Endocrinology and metabolism (Seoul, Korea)Oct 1, 2019

How Diabetes Drugs Affect Muscle and Fat Levels in People

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Mar 29, 2026

Abstract

In over half of the studies reviewed, the proportion of reduction ranged between 20% and 50% of total weight lost.

Weight loss from glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) is primarily due to reduction.
Significant variability exists among studies regarding the impact of these therapies on body composition.
Lean body mass loss is observed alongside weight loss from both GLP-1RAs and SGLT2is, similar to effects seen with diet and bariatric surgery.
No significant differences were noted between GLP-1RAs and SGLT2is in terms of body composition changes.
Attention is needed to strategies that preserve skeletal muscle and enhance physical function during weight loss treatments.

Simplified

Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to (FM). Given the importance of skeletal muscle and (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting the effects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associated with both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In over half of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistent with diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently, the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategies to preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.

Key numbers

20% to 50%

Contribution to Weight Loss

Proportion of weight loss attributed to across various studies.

2.5 kg

Weight Loss with Canagliflozin

Weight loss after 26 weeks of treatment with canagliflozin.

4.5 kg

Weight Loss with Dapagliflozin

Total weight loss after 104 weeks of dapagliflozin therapy.

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Funding

Competing interests

Melanie Jane Davies has acted as a consultant, advisory board member and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca and Janssen, an advisory board member for Servier and as a speaker for Mitsubishi Tanabe Pharma Corporation and Takeda Pharmaceuticals International Inc. She has received grants in support of investigator and investigator-initiated trials from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim, and Janssen.

PubMed

How Diabetes Drugs Affect Muscle and Fat Levels in People

Abstract

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Competing interests

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Related papers

You found one interesting study. We’ll send the next 7.

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Recent issues from the glp-1 therapies brief