Weight loss from GLP-1 drugs like Ozempic may also result in some muscle loss, not just fat. Researchers are, therefore, testing whether a second drug could help protect muscle while people lose weight.

According to new trial data, an experimental drug developed by Regeneron called trevogrumab reduced muscle loss when it was taken along with Novo Nordisk's semaglutide, the active ingredient in Ozempic and Wegovy.

It could be a significant development in the GLP-1 weight loss drugs market as researchers are focusing on what kind of weight people are losing rather than how much.

Ozempic Results In Muscle Loss

Ozempic contains semaglutide, a GLP-1 drug that helps lower blood sugar and reduce appetite. As people eat less consistently and lose weight, the body can lose both fat mass and lean mass, which includes muscle.

Reuters reported researchers found that patients who took semaglutide lost 6.7% of their lean muscle mass over 26 weeks in one part of the trial.

This also does not mean that everyone on Ozempic will lose a large amount of muscle. Diet, physical activity, protein intake, age and starting muscle mass can all influence body composition during this weight loss.

But preserving muscle is crucial, especially for older adults and people who already have low muscle mass.

Also read: 2 Indians Charged In US Over Fake Ozempic Scheme: How To Spot Counterfeit GLP-1 Drugs

Could Trevogrumab Help?

Trevogrumab, developed by Regeneron, belongs to a class of drugs that targets myostatin, a protein involved in regulating muscle growth and maintenance.

While semaglutide helps drive weight loss, trevogrumab may help prevent the body from breaking down as much muscle during that process.

In the trial, people who received semaglutide alone lost 6.7% of their lean muscle mass over 26 weeks. Those who received semaglutide along with 75 mg of trevogrumab lost 3.3%, while the group receiving 25 mg lost 4.7%.

That means the higher dose nearly halved the lean-mass loss seen with semaglutide alone.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

More About The Trial & Trevogrumab

The drug is experimental and has not been approved as a treatment for people taking GLP-1 drugs.

The trial involved nearly 1,000 people aged 18 to 65, and the researchers are continuing to study trevogrumab. Regeneron has selected the 75 mg once-weekly dose for further studies and plans another mid-stage trial involving people over 65.

The larger trial initially included another experimental drug, garetosmab. Two people receiving higher-dose trevogrumab in combination with garetosmab died during the first 26 weeks.

One death had an undetermined cause in a person with multiple cardiovascular risk factors, while the other was due to cardiac arrest in someone with a history of cardiovascular disease. Regeneron said it will not continue developing the triple-drug combination.

Maintaining Muscle Mass During Weight Loss

Muscle is important for strength, mobility, balance and everyday physical function. Losing too much muscle during rapid weight loss could be particularly concerning for older adults, who are already at risk of age-related muscle loss.

This is why the next generation of obesity treatments may focus on more than the number on the weighing scale.

Regeneron executive Boaz Hirshberg said, “What we want to do is concentrate on the quality of weight reduction. We want to find the best way to approach weight reduction, especially in vulnerable patients.”

Most athletes and gym-goers cannot help but boast about the many benefits of creatine. When it comes to boosting performance and supporting muscle growth, this supplement is trusted often.

But a new study suggests that creatine may also have benefits when you are out of the gym. But the researchers caution that it does not mean that creatine can replace exercise, especially strength training.

Researchers at Texas A&M University found that adults who took creatine gained lean tissue and improved muscle strength even when they did not follow a structured exercise programme. The 12-week study was published in the Journal of the International Society of Sports Nutrition.

Could Creatine Help Build Muscle?

The study is based on 64 healthy adults aged 45 to 65 who completed the 12-week intervention. Participants were divided into exercise and non-exercise groups and were randomly assigned to take either 10 grams of creatine monohydrate or a placebo every day.

The exercise group followed resistance and aerobic training three times a week, while the other participants did not follow a structured exercise programme.

Among those who did not exercise, those taking creatine gained about 2.4 pounds (1.1 kg) of lean tissue over 12 weeks. They also improved their leg and bench-press strength. Those who combined creatine with exercise saw even greater improvements in strength.

Creatine occurs naturally in the body and helps cells produce energy. Most of the body's creatine is stored in skeletal muscle, where it helps regenerate ATP, the main source of energy for the cells.

This is one reason creatine has traditionally been associated with better performance during short, intense exercise. The researchers believe its ability to support cellular energy may also help preserve or even increase lean tissue, especially in middle-aged adults.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

Creatine & Weight Loss

The study also studied whether creatine could help people preserve muscle while losing weight.

Participants following the exercise and low-calorie diet who took creatine gained nearly 3 pounds of lean tissue while reducing fat mass.

The exercise and diet group taking placebo showed little change in lean tissue. Creatine was also associated with a greater reduction in body fat percentage. This could be relevant during weight loss, when some muscle loss may occur along with fat loss.

No, Creatine Will Not Replace Exercise

The small study is lasted only 12 weeks and also involved healthy adults aged 45 to 65, so the results cannot be applied to younger people, older adults with health conditions, or other people with muscle disorders.

The findings are also somewhat different from the much larger body of evidence showing that creatine's most established benefits occur when it is combined with resistance training.

Maintaining muscle becomes crucial with age. Loss of muscle mass and strength can affect mobility and physical function. The Texas A&M researchers say the findings add to growing interest in creatine as a tool for healthy ageing and maintaining muscle.

Eli Lilly’s highly anticipated GLP-1 weight-loss drug retatrutide has delivered nearly 21% average weight loss in people with type 2 diabetes and obesity, according to results from a large Phase 3 trial published in The Lancet. In an ever-expanding weight loss medication market, retatrutide is already showing significant promise in obesity and diabetes management.

The drug, retatrutide, is being developed by Eli Lilly and is not approved by the FDA yet. In the TRIUMPH-2 trial, people receiving the highest 12 mg dose lost an average of 20.8% of their body weight over 80 weeks, equivalent to about 49.6 pounds or 22.5 kg.

The findings about retatrutide's trial were presented at the European Association for the Study of Diabetes (EASD) annual meeting in Milan and published simultaneously in The Lancet.

How Is Retatrutide Different From Other GLP-1 Drugs?

Retatrutide is a triple agonist because it activates three hormone receptors:

• GIP
• GLP-1
• Glucagon

GLP-1-based medicines are already widely used for diabetes and obesity. Retatrutide activates GIP and glucagon pathways as well, creating a three-way approach to manage appetite, blood sugar and metabolism. The drug is given once weekly by injection and remains experimental and investigational.

Also read: World Heart Day: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s

Retatrutide Weight Loss Results

TRIUMPH-2 included adults with obesity or overweight and type 2 diabetes. Participants receiving retatrutide were assigned to 4 mg, 9 mg or 12 mg doses and followed for 80 weeks. The average weight loss was:

• 4 mg: 12.7%
• 9 mg: 19.1%
• 12 mg: 20.8%
• Placebo: 4.0%

The response was even greater among participants who started the study with a BMI of at least 35. Those receiving 12 mg lost an average of 23.4% of their body weight, or about 60.8 pounds.

By week 80, 59.5% of people taking 12 mg no longer met the BMI criteria for obesity.

Also read: 100% Blockage At 18, 25% Patients Under 40: On World Heart Day, Cardiologists Reveal An Alarming Heart Attack Pattern

Retatrutide Blood Sugar Results

Retatrutide not only led to one of the biggest weight losses ever seen, it also improved HbA1c, a measure of average blood glucose over the previous two to three months. At 80 weeks, HbA1c fell by:

• 1.4 percentage points with 4 mg
• 1.6 percentage points with 9 mg
• 1.5 percentage points with 12 mg

Up to 40% of participants receiving retatrutide achieved an HbA1c below 5.7%, which is within the normal range.

The Next Big Weight-Loss Drug?

The results are certainly seem promising, particularly as people with type 2 diabetes can sometimes lose less weight with obesity medicines than people without diabetes.

Retatrutide's combination of substantial weight loss and improved blood sugar control makes it an important drug to watch in a competitive GLP-1 market.

Since it's not approved yet, more evidence will be needed on its long-term safety, cardiovascular effects and how its benefits compare with existing treatments. It is also worth remembering that the 20.8% figure represents an average, not the amount every participant lost.

Retatrutide's development is a sign that obesity and diabetes treatment is extending beyond just managing blood sugar. The next generation of drugs is all about targeting weight, glucose and metabolism together.

Exercise is good for the heart. That part is not in question. But on the occasion of World Heart Day, doctors say the way you exercise, and how suddenly you start, can matter just as much as whether you exercise at all.

The Weekend Warrior Problem

A lot of us live sedentary weekdays and then try to make up for it with one hard gym, swimming or sports session over the weekend. Dr Dhirendra Singhania, Director of Interventional Cardiology at Yashoda Medicity, says this pattern puts real strain on the body. "In an untrained person, a sudden switch to a much increased load in terms of time or intensity of training is a huge physiological stress on the heart," he told Health and Me.

Dr Ajeet Singh, Senior Consultant and Head of Cardiology at ShardaCare Healthcity, describes the same risk from the other direction. "Stepping into a sedentary lifestyle with a sudden burst of extreme activity, and vice versa, can strain the heart," he told Health and Me. Weekend sport, after a week of sitting, is one of the most common triggers.

Dr Udgeath Dhir, Principal Director, Cardio Thoracic and Vascular Surgery at Fortis Gurugram, points to a related trend: people jumping straight into long-distance running or marathon training without building up to it. "Suddenly pushing an untrained body into long-distance running, marathon training or extreme high-intensity workouts can place unnecessary acute stress on the cardiovascular system," he says.

What the Research Shows

Medical literature backs this up. New England Journal of Medicine study found that people who exercised regularly were far better protected against a heart attack being triggered by sudden exertion than those who rarely worked out. Research published in Circulation notes that the least fit individuals face the greatest risk during sudden physical effort. Doctors describe this as a fitness "buffer". A trained heart handles a sharp rise in oxygen demand and blood pressure far better than an untrained one.

This doesn't mean irregular exercise is pointless. A large 2023 study in JAMA, using activity-tracker data from close to 90,000 people, found that "weekend warriors" who packed their exercise into one or two days had a similarly lower cardiovascular risk to people who spread activity evenly through the week. The catch, researchers noted, is that this benefit shows up in people who are already getting regular activity in some form. Suddenly forcing an untrained body into a high-intensity session is a different scenario altogether.

Read More: 100% Blockage At 18, 25% Patients Under 40: On World Heart Day, Cardiologists Reveal An Alarming Heart Attack Pattern

Who Should Be Extra Careful

All three doctors agree that people with undiagnosed heart problems, high blood pressure, high cholesterol, diabetes or a family history of heart disease need to be more cautious. Dr Singh says this doesn't mean exercise should be avoided. It simply has to match "age, fitness level, and overall health and medical history." Dr Singhania advises anyone with existing heart disease or risk factors to consult their doctor before starting intense activity.

Warning Signs to Watch For

All three point to the same red flags. Chest pain or pressure, unusual breathlessness, dizziness, a racing heart, or simply feeling off during exercise. Dr Singhania lists "angina, unusual breathlessness, pre-syncope, syncope and palpitations" as symptoms that should never be ignored.

The advice from all three doctors is simple. Warm up. Build intensity gradually. Cool down. Stay hydrated. And if something feels wrong mid-workout, stop and consult a doctor rather than trying to push through the discomfort. As Dr Dhir puts it, "Fitness is not about pushing the body to its maximum every day; it is about building a level of fitness that your individual heart can safely sustain."