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Does Ozempic cause muscle loss and how to prevent it?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 19, 2025.

Official Answer by Drugs.com

Clinical trials have shown GLP-1 agonist drugs like semaglutide (Ozempic) can lead to a 13.9% loss of lean muscle mass (equal to a 6.9 kg or 15 lb) during treatment. Strategies to help prevent muscle loss include regular strength (resistance) training, aerobic exercise and adequate dietary protein, fluid and nutrient intake.

Do studies show muscle loss with Ozempic?

Yes, obesity trials have shown that participants using incretin mimetic agents like semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound) lost 10% or more of their muscle mass in 68- to 72-week long clinical studies, which equates to roughly 20 years of muscle loss due aging, according to experts.

Studies have shown that patients who lose weight (fat mass) in clinical trials may also lose lean body mass, which includes muscle mass. Muscle makes up about 50% of lean body mass.

In the 68 week STEP-1 trial of semaglutide for the treatment of obesity, patients saw a 17.3 kg (38 lb) reduction in body weight with semaglutide, vs. a 2.7 kg (6 lbs) weight loss in the placebo group.

In a systemic review, the effects of semaglutide on lean body mass in obesity management were evaluated in 6 studies with 1,541 overweight or obese adults.

A small, retrospective review evaluated the clinical effectiveness of semaglutide (Ozempic) on weight loss, body composition and muscle strength in a Chinese population with obesity.

The manufacturer does not list muscle loss as a side effect in the FDA product labeling for Ozempic, made by Novo Nordisk. However, if you are starting treatment with a GLP-1 agonist such as semaglutide (Ozempic Wegovy), speak with your healthcare provider about preventing muscle loss with a resistance (strength) training program.

Also, consider meeting with a registered dietician (RD) who can provide information on how much protein you should eat per day and types of protein, your need for supplemental vitamins, and other nutritional strategies to help retain muscle mass and function.

Age-related loss of muscle mass can lead to reduced strength and physical function, a term often called sarcopenia. Sarcopenia may be associated with injury, falls, bone fractures and higher rates of death.

The long-term risks due to muscle loss when using incretin mimetic treatments like Ozempic are not fully known at this time. Clinicians and patients should work together to assess the benefits of blood sugar control, weight loss and heart protection against any risks associated with loss of muscle.

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How to prevent muscle loss with Ozempic?

The good news is that there are proven way to help maintain muscle strength if you are at risk of muscle loss.

Adequate nutrition and protein intake is also important to maintain muscle. The loss of skeletal muscle mass has been associated with calorie-restricted diets and rapid weight loss in general, as well as with use of incretin mimetic agents such as semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro).

Factors that may contribute to muscle loss during weight loss in general, or with Ozempic treatment include:

Obesity occurring with type 2 diabetes or prediabetes may also be associated with lower muscle mass, and can lead to a more rapid decline in muscle mass in the older person.

To help maintain your muscle mass while taking Ozempic or other incretin mimetic agents like Wegovy, Mounjaro or Zepbound, you can:

Speak with your healthcare provider before you engage in a modified diet or exercise program and follow your medication dosing instructions exactly as prescribed by your doctor.

Do any medicines stop muscle loss with Ozempic?

Obesity treatments that work a new way may help to address muscle loss associated with incretin mimetic agents. Clinical studies on these agents are in early phases of investigation.

Eli Lilly, the manufacturer of the GLP-1 / GIP agonist tirzepatide (Mounjaro, Zepbound) has announced the development of bimagrumab (LY3985863), a monoclonal antibody that binds the activin/myostatin type II receptors ActRIIA and ActRIIB and blocks ligand binding.

In the BELIEVE Phase 2b study, bimagrumab is being studied alone and in combination with semaglutide in adults who are overweight or obese. The company states that combining these agents may further reduce fat mass while preserving muscle mass and lead to improved outcomes in obesity treatment.

This is not all the information you need to know about Ozempic (semaglutide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References
  • Mechanick JI, Butsch WS, Christensen SM, et al. Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity. Obes Rev. 2025 Jan;26(1):e13841. doi: 10.1111/obr.13841
  • Bikou A, Dermiki-Gkana F, Penteris M, et al. A systematic review of the effect of semaglutide on lean mass: insights from clinical trials. Expert Opin Pharmacother. 2024 Apr;25(5):611-619. doi: 10.1080/14656566.2024.2343092
  • Xiang J, Ding XY, Zhang W, et al. Clinical effectiveness of semaglutide on weight loss, body composition, and muscle strength in Chinese adults. Eur Rev Med Pharmacol Sci. 2023 Oct;27(20):9908-9915. doi: 10.26355/eurrev_202310_34169
  • Lilly to Acquire Versanis to Improve Patient Outcomes in Cardiometabolic Diseases. PRN Newswire. July 14, 2023. Accessed Dec. 6, 2-24 at https://www.prnewswire.com/news-releases/lilly-to-acquire-versanis-to-improve-patient-outcomes-in-cardiometabolic-diseases-301877184.html
  • Lilly.com. Medicines in Development. Bimagrumab. Accessed Dec 6, 2024 at https://www.lilly.com/innovation/clinical-development-pipeline#
  • Ozempic [prescribing information]. Revised 11/2024. Bagsvaerd, Denmark. Novo Nordisk. Accessed Dec 6, 2024 at https://www.novo-pi.com/ozempic.pdf
  • Rapid weight loss can lead to a loss of muscle mass. May 2, 2024. UCLA Health. Accessed Dec. 6, 2024 at https://www.uclahealth.org/news/article/rapid-weight-loss-can-lead-loss-muscle-mass

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Tirzepatide vs semaglutide: How do they compare?

Both tirzepatide and semaglutide are prescription medicines used with diet and exercise to treat people with type 2 diabetes or to help people lose and maintain weight loss. Tirzepatide is also approved by the FDA to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity, while semaglutide is approved to reduce the risk of serious heart problems and to help reduce the risk of worsening kidney disease.

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Can you get tirzepatide from a compounding pharmacy?

Tirzepatide cannot be legally compounded in a U.S. pharmacy at this time. It has been removed from the FDA drug shortage list as of October 2, 2024. When drugs are in short supply, the FDA may allow temporary compounding of some medicines to allow patients to continue to access their treatments. Tirzepatide is now widely available as a prescription medicine made by Eli Lilly under the brands names Mounjaro (for type 2 diabetes) and Zepbound (for weight loss and sleep apnea).

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Why am I not losing weight on Ozempic?

Although Ozempic is not FDA-approved for weight loss, over 86% of people lose at least 5% of their body weight in trials that have studied semaglutide, the active ingredient of Ozempic. But the same clinical trials also show that just under 14% don’t lose weight, and some may even gain weight. Continue reading

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