Preserving Muscle During Weight Loss — What Clinicians Need to Know

I had the opportunity to present at GPCE Sydney alongside Professor Daniel Green, discussing the topic of preserving muscle during weight loss interventions. It was a rich conversation that touched on an area I think deserves far more attention in clinical practice.

The evidence examining muscle loss with GLP-1 receptor agonists is still relatively limited, although the literature is expanding rapidly. What is becoming increasingly apparent is that we need to assess not only muscle mass, but also muscle function — and these are not always the same thing.

Interestingly, some of the emerging data suggests that muscle function may improve despite reductions in lean mass. This is an important distinction and highlights the need for further studies examining the relationship between changes in body composition and functional outcomes.

In clinical practice, this means we should be incorporating both body composition and functional assessments into obesity management wherever possible. Two broad categories of tools are available:

There are also patient groups in whom we need to be particularly mindful of preserving muscle. Those at highest risk include:

Early intervention with dietary support and resistance training is critical in these populations. In an ideal world, all patients undergoing weight loss interventions would have access to high-protein dietary guidance from a dietitian and resistance training support from an exercise physiologist. However, real-world practice requires us to work within the limitations of time, finances, access, and the broader demands of patients' lives.

This is something we take seriously at MedSurg Weight Loss. Our dietitian team provides targeted nutritional guidance — including protein optimisation during weight loss — and our exercise physiologist designs individualised resistance training programmes for patients who need them most.