnutrition and low muscle mass risk before commencing treatment with these drugs.
“Finally,” added Angadi, “exercise training during GLP1 therapy remains to be assessed in its ability to preserve or improve VO2max during GLP1 therapy.”
Source: UVA Health