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Does Ozempic Cause Muscles Loss?

You’ll shed pounds, but your gains in the gym may take a blow.

Patients eager to lose weight are snatching up trending diabetes drugs Ozempic and Wegovy to speed up the process. Despite side effects like Ozempic face, the drug has become so popular that some high-end restaurants are offering Ozempic-sized meals to appease their customer base with newly suppressed appetites.

Ozempic and Wegovy are brand-name versions of semaglutide— a medicine that was originally manufactured for people with type 2 diabetes. But their ability to reduce appetite and to trick your brain into thinking you’re fuller has boosted their popularity for weight loss (1).

Physician and longevity expert Peter Attia, M.D. warns that they can also cause muscle loss in patients

Does Ozempic Cause Muscle Loss

Yes, Ozempic can cause muscle loss “when it’s not used correctly,” says Dina Peralta-Reich, M.D. “When you have either rapid or significant weight loss and you’re not monitoring your body composition, muscle mass, or fat percentage, you can be losing muscle mass,” she says. 

But Carlo Manzana, M.D. notes that this isn’t unique to Ozempic. “Any weight loss—especially rapid weight loss, by any means, whether it is from dieting, medications or weight loss surgery—can potentially lead to muscle loss,” he says. 


About the Experts

Dina Peralta-Reich, M.D., is director of New York Weight Wellness Medicine and a fellow of the Obesity Medicine Association

Carlo Manzana, M.D., is a family medicine physician with virtual health platform PlushCare. He is a provider in PlushCare’s weight management program.

What Happens to Your Body Composition?

Ozempic may prompt equal muscle-to-fat loss, says Attia. Meaning: even though you see the number on the scale drop, your fat-to-muscle percentage is skyrocketing. In an Instagram story, Attia notes that some muscle loss is expected in weight loss patients, but drugs like Ozempic can exacerbate the issue.

“Almost without exception, every patient we’ve put on this drug has lost muscle mass. And they have lost it at a rate that alarms me,” he says. “If you lost ten pounds of muscle and ten pounds of fat to go from 200 to 180, would that be good? Only if you were more than 50 percent body fat.”

Attia has “drawn a line in the sand” at his practice after observing these outcomes, telling patients that they “must have a DEXA scan first” to test their bone density and body composition before going on Ozempic.

How Can You Prevent Muscle Loss on Ozempic?

Weight loss specialists are aware of this concern, and actively work to prevent it, Peralta-Reich says. That includes monitoring patients’ protein intake and encouraging them to do resistance-based exercises. 

Manzana agrees, adding “The best way to prevent muscle loss while working on losing weight would be to have regular physical exercise, including resistance training, as well as having a high protein intake in your diet.” 

Peralta-Reich makes sure that her patients focus on these important elements as well. “If I have a patient that is losing too much muscle, I would not increase the dose if they’re not improving protein intake or increasing resistance exercise,” she says.

Getting enough protein is essential to avoid lean muscle loss while taking weight loss drugs like Ozempic and Wegovy, says Attia.

“We work closely with patients to make sure that if they’re on these drugs, they understand that their protein requirements do not change,” he says on Instagram. “If you’re 200 lbs and your target weight is 180 lbs, you’re still going to be consuming 200 grams per day of protein.”

Simply put, you need to eat a 1:1 ratio of grams of protein to your starting weight in pounds, notes Attia (some experts recommend 0.8 grams of protein per pound of body weight.) 

Attia says if you maintain your exercise levels to continue building muscle mass, you can lower your fat percentage without disproportionately losing muscle while taking Ozempic.

“Ultimately, it’s not your weight so much that matters. It’s your body composition and your health,” he says.

Despite the risk of muscle loss, Peralta-Reich says that weight loss drugs can be helpful for patients. “These are fabulous medications when used appropriately,” she says.

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