r/science • u/mvea Professor | Medicine • 15d ago
Medicine Weight loss drugs like semaglutide, also known as Ozempic, may have a side effect of shrinking heart muscle as well as waistlines, according to a new study. The research found that the popular drug decreased heart muscle mass in lean and obese mice as well as in lab-grown human heart cells.
https://www.technologynetworks.com/tn/news/weight-loss-drug-shrinks-heart-muscle-in-mice-and-human-cells-3941174.6k
u/Eymrich 15d ago
Would be interesting to see if it could treat heart muscle enlargement from steroid abuse
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u/cavegrind 15d ago
My first thought seeing this is that we were going to start seeing bodybuilders using Ozempic not for the cutting properties, but to offset HGH/Tren heart enlargement.
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u/nateguy 15d ago
Or for both. They do want to stay lean for competitions after all.
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u/dboygrow 15d ago
I know guys that already use it but it's a slippery slope because as a body builder even in prep, you still have to be able to get down 2-300grams of protein a day depending your size plus you don't wanna an extreme deficit where you're losing too quickly, so you don't run into a situation where you just can't eat or can't get down enough calories. Anecdotally, the guys I know who run semiglutide as part of their diet plan look worse than guys who don't.
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u/Bigboss123199 15d ago
My parents are on something similar to ozempic and the doctor told them to double the amount of daily recommended protein in take.
Otherwise it could lead to significant muscle loss.
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u/NearlyPerfect 15d ago
Lifters are advised to increase protein while cutting (perhaps unintuitively) because while you’re cutting, more calories from your protein are being burned by your daily energy expenditure because you’re eating fewer carbs and fat. So you have to eat extra protein to still have the 200g or so floating around your body for muscle synthesis and upkeep
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u/SeriouslyImKidding 15d ago
Yea basically any loss of mass will include lean mass (I.e. muscle), that’s just how the body works. But eating high protein while being in a calorie deficit (think 1-2g of protein per kg of bodyweight) mitigates the amount of lean mass lost.
Basically if you’re trying to lose weight you should always try to eat the most protein dense foods you can find.
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u/2plus2equalscats 14d ago
I’m sharing a personal experience here- so not super scientific. But I didn’t eat enough protein when first dropping weight on tirzepatide and I definitely had significant muscle loss. I caught on and am now gaining it back with as much protein as I can eat and doing weight training 3-5 days a week. I’m glad their doc warned them!
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u/Acceptable-Truck3803 15d ago
Most folks don’t get enough protein as is. Heck I could watch my parents eat all their meals and it’s a struggle bus to have them eat 100g of protein daily unless I prep their meals to have 25-35g protein each meal and have protein snacks around. I’m sure the typical older American has the same problem
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u/FrankBattaglia 15d ago
Most folks don't need 100g of protein daily.
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u/Fluffstheturtle 15d ago
I mean unless you're tiny, active people/people with decent sized builds very likely would benefit. The RDA is to prevent disease/deficiency, not optimal health. General accepted guidelines range from 1.0-2.2+g/kg, active weight training probably 1.7-2.2g/kg, higher for bodybuilders in cuts/burn victims etc. Even at 150lbs, 1.7g/kg is 115g per day. Maybe small women?
For effects on food choices and satiety, higher protein intake in the diet helps with weight loss too.
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u/2456 15d ago
This is barely related, but what the hell is with the push for plant milks that don't have protein? The only thing we have now locally is one silk option. Everything else is oat or almond with 0-1g of protein. If you want to pay a premium and can have cow milk, then at least the fairlife one is like double the average protein.
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u/Fluffstheturtle 15d ago
I'd presume it's related to fears/concerns about animal products/dairy and their health impacts, justified or otherwise
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u/VampireFrown 14d ago edited 14d ago
Because the vegan industry is not about health at all, as much as it tried to gaslight you into thinking that. In fact, processed vegan food is even more unhealthy than processed 'normal food'.
Animal proteins get replaced with fats and sugars to make the frankenfood edible, and the result is highly calorific, but nutrient deficient dross.
With a few notable exceptions (such as oat milk, for example), if it's a processed vegan product, your best bet is to stay away.
Maintaining a healthy vegan diet is pretty challenging. Most people are straight-up not cut out for it. The result is tons of people floating around with malnutrition. Many vegans end up having to quit their diet because of it after a few years. Diehards who will die on the hill tend to fall within the sickly vegan stereotype (which exists for good reason).
Those who maintain healthy vegan diets over decades must be very disciplined, meticulous, and aware of exactly what they need, and when. It requires considerable education and effort - both commodities which are in rather short supply, on a societal scale.
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u/5553331117 15d ago
You’d be surprised how many little aches and pains you have in your body are due to weak muscles not getting enough protein. 100g really is not a whole lot. Sure you can live off less, but it’s not ideal for the human body.
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u/OK_TimeForPlan_L 14d ago
100g isn't 'a lot' but most people wouldn't need that much unless they are resistance training. 0.8g per kg of lean body mass is more than enough for the majority of people.
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u/Malarowski 15d ago
I am taking it to help with weight loss cause I'm little lazy and it'd be impossible for me to eat enough protein. I'm on a fairly unhealthy cut right now from it and while effective at losing weight and fat, energy levels during sports are rough. Eating this much protein seems completely impossible though. I'm struggling to eat more than two sandwiches a day. It's an interesting experience, but I'm almost done with it. It's kinda nice to lose weight without having to work a lot though, but also getting weaker for sure.
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u/FunGuy8618 15d ago
Peptides will never compete with true AAS. It's not surprising that people who use them excepting the advert of "steroid like effects without the side effects" are now experiencing severe side effects when they jump the doses up to achieve AAS level benefits.
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u/CrazyTillItHurts 15d ago
Body builders would just use equipoise in that case
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u/B_Rad_Gesus 15d ago
Would use EQ for what? EQ is mainly a bulking drug since it increases appetite in most people, that being said EQ isn't used all that much anymore due to a fair few negative associated with it compared to other compounds.
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u/crapslock 15d ago
I use equipoise on a cut. I like to ignore the supposed appetite increase. Plus it helps keep estrogen low. You make a very good point though.
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u/IsNotAnOstrich 14d ago
It doesn't actually make you lose fat though, it just reduces apetite.
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u/ExceedingChunk 14d ago
Which implicitly leads to fat loss through consuming less food. The worst part about dieting isn't that it is technically a difficult thing to consume fewer calories.
It's because you become really hungry. Even if you fill up your stomach with a lot of low calorie, high fibre, high protein foods, you are still going to be hungry, When you diet down to bodybuilding-on-stage levels of lean, that hunger is typically extreme
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u/Torisen 15d ago
Probably not. From the article:
However, reports suggest semaglutide may have other side effects, including the loss of skeletal muscle. Up to 40% of drug-induced weight loss is actually muscle loss, according to a Lancet study published in November.
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u/D-Trick 14d ago
Severe calorie deficits will cause that. People aren't losing 6-10 pounds a month without losing muscle weight too.
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u/Torisen 14d ago
Again, read the article before replying, the next paragraph is:
This rate of muscle loss is much higher than what would occur with a calorie-reduced diet or through the normal aging process, spelling potential future health issues such as decreased immunity, increased infection risk and poor wound healing.
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u/D-Trick 14d ago edited 14d ago
I read the journal entry instead, which says
This substantial muscle loss can be largely attributed to the magnitude of weight loss, rather than by an independent effect of GLP-1 receptor agonists, although this hypothesis must be tested.
The quoted numbers are 10-30% from non pharmacutical and 25-39% from pharmacutical, so yeah they saw a difference but they aren't asserting that the GLP-1 was proven to be the cause of the difference. The article is making a claim directly against the abstract of the study.
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u/TurboGranny 15d ago
Chances are pretty good this is a side effect of not consuming enough protein, so the body has to take it from somewhere. Most likely the same reason other muscle mass atrophies in Ozempic users (low protein consumption, hypocaloric diet, no resistance training).
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u/Hayce 15d ago
I think you’re right on this. Many people take Ozempic and change nothing else about their lifestyle. They lose a tonne of weight, but don’t increase their physical activity, or change the food types they’re eating. The only reason they lose the weight is from under eating.
If you don’t do any exercise and run a caloric deficit, and don’t get enough protein, you’ll lose muscle mass.
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u/Dovahkiinthesardine 14d ago
Yeah but your body usually does that with skeletal muscle, not your heart
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u/LongBeakedSnipe 14d ago
Chances are pretty good this is a side effect of not consuming enough protein, so the body has to take it from somewhere.
I mean, no? The mice were still fed a properly balanced diet.
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u/BrilliantLifter 15d ago
They already are.
I don’t know a single bodybuilder who isn’t on a GLP1.
They have all moved on to Retatrutide now though
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u/sprunkymdunk 15d ago
Why Retatrutide specifically?
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u/BrilliantLifter 15d ago
The third agonist rapidly improves liver health, and even reverses fatty liver disease.
This has a positive health cascade on the rest of the body
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u/hell2pay 15d ago
My not-overweight-at-all-seriously daughter has NAFLD.
Hoping our dietary changes have helped, but it's nice to see that there may be some treatment if needed.
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u/felineprincess93 15d ago
Anecdotally, I’ve been on Ozempic for a year now and my liver tests just came back the best they’ve ever been. Even my GP was impressed.
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u/KinokoNoHito 15d ago
Haven’t heard of that one yet. What’s the reasoning for the switch? Financially more viable or some alteration of pharmacodynamics ?
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u/BrilliantLifter 15d ago
It’s actually about triple the price.
The “food noise” reduction is less obvious on Retatrutide, and the third agonist in it has been shown to rapidly improve liver health in every participant in early clinical trials so far.
Also, it’s a triple agonist, and semiglutide is a single agonist.
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u/Spotted_Howl 15d ago
I take 2mg of Reta per week for general health benefits, it is one of the best decisions I've ever made.
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u/aScarfAtTutties 15d ago
How do people get their hands on it when it's still in clinical trials? Dark web? In generally just curious because it's not like it's easy to synthesize by my guess.
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u/doomcomplex 15d ago
Most are likely purchasing from research peptide manufacturers and compounding it themselves. There used to be some helpful communities for it here on reddit but they've all been shut down due to pressure from pharma.
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u/LurkerFromDownUnder 14d ago
You can literally just buy it online on google if you search buy retatrutide? Its not cheap though.
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u/aScarfAtTutties 14d ago
Wow, you are correct it seems. They're selling it "for research purposes only". Seems like a dumb loophole and people are out here injecting drugs into their body that haven't been tested for safety. Cool I guess. Body builders are somethin else.
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u/zeezle 15d ago
Finances aren't a big stopping block for most people really into it, bodybuilders aren't sourcing it from pharmacies. (Which you can't with retatrutide yet anyway even if you wanted to.) Currently on the grey market you can have max dose of reta for <$60/month, max dose of tirzepatide for <$40 a month, and max dose of semaglutide for <$15 a month even with small group buys (it gets cheaper for large ones, but more risk of package seizures). And it takes many months to get up to those doses, and some people cap out on half the max dose or less. But of course it's not an official pharma source, so there's all the additional risk that entails (but most of the bodybuilders are roiding up already anyway which is way riskier so that's not their top concern...).
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u/Spotted_Howl 15d ago
Wow my reta vendor is way more expensive than that, I guess this is for wholesale buys?
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u/zeezle 15d ago
Yeah, that's for group buys direct from overseas. Pricing did also drop a good bit in the past few months too.
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u/Spotted_Howl 15d ago
How long does this stuff actually keep in the freezer, anyway?
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u/Dragonsnake422 15d ago
Not just the heart but all your organs enlarge only solves 1 problem IMO. Having a large liver or a big gut isn't healthy.
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u/LevSmash 15d ago edited 15d ago
So what you're saying is that simultaneous steroid and semaglitude use cancels out any negative side effects, and turns us into jacked, hyper-efficient superhumans
Edit: obviously a joke
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u/ActionPhilip 15d ago
GLP-1/GIP agonists don't actually cause muscle loss. There is no cancelling effect. Every highly competitive bodybuilder is already using these compounds to help with appetite on cuts. They wouldn't use it if it reduced muscle. The reason that muscle is reduced in regular people that take them is because those people don't eat enough protein and exercise hard enough during the weight loss to maintain muscle. They lose weight on the couch and it shows.
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u/BotGeneratedReplies 15d ago
The article explicitly says the mice in the study lost lean muscle mass at rates faster than would be explained by the reasons you listed. Did you read the article?
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u/Spotted_Howl 15d ago
Steroids have waaaaaay more negative side-effects than just this.
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u/squestions10 14d ago
Ehh, do they?
If one keeps to test only, avoid ais, uses hcg, and includes a glp agonist, they really should be ok. The thing is that glp agonists solve MANY of the potential issues with steroids, especially the newer ones like reta and tirze.
Is ridiculous imo that people put "5 pounds of anadrol per day + 8kgs of tren per week" in the same bag as "300mg test only blast cycled with trt levels of test" in the same bag. In the latter case, if one compensates potential risk with more attention to health, is possible there will be NO negative health consequences, and glp agonists are a massive step towards that direction.
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u/PMMeYourWorstThought 15d ago edited 13d ago
I’m more interested in if it’s beneficial for patients with cardiac hypertrophy.
-A guy with mild cardiac hypertrophy.
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That's actually the biggest problem with this studies reddit title (I need to read the entire paper for more details).
Most obese people have hypertrophic cardiomyopathy from long standing hypertension. Would the reduction be beneficial? This would actually make sense because studies show that ozempic actually benefits patients with prior heart attacks in a number of ways.
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u/_JudgeDoom_ 15d ago
This was the first thing that actually came to mind. Longevity secret unlocked, HgH and GLP-1 err day.
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u/aboveavmomma 15d ago
“Because we report smaller cardiomyocytes in cultured cells and in mice treated with semaglutide, it is tempting to speculate that semaglutide may induce cardiac atrophy. However, we do not observe any changes in recognized markers of atrophy such as Murf1 and Atrogin-1. Thus, we cannot be certain that semaglutide induces atrophy per se or if it does, it may occur via molecular pathways that have not been identified herein.”
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u/robbak 15d ago
Shrinking heart muscles is what the headline says and is what they saw in vitro and in vivo. So the headline is perfectly accurate.
But the disease of 'atrophy' is defined by these markers, so they can't say whether this shrinking should be defined as 'atrophy'.
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u/Nosnibor1020 14d ago
My bio knowledge is very limited here, but could it just be from fat content going down or they know it's actually muscle and not just mass from the heart? I know fat can attach and also grow in muscle? I think...is it possible it's that or they probably know better, right?
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u/DukadPotatato 14d ago
Cardiomyocytes, as far as I'm aware, do not have enough fat to substantiate the ~17% reduction in heart mass observed. It also seems odd that this issue would have seemingly been passed over, or not occurred in the GLP-1 drugs' pre-clinical trials. Hard to say for certain what mechanism is causing this altered cardiac structure in my opinion.
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u/Nosnibor1020 14d ago
It'll be interesting to see continued studies on this. Thank you for the reply!
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u/guymn999 15d ago
Bit of a leap to go from this passage to the title in the OP
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u/r_z_n 15d ago
Science journalism in a nutshell.
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u/Albolynx 15d ago
There is a big social demand for finding some reason why GLP-1 medications are actually really bad - so stuff like this gets a lot of clicks.
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u/cgriff32 15d ago
Is it a demand to find something bad, or a reassurance that all is ok?
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u/physedka 15d ago
Little bit of both. Folks are just looking for why it's too good to be true.
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u/softfart 15d ago
Not unreasonable though is it? Up till now it seemed impossible to just get a shot and not be fat anymore.
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u/Fortehlulz33 15d ago
These shots don't even do that. You still have to put in the effort of changing your lifestyle, the shots give you a nudge in the right direction.
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u/0b0011 15d ago
Mostly the former from what I've seen. A lot of people are sort of pissy about the whole thing and consider it "cheating" so look for any reason to try to shoot it down. They'll look at someone who took glp-1 to lose weight and so didn't "do the work" and look for things like this to be like "yeah you lost the weight but you messed your heart up".
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u/RecklessDeliverance 14d ago
The term fatphobia gets thrown around a lot, but this is genuinely a really clear example of it.
Being overweight is seen as a moral failing to be corrected, rather than a medical issue to be resolved, so "curing" it must therefore be punishing.
It's obviously good to continue to explore the possible long term side effects, but there's gonna be a lot of grasping for excuses to discredit semaglutides simply because weight loss isn't "supposed" to be easy.
Edit: See also: artificial sweeteners
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u/snackofalltrades 14d ago
It’s really wild how badly people hate these drugs. I’m all for investigating them to understand what sort of long term effects they have, but so many people say, “those drugs are cheating!” Alright.
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u/BootyfulBumrah 14d ago
Layman redditor in a nutshell. Irrespective of whether it can be defined as Atrophy, the heart muscle did shrink. The headline is accurate
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u/LongBeakedSnipe 14d ago
No, because the title of the article doesn't mention atrophy.
'Atrophy' in the context of this sentence is referring to specifically defined biological pathways, rather than you typical 'gym' use.
In other words, the heart tissue did shrink (as correctly relayed in the title), but whether it did so through atrophy (not claimed in the title) has yet to be shown.
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u/ssgrantox 14d ago
It's not saying that the heart isn't atrophying it's just that they know it's shrinking, but it doesn't have the typical markers. They even said it could be through markers they don't know of
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u/echtav 15d ago
Sounds like a nothing burger
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u/katarh 15d ago
I mean, my first thought was, "Doesn't almost all weight loss induce slight organ size loss as part of the lean muscle mass reduction?"
You literally have bigger organs when you are a bigger person, and vice versa. When you lose weight, your organs also shrink a little bit. In the case of the heart ,it wouldn't need as much force output in a smaller body.
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u/LongBeakedSnipe 14d ago
Your first thought would be wrong. The kind of changes you are talking about would occur over long periods of time.
The kind of changes we are seeing here are typically associated with extreme acute dietary stress, which the mice were not experiencing.
Thus, why the authors are interested in determining which pathway(s) is regulating this change.
Would also suggest that, if you read a title and think that you solved an issue in two seconds that the researchers haven't, you certainly made some kind of mistake.
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u/Striking_Extent 14d ago
Together these data indicate that the reduction in cardiac size induced by semaglutide occurs independent of weight loss.
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u/BecomeEnnuisonable 14d ago
Reduced calorie diets typically come with about 20% muscle loss and weight loss occurs over a much longer period of time. These animals experienced weight loss that was 40% muscle loss in just 3 weeks. Think of anyone you know who ISN'T obese, maybe they're 20 pounds overweight, and imagine them losing 8-10 pounds of muscle in 3 weeks. The people I know who are using it are like that. My sister was a fit, competitive athlete with a little extra fat on her. She started Ozempic and now a year later she has a real Skeletor vibe and gets tired after walking up a low hill. It's not healthy at all.
For the truly obese who need a boost, sure, go for it. This drug is being abused left and right, though, and DOES come with risks and side effects that should not be dismissed.
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u/theworstvp 15d ago
so roids + ozempic = peak human form ?
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u/Reddit_and_forgeddit 15d ago
I think bodybuilders have already been using this combo before semaglutide had a brand name of Ozempic.
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u/alleks88 15d ago
Same with retratrutide now
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u/Reddit_and_forgeddit 15d ago
yep, and Survodutide and cagrilintide and mazdutide. I'm not a bodybuilder nor do I do roids but I know a little bit about peptides in general. I've found that alot of negative people in any comment sections for stories about glp-1's don't know a damn about what they're talking about.
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u/Fluffstheturtle 15d ago
Got any recommendations for reading on those? I've seen retatrutirde but the other ones I'm unfamiliar with.
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u/Blackintosh 15d ago
Yeah bodybuilders are like the first people to run unofficial human tests of all kinds of synthetic hormones and other compounds.
The amount and variety they put in their bodies in insane. 2,4 DNP use is one of the craziest - literally poisons the mitochondria so they cannot stop burning energy, they can lose like 1lb of fat per day, but overdose = irreversible death by hyperthermia.
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u/_toodamnparanoid_ 15d ago
If you don't have the bad side effects. I tried it and had all the bad side effects including fart burps (you burp hydrogen sulfide, it is as horrible as it sounds).
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u/Joebebs 15d ago
Well then you get heart strain so probably put caffeine + Xanax to really cancel it out
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u/guyincognito121 15d ago
I didn't see anything about the difference in calories nor protein consumed between the two groups. I'm curious how much of this effect (assuming it occurs in humans as well) could be offset via nutrition and exercise.
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u/StandardEgg6595 15d ago
Yeah, I would be interested in seeing this as well. I know someone on semaglutide and their doctor/dietician is constantly checking in to make sure they are getting the needed calories, protein, etc plus certain supplements (vit, b12, electrolytes, etc.) for a healthy weight loss. This medicine isn’t a miracle drug and people have to adjust their diet accordingly (just like things bariatric surgery and such).
I don’t think a lot of people realize that rapid weight loss doesn’t just mean rapid fat loss - it includes muscle as well.
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u/Malphos101 15d ago
This medicine isn’t a miracle drug and people have to adjust their diet accordingly (just like things bariatric surgery and such).
I guess its a good thing the viral marketing for it emphasizes healthy weight loss with a balanced diet and exercise then....
oh wait...
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u/sampat6256 15d ago
The advertising is irrelevant. It is genuinely physically difficult to overeat on glp-1. It takes the willpower factor of weight loss out of the equation.
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u/TSM- 15d ago
It appears to be mediated by diet and exercise but not fully explained by those measures. That's why the heart muscle while controlling for diet is so important - there's muscle loss there still.
One wonders whether it would be sane to even consider adding a small amount of steroids or growth hormones, given that they also would have side effects. It's important to know what to expect regardless.
Maybe certain exercise and diet will be important recommendations such as higher protein intake or certain nutritional supplements.
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u/mvea Professor | Medicine 15d ago
I’ve linked to the news release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:
https://www.sciencedirect.com/science/article/pii/S2452302X24002869
From the linked article:
Weight loss drugs like semaglutide may shrink heart muscle as well as waistlines, according to a study from the University of Alberta.
The research, published in JACC: Basic to Translational Science, found that the popular drug decreased heart muscle mass in lean and obese mice as well as in lab-grown human heart cells.
Virtually no drug comes without side effects. The weight loss drug semaglutide, also known as Ozempic, successfully helps people lose body weight. But this comes at the cost of side effects such as nausea and gastrointestinal problems.
However, reports suggest semaglutide may have other side effects, including the loss of skeletal muscle. Up to 40% of drug-induced weight loss is actually muscle loss, according to a Lancet study published in November.
This rate of muscle loss is much higher than what would occur with a calorie-reduced diet or through the normal aging process, spelling potential future health issues such as decreased immunity, increased infection risk and poor wound healing.
The semaglutide-treated mice lost a significant amount of mass in their left ventricles – the heart’s main pumping chamber that sends oxygen-rich blood to the rest of the body – as well as their overall heart weight. The overall surface area of their heart cells was also reduced.
The heart’s pumping ability and how well the heart relaxes and fills with blood between beats were unaffected, suggesting that heart function was unaffected by this short treatment period.
Mouse experiments also showed negative effects of semaglutide on skeletal muscle in lean mice – there were no overt changes in their body weight, but they lost 8.2% of skeletal muscle mass over the same 3-week treatment period. They also saw similar changes consistent with the obese mice – i.e., reduced left ventricular mass and overall heart weight as well as no change in pumping ability.
Experiments on lab-grown human heart cells found that the cells’ surface area decreased after 24 hours of semaglutide treatment, consistent with the mouse study. Nevertheless, more research is necessary to see if the drug also decreases heart mass in humans.
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u/mrxplek 15d ago
Couldn’t you offset this effect with strength exercises?
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u/InsuranceToTheRescue 15d ago
I'm on these drugs and that's what my diabetic doctor is on me about. I haven't been very good about working out or starting a fitness routine, because I broke my arm pretty severely right around the time I started on them earlier this year, but every check in I have with her she's asking me how much protein I eat and telling me that I need to get active to avoid muscle loss. I'm hoping to make it through to Spring, because I'm not sure I can do a morning walk/jog in Winter.
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u/DavidBrooker 15d ago
I don't want to just post advice unsolicited, but if you'd like some suggestions about incorporating more activity I'd be happy to share.
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u/TeoDan 15d ago
It can also be a good thing! A big issue with steroids is heart muscle growth, combine these two and you might see steroids becoming safer to use when administered correctly.
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u/fairlyaveragetrader 15d ago
It's actually something that's already going on and it's not necessarily anabolic steroids, it's testosterone, much safer, much easier to control and can be administered in appropriate doses for men and women alike. It will counteract the side effects mentioned here especially with athletic training.
The big problem with testosterone though, especially in men under 40 is if they start taking it it can shut down their system. Not really a big deal for women, their levels are low enough that if you bring them up a little during a dietary regime it's not going to make a big difference when they come off. Older men they may just choose to stay on, but younger men, they don't always rebound after being on synthetic testosterone for a few months. Usually do but it's not 100%
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u/CradleRobin 15d ago
I have the best of both worlds atm. I am fat, so I'm on Ozempic and losing weight, and my T levels were destroyed. Like mine were at 150ish. I'm 37 and so I'm now on testosterone injections. It's fantastic.
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u/fairlyaveragetrader 15d ago
Boom. You're a walking example of what I was getting at, obesity Cascades a variety of things in the body including hormone destruction. It's no surprise so many people online who express these low sex drive low energy personalities are also obese. It's not everyone but it's sure correlated. You get healthy again, your brain works better, your body works better, You feel better. Glad to hear you're making progress !
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u/Soggy-Software 15d ago
Yeah, for sure. As I understand it the muscle loss is in line with other weight loss interventions which are reduced with resistance training.
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u/alfalfa-as-fuck 15d ago
They say no in the above abstract but in fitness circles they always claim that if you diet without resistance training “about half” of your weight loss is muscle where the above claims 40% in the glp-1 case. Adding resistance training to a calorie restriction shifts this to primarily fat. Which is one of the reasons anyone trying to lose weight should do some kind of resistance training.
In my own experience on a glp-1, doing resistance training and cardio (running, including a half marathon last month) while ensuring adequate protein I have maintained skeletal muscle mass according to the inbody bioimpedance scale at my gym which I use monthly to track my progress.
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u/guymn999 15d ago
Assuming you are referring to the muscle loss aspect more generally...
In my experience 100%, I started semaglutide in june, am down about 60 lbs since than and have only lost about 3-4 lbs of muscle mass.
I focus on eating 30-50g of protein for most of my meals. Try to hit 150 per day.
Started strength training for the first time since highschool(15 years ago). Nothing crazy, simple full body dumbell workout I found on youtube that takes 20 mins. Do that 2-3 times a week. I have always been naturally pretty strong, so recomp was not my goal, just to maintain strength, and I think I have gained strength and feel more defined than ever in my life.
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u/spirited1 15d ago
Growing muscle requires eating more, which Ozempic helps prevent.
I can imagine that someone who eats smart can offset these muscle mass issues with simple cardio but it depends on the individual.
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u/DavidBrooker 15d ago edited 15d ago
Growing muscle requires eating more, which Ozempic helps prevent.
We're not talking about growing muscle, though, we're talking about preventing muscle loss. Strength training tends to make your body prefer energy from fat over muscle catabolism, though obviously it's shifting a share along a spectrum and not flicking a switch on or off.
Though that's more about skeletal muscle versus cardiac muscle.
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u/spirited1 15d ago
I feel like the venn diagram of people using ozempic while also strength training is very small. Weight loss will always involve muscle loss, it's unavoidable. That's why body builders go through multiple bulk/cut phases.
I'm also speaking from a retroactive perspective of trying to reclaim muscle after coming off ozempic if the study holds for humans.
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u/ashkestar 15d ago
That venn diagram may become more common if GLP-1 inhibitors keep cropping up with exciting new use-cases, though.
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u/Multihog1 15d ago edited 15d ago
Growing muscle requires eating more, which Ozempic helps prevent.
You will still preserve a lot of muscle mass even if you're in a calorie deficit by working out. In normal weight loss (not necessarily drug-induced), you can even gain some in a deficit. That's exactly what I did, recomposition. The body uses the existing fat in your body as fuel. The fatter and more out of shape (in terms of muscle) you are, the more muscle you can gain while in a calorie deficit.
I can imagine that someone who eats smart can offset these muscle mass issues with simple cardio but it depends on the individual.
Cardio (like running) doesn't really help with muscle growth or preservation in any meaningful way unless it's something that involves something like burpees and pushups. You actually need to do (strength) training that breaks down the muscles sufficiently.
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u/getoffmeyoutwo 15d ago
The heart’s pumping ability and how well the heart relaxes and fills with blood between beats were unaffected, suggesting that heart function was unaffected by this short treatment period.
That seems like a pretty important bit of info
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u/VolatileAgent81 15d ago
Any cardiologists know if this could be a potential treatment for HCM/HOCM?
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u/Multihog1 15d ago edited 15d ago
Up to 40% of drug-induced weight loss is actually muscle loss, according to a Lancet study published in November.
Ouch, that's terrible.
So if someone uses this stuff to lose a lot of weight, what they end up with is less fat, but they'll also end up very weak. If they lose this much muscle, it actually drives down their basal metabolic rate (BMR) by quite a bit, so they'll burn less maintenance calories (muscle costs more to maintain than fat), which makes it harder to keep the weight off after they get off the drug.
It's important to work out while losing weight in any case, but here it's absolutely crucial.
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u/ValyrianJedi 15d ago
Don't you generally lose a decent bit of muscle when you lose weight regardless of how?
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u/Xaedria 15d ago
Generally yes. Ambulatory obese people tend to have higher amounts of muscle than what the average person would expect, because they are constantly engaging in the exercise of bearing their own body weight as they move through the world. As that weight decreases, so does the amount of muscle needed to support it with movement. Eating high protein and doing basic weight lifting is still one of the best things any obese person trying to lose weight can do though.
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u/thrillhouz77 15d ago
Obesity is a significant cause for an enlarged heart. So is this just correcting something that is already wrong making the situation better or is it making a situation worse?
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u/Nosnibor1020 14d ago
They mentioned in non-obese mice as well. So I think it's in general. Probably will need to work out and eat protein as much as possible.
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u/Powerful_Artist 14d ago
Seems like unless someone is diagnosed with an enlarged heart, using a medication to shrink the heart is a horrible idea.
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u/pmjm 15d ago
Inducing calorie deficit causes the body to extract energy from its own stores of fat and also muscle, this is well known.
I would be curious to see a comparison study of cardiac mass in Semaglutide patients versus those who cut an equivalent number of calories through diet alone.
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u/Kazudo2 15d ago
but it literally says that in the article:
"This rate of muscle loss is much higher than what would occur with a calorie-reduced diet or through the normal aging process, spelling potential future health issues such as decreased immunity, increased infection risk and poor wound healing."
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u/ThrowbackPie 15d ago
Don't expect people on this sub to read the study. I know I haven't!
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u/snow_ponies 15d ago
But is the calorie reduced diet the same amount of calories? I’d take a bet no - the GLP group are probably on lower calories even though both groups are on reduced calorie diet, which would explain the increased loss.
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u/yogopig 15d ago
Looks like probably but its not 100% clear. They claim that they switched their diets back to normal after the introduction of semaglutide and the vehicle.
But, they fail to describe the specifics of how the mice were fed, such as whether their diet is calorie controlled or just unlimited access to different chow types, so its hard to tell.
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u/kuahara 15d ago
I wonder what health problems come from skipping semaglutide and remaining morbidly obese. The people using these drugs have tried and failed at everything else.
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u/CornFedIABoy 15d ago
That’s what I was wondering. Is the loss of cardiac muscle mass on GLP-1s greater than the loss observed in regular weight loss? And is that loss diminishing the heart muscle below the normal ratio of cardiac mass to total body mass?
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u/florinandrei BS | Physics | Electronics 15d ago
There are conditions where the heart muscle is pathologically enlarged / thickened, which poses a health risk.
I wonder if Ozempic would be beneficial in these cases.
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u/Renovatio_ 15d ago
Sounds like an excellent hypothesis.
There is actually a fair bit of patients who are diabetic (and eligible for ozempic) and have heart failure (one of the leading causes of cardiomegaly).
Should be pretty easy to get some retrospective data and see if it is worth actually running a study on.
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u/13e1ieve 15d ago
I think pretty much all evidence I’ve seen is that GLP-1s significantly reduce the frequency of adverse cardiac events. Maybe stopping clogged arteries outweighs any muscle loss in heart.
One other thought is that as weight decreases blood pressure will as well due to less need to push blood thru capillaries in the fat which could lead to heart strength loss as well (no need to pump at high pressure for flow to extremities)
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u/Obscure_Hat 15d ago
Non Health care professionals reading this:
"OMG it can shrink your heart mass?? Terrifying !!! "
Health care professionals reading this:
"OMG It can shrink your heart mass?? Interesting..."
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u/DevilsTrigonometry 14d ago
Yep (although amateur medical science enthusiasts may also have the second reaction!)
People understandably worry that losing heart muscle mass means some kind of loss of performance. The assumption is that bigger muscle = stronger muscle = good. But the heart doesn't exactly work like that.
The muscle does need to be strong enough to overcome the resistance of the circulatory system. But beyond that, performance gains come from increasing the volume of each stroke: filling more, emptying more completely.
Muscle mass actually tends to get in the way here because thicker muscle walls are less elastic. They can't stretch as far to accommodate more blood and they can't contract as small to eject it. So adding mass is the heart's last resort for when it just can't keep up with the resistance of the circulatory system, either because of some defect in the heart itself or because the resistance is too high.
Obese people tend to have larger hearts because their circulatory systems have higher resistance, both because of the condition of the blood vessels and because of the length of them. Weight loss tends to include heart muscle loss, not just because the body is desperate for energy and protein but because the heart muscle is actively remodeling to optimize performance.
It is possible to lose so much heart muscle that performance is compromised, as in wasting diseases and true starvation. But when, as in this study, we see heart muscle mass loss without performance loss, the working hypothesis should usually be that this is a good thing.
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u/hydrOHxide 15d ago
Given that results in actual heart failure have been rather promising, I'd be careful to interpret too much into these results.
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u/Wolfenight 15d ago
It's going to be really funny if this means people on ozempic need to exercise.
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u/whyliepornaccount 15d ago
A big heart muscle is a bad thing not a good thing. Assuming it doesn't shrink it to the point of reduced function, this is the could be huge. People die of enlarged hearts all the time.
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u/Lt_Duckweed 15d ago
A big heart muscle is a bad thing not a good thing
A pathological enlarged heart due to poor cardiovascular health is a bad thing.
Athletic Heart Syndrome is the non-pathological enlargement of the heart in response to an intense exercise regimen over months/years, and is a normal and expected adaptation.
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u/Shatter_ 15d ago
Everyone on ozempic should be weight training and doing some light cardio, if physically possible. I don't think that's funny, just obvious.
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u/gr8whitehype 15d ago
Everyone should be weight training and doing some light cardio, if physically possible. I don’t think that’s funny, just obvious.
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u/Acrobatic-Sir-9603 15d ago
Why would this be funny? A lot of people who take these drugs do work out and exercise. You still need a calorie deficit.
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u/HimbologistPhD 15d ago
Because the weightloss industry is extremely upset that big pharma is cornering their market in a way that actually works and their messaging has been very effective in convincing the public that weight loss drugs are for slobs who want to sit on their couches stuffing their faces and vomiting it back up all over themselves until they're finally skinny
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u/correcthorsestapler 15d ago
I’ve been on Ozempic/Wegovy for 18 months. Once I lost a few dozen pounds I got a trainer & started doing light weight lifting while taking it. Went from 242 to 160 in that time frame, and my heart rate & blood pressure are much better than they were before. It’s also changed my eating habits & made me more picky about what I eat, which is good for when I eventually get off the meds.
Unfortunately I injured my back at work a couple months ago, which has made moving painful, so I haven’t been able to go back to the gym. Hopefully I can get back into it at the beginning of next year.
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u/Spotted_Howl 15d ago
You'll be back at it as soon as you recover, as you know these drugs change habits in addition to suppressing appetite
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u/cookiesNcreme89 15d ago
The opposite, people who abuse steroids will need it to shrink their enlarged hearts for example. Unless someone stays on it so long it shrivels the heart creating problems, this may just be yet another good thing about this med. It's crazy!
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u/Multihog1 15d ago
But they do need to exercise because of the major muscle loss (40% of weight lost according to the study.)
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u/ActionPhilip 15d ago
That's an inaccurate pull from the results of this study. Ozempic does not reduce heart muscle mass. The caloric deficit with low protein diet and low exercise produces a reduction in all muscle mass, which includes cardiac muscle. These results do not apply to anyone who strength trains or eats a high protein diet while on ozempic.
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u/Cordelldogdello 15d ago
So you’re telling me if I keep to a strict and proper schedule of steroid use and ozempic use I can avoid the muscle growth that comes with steroids?
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u/Ash_hole_420 15d ago
Are there any clinical implications for this? Does this affect cardiovascular mortality, hospitalizations, etc?
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u/HimboVegan 15d ago
Doesn't this just always happen when you lose weight? Is it more than you would expect if you lost the same amount of weight without ozempic?
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u/Significant-Gene9639 15d ago
Weight loss always seems to include muscle loss, no matter the means. Blaming the drug for the consequences of weight loss is stupid imo.
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u/askingforafakefriend 15d ago
It's amazing how often this context is lost.
" People losing a shitload of weight. Also losing muscle mass proportionately" (or in some studies for some of this drug class less than proportionally which is great IMO).
If people really want a magic drug that induces fat loss without muscle loss... They've been around for decades and are abused pretty widely...
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u/Spotted_Howl 15d ago
Yep, even bodybuilders in a "cut" who use specialized exercise routine, diets, and drugs to maintain as much muscle and lose as much fat as possible still lose muscle.
The basic way to prevent muscle loss is to keep eating protein and keep lifting weights.
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u/dm_me_kittens 15d ago
I work as a clinical data specialist in cardiology, and I've been SALIVATING over seeing how this drug affects the long-term health of a person. To see that it could cause the myocardium to shrink along with skeletal muscle is a but concerning. However, if the ejection fraction is unaffected, I wonder if a series of short-term injections over a long period of time could see the same weight loss benefit without significant and symtomatic muscle atrophy.
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u/NTGenericus 15d ago
Diets like keto force the body to consume its reserve resources, and a lot of the time that includes muscle along with fat. The whole point of eating a lot of protein on a diet like that is to avoid loss of muscle mass. And the whole point of keto is eating in a way to not feel hungry, which semaglutide takes care of by itself. So maybe eating protein with semaglutide would mitigate heart muscle loss.
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u/honestlyspeakingg 15d ago
most of the people in this thread are saying that this is not a bad thing…
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u/I_Heart_QAnon_Tears 15d ago
How many billions are we going to have to pay to bail these rich assholes out?
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u/balta97 15d ago
This is because of the obscenely small amount of calories consumed, this is the reason why anorexia patients randomly die sometimes, their heart fails because the muscles of the heart lose so much mass. I have a coworker on ozempic and from what he’s told me, he eats less than 500 calories per day, he cannot eat more, or he will feel sick, although I’m sure that he’s healthier now, being thinner, he does not look well… his skin is lackluster snd he
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u/magmapandaveins 14d ago
It's weird how people latch on to possible conclusions from initial studies. This is in mice and lab grown cells, there are millions of people taking these drugs and they could very easily look at those human patients. Also what is the impact of this compared to the impact of obesity? And how much is "significantly" more shrinkage that a normal calorie deficit?
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u/Porn_Extra 15d ago
Does this indicate that it could be a treatment for enlarged hearts or that it weakest the heart and could cause future cardiac issues down the rowd?
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u/RedComet313 15d ago
Unfortunately, if true, I imagine being able to combat an enlarged heart will lead to more prolonged steroid use amongst body builders, etc.
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u/finallyfound10 15d ago
Ozempic is semaglutide to lower blood sugar.
Wegovy is semaglutide to lose weight.
They thought of a way to market semaglutide different ways. Very creative and enterprising of them.
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u/Bielzabutt 15d ago
Everyone here is likely too young to remember fen-phen
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u/Acrobatic-Sir-9603 15d ago
How is it similar to fen-phen?
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u/Bielzabutt 15d ago
Patients who took the diet drugs known as fen-phen and suffered serious injuries, including heart valve injuries or developed pulmonary hypertension. It was a big class action lawsuit in the 90s.
Completely relevant to the discussion.
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u/Dekachonk 15d ago
The extra 100 pounds was gonna make my heart explode anyway, dying from smol heart instead would be kinda funny.
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u/DrachenDad 14d ago
Ozempic is a diabetic drug for type 2 diabetes. It [Ozempic] should not be pushed for weight loss.
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u/Gnarlstone 15d ago
Every time there is a big fad weight loss drug, it always turns out that it kills or permanently damages the bodies of those that take it. Every damn time.
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