EFFECTS OF GLP-1 ANALOGS ON MUSCLE MASS: EVIDENCE OF SARCOPENIA

Abstract

 Glucagon-like peptide-1 (GLP-1) receptor agonists have been widely used in the treatment of obesity and type 2 diabetes mellitus due to their high effectiveness in weight reduction and metabolic control improvement. However, recent evidence suggests that part of the weight loss promoted by these medications may occur at the expense of muscle mass reduction, raising concerns regarding the development of sarcopenia. This study aimed to analyze the effects of GLP-1 analogs on muscle mass, focusing on scientific evidence related to sarcopenia. This is an integrative literature review with a descriptive and qualitative approach, carried out through searches in PubMed/MEDLINE, Virtual Health Library, SciELO, and Google Scholar databases. Articles published between 2020 and 2026 in Portuguese, English, and Spanish were selected. The results demonstrated that medications such as semaglutide and tirzepatide promote significant body weight reduction, improvement in glycemic profile, and reduction of cardiovascular risk factors. However, part of the studies showed a concomitant reduction in lean body mass, especially among elderly, sedentary individuals or those with low protein intake. It was also observed that resistance exercise and adequate nutritional monitoring contribute to muscle preservation during pharmacological treatment. It is concluded that GLP-1 receptor agonists represent an important therapeutic advance in the management of obesity and type 2 diabetes mellitus; however, the possible impacts on muscle mass require continuous monitoring of body composition and adoption of multidisciplinary strategies aimed at preventing sarcopenia. Therefore, it is essential to combine pharmacological therapy, physical activity, and nutritional support to ensure healthy weight loss and better clinical outcomes.