Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of obesity, demonstrating significant efficacy in inducing weight loss and improving metabolic parameters. However, emerging clinical and paraclinical evidence suggests that these agents may also contribute to an unintended reduction in skeletal muscle mass, potentially exacerbating or precipitating sarcopenic obesity, particularly in older or frail individuals with limited muscular reserves. This review critically examines current data on the effects of GLP-1 RAs on body composition, explores the underlying pathophysiological mechanisms of skeletal muscle wasting, and offers evidence-based strategies for attenuating these potential adverse outcomes. While GLP-1 RAs therapy remains central to obesity management, optimizing its use through early recognition and management of associated risks is essential to preserve muscular health, patient functional status and quality of life.
Ceasovschih et al. (2025) studied this question.