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Obesity therapy: Is concomitant administration of anabolic agents and related compounds warranted during GLP-1 receptor agonist treatment?

IDM

The October 3, 2025, issue of Deutsches Ärzteblatt discussed whether GLP-1 receptor agonists, which have proven to be extremely effective in weight loss, are associated with increased muscle loss - and whether complementary therapies are therefore necessary to maintain muscle mass. The editorial team interviewed several experts on this topic, including Prof. Dr. Andreas Birkenfeld, head of the Institute for Diabetes Research and Metabolic Diseases (IDM) at the University Hospital of Tübingen.

In his statement, Prof. Dr. Birkenfeld emphasizes that a decrease in muscle mass in the context of successful weight loss is usually a physiological adaptation:

"Greater weight loss is usually accompanied by an adjustment in muscle mass [...]. Overall, the evidence – including evidence from imaging and animal studies - suggests that muscle changes under incretin RA therapy are primarily adaptive: the lower muscle volume is in line with expectations depending on age, disease burden, and extent of weight loss - and is comparable to the effects of diets or bariatric surgery."

At the same time, Prof. Dr. Birkenfeld emphasizes that sufficient protein intake and regular physical activity remain essential. Combination therapies with anabolic substances should be reserved for special situations and remain the exception.

You can read the full article from Deutsches Ärzteblatt here.