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GLP-1 Drugs and Muscle Loss: What You Need to Know

Understanding the impact of GLP-1 medications on lean mass—and how WORTHY’s EMS and NMS technology helps preserve strength, structure, and long-term success.

GLP-1 medications like Ozempic, Wegovy, and Mounjaro have become powerful tools in the weight loss landscape. For many, they mark a shift toward better metabolic health, improved energy, and renewed confidence.

But there’s a hidden cost that most people—and many providers—aren’t talking about. Beneath the changes on the scale is a lesser-known but significant concern: muscle loss.

Clinical data show that up to 40% of the weight lost on GLP-1 receptor agonists may come from lean tissue, including skeletal muscle¹²³. This isn’t just a cosmetic issue. Muscle loss affects your metabolism, energy, strength, mobility, and your ability to maintain results over time.

At WORTHY Self-Care Studio in Berkeley, we support clients on GLP-1 therapies with a proactive, evidence-based strategy. Using InstantSculpt EMS and NMS Face technology, we help preserve and rebuild the muscle that matters—so your transformation supports lasting health, not just short-term change.


The Science Behind Muscle Loss on GLP-1s

GLP-1 medications reduce appetite and food intake, creating a calorie deficit that supports fat loss, but also puts lean muscle at risk, especially without adequate protein and resistance training.

Mechanisms contributing to muscle loss:

  • Reduced protein synthesis from decreased food intake and insufficient amino acids
  • Metabolic adaptation, where the body downregulates muscle-preserving processes to conserve energy
  • Hormonal shifts affecting testosterone, IGF-1, and growth hormone
  • Reduced activity levels, particularly in early treatment, due to fatigue or nausea

The Clinical Evidence

The data is clear—and concerning:

  • The STEP 1 and SUSTAIN 8 trials showed that 39–40% of the weight lost on semaglutide came from lean mass¹
  • Regeneron’s COURAGE trial found that 35% of semaglutide-induced weight loss was lean mass²
  • A review published in The Lancet Diabetes & Endocrinology confirmed that lean mass loss ranges from 25% to 39% over 36–72 weeks³
  • The American Diabetes Association states that 15–40% of GLP-1-related weight loss can come from lean body mass⁴

If you lose 50 pounds on a GLP-1 medication, you could be losing between 12 and 20 pounds of muscle—a change with long-term consequences for your health and metabolism.


Why Muscle Loss Matters

Muscle is a metabolic engine. It burns more energy at rest than fat, supports hormone regulation, and protects your physical capacity as you age.

The risks of losing muscle mass:

  • Lower resting metabolic rate: Each pound of muscle burns 6–7 calories/day vs. 2–3 for fat.
  • Reduced strength and mobility: Loss of muscle impacts your ability to move, recover, and stay active.
  • Altered body composition: You may reach your goal weight but feel “soft” or less toned than expected
  • Higher risk of weight regain: With less muscle, the body becomes more efficient at storing energy as fat.
  • Long-term difficulty rebuilding: Harvard research shows people lose about 30% of their muscle mass over a lifetime, and regaining it takes more time and effort than preserving it⁵.

Facial Muscle Loss: Understanding “Ozempic Face”

While body composition gets most of the attention, facial changes can be equally impactful—and far more visible.

Commonly referred to as “Ozempic face”, these changes include sunken cheeks, sagging skin, and a prematurely aged appearance. What’s happening is a combination of:

  • Volume depletion in facial fat pads that support midface structure
  • Muscle atrophy in the jawline, cheeks, and around the eyes
  • Collagen breakdown, often accelerated by rapid body composition shifts
  • Dehydration, which can impact skin tone and elasticity

These facial changes can undermine the emotional benefits of weight loss—and in some cases, make people feel older rather than healthier.

NMS Face therapy session with muscle stimulation device at WORTHY Self-Care in Berkeley

WORTHY’s Solution: NMS Face Technology

To help protect facial structure and restore tone, we use NMS (Neuromuscular Stimulation) Face Therapy—a non-invasive treatment that activates deep facial muscles using targeted electrical impulses.

How NMS Face supports muscle preservation and rejuvenation:

  • Activates muscles that are hard to reach through voluntary movement
  • Enhances tone and definition in the face and jawline
  • Increases blood flow and nutrient delivery to skin and muscle tissue
  • Stimulates natural collagen production through mechanical activation
  • Supports lymphatic flow and reduces puffiness

Clinical results show NMS can improve facial muscle tone by 25–30% within 4–6 sessions, helping restore structure and vibrancy during and after GLP-1 treatment.


Body Muscle Preservation with InstantSculpt EMS

To preserve and build full-body muscle during weight loss, we use InstantSculpt EMS (Electromagnetic Muscle Stimulation)—a technology that delivers supramaximal contractions far beyond what voluntary movement can achieve.

Why EMS is so effective:

  • Each 30-minute session produces 20,000+ muscle contractions
  • Activates up to 90% of muscle fibers (compared to 45–65% in typical workouts)⁶
  • Stimulates both slow-twitch and fast-twitch fibers
  • Triggers anabolic pathways that promote muscle growth and fat metabolism

The Benefits of EMS for GLP-1 Users

  • Muscle preservation during rapid weight loss
  • Improved insulin sensitivity and glucose regulation
  • Enhanced fat oxidation through greater muscle efficiency
  • Stable metabolic rate, reducing the risk of rebound weight gain
  • Low fatigue impact, ideal for clients with limited energy or nausea
  • Time-efficient: Sessions take just 30 minutes
  • Progressive overload: Intensity increases over time for continued results

Research-Backed Outcomes

  • An 8-week study showed 43.2% strength gains with EMS + strength training, compared to 20.5% with strength training alone, and 21.6% muscle thickness gains vs. 11.9%⁷
  • Another study found that combining EMS with resistance training significantly improved muscle mass, upper body strength, and reduced body fat⁸

Why Early Intervention Matters

Preserving muscle early in the GLP-1 journey isn’t optional—it’s essential. Waiting until visible muscle loss or weakness appears makes recovery harder and less effective.

What the research shows:

  • High-protein intake helps maintain lean mass during weight loss⁹
  • Both endurance and resistance exercise are beneficial, but resistance training is critical for strength preservation⁹
  • Starting muscle support strategies early results in significantly better outcomes than trying to rebuild later

At WORTHY, we begin muscle preservation protocols on day one, not after problems develop.


The WORTHY Approach: Supporting the Whole Picture

Muscle is your most valuable asset during weight loss, and our approach is designed to protect it.

Our comprehensive GLP-1 support includes:

  • InstantSculpt EMS for full-body muscle preservation
  • NMS Face Technology for facial structure and tone
  • InBody Analysis for precise lean mass tracking
  • CryoSkin Contouring to target fat and support skin tightening
  • BallancerPro Lymphatic Therapy to optimize circulation and detox
  • Infrared sauna and red light therapy for recovery and cellular health

We combine science-backed modalities, individualized care, and a focus on long-term outcomes—not just short-term weight loss.


WORTHY Self-Care Studio is Berkeley’s trusted destination for GLP-1 optimization, muscle preservation, and intelligent self-care. To schedule a consultation or learn more, visit worthyselfcare.com.


References

  1. Drug Discovery Trends. “Semaglutide and GLP-1: Effects on lean body mass still unclear.” March 19, 2024. https://www.drugdiscoverytrends.com/glp-1-impact-lean-mass/
  2. Regeneron Pharmaceuticals. “Interim Results from Ongoing Phase 2 COURAGE Trial Confirm Potential to Improve the Quality of Semaglutide-induced Weight Loss by Preserving Lean Mass.” https://newsroom.regeneron.com/news-releases/news-release-details/interim-results-ongoing-phase-2-courage-trial-confirm-potential/
  3. The Lancet Diabetes & Endocrinology. “Muscle matters: the effects of medically induced weight loss on skeletal muscle.” https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00272-9/abstract
  4. American Diabetes Association. “New GLP-1 Therapies Enhance Quality of Weight Loss by Improving Muscle Preservation.” https://diabetes.org/newsroom/press-releases/new-glp-1-therapies-enhance-quality-weight-loss-improving-muscle-0
  5. Harvard Health Publishing. “Preserve your muscle mass.” February 19, 2016. https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass
  6. Scientific American. “How to Get Fit Using Electrical Muscle Stimulation (EMS).” February 20, 2024. https://www.scientificamerican.com/article/how-to-get-fit-using-electrical-muscle-stimulation-ems/
  7. ScienceDirect. “Does whole-body electrical muscle stimulation combined with strength training promote morphofunctional alterations?” https://www.sciencedirect.com/science/article/pii/S1807593222007372
  8. PMC. “Effect of 8-week frequency-specific electrical muscle stimulation combined with resistance exercise training on muscle mass, strength, and body composition in men and women: a feasibility and safety study.” https://pmc.ncbi.nlm.nih.gov/articles/PMC10586320/
  9. PMC. “Preserving Healthy Muscle during Weight Loss.” https://pmc.ncbi.nlm.nih.gov/articles/PMC5421125/
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