GLP-1 RECEPTOR AGONISTS AND MUSCLE MASS LOSS: IMPLICATIONS FOR MULTIPROFESSIONAL CARE

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide and tirzepatide, have transformed the treatment of obesity. They produce weight losses previously seen almost only after bariatric surgery. Part of this weight, however, is lean mass. Concern about skeletal muscle has grown alongside the popularity of these drugs. Based on a narrative literature review, the study analyzes the evidence on muscle mass loss associated with these drugs and discusses its implications for multiprofessional care. The search covered the PubMed/MEDLINE, SciELO and Google Scholar databases, giving priority to randomized clinical trials, meta-analyses and consensus documents published between 2013 and 2025. In trials that used dual-energy X-ray absorptiometry, lean mass accounted for one quarter to two fifths of the weight lost. This proportion does not differ much from that observed with other forms of weight loss, but the absolute amount is greater. Clinical risk depends on the patient profile. It is of greater concern in older adults, in people with sarcopenic obesity and in users without professional follow-up. Three measures are widely agreed upon: periodic assessment of strength and body composition, adequate protein intake and supervised resistance exercise. The safe use of these drugs therefore requires a coordinated team. Within it, nursing holds a central position in screening, health education and timely referral.