How to Preserve Muscle While Losing Weight, According to a Sports Medicine Physician
Many people feel pressure to lose weight or maintain a lower weight as they grow older. And beyond social pressure, the scientific research indicates a number of advantages for your health when you maintain a healthy body weight.
According to the American Heart Association, cutting those extra pounds can lower your risk of diabetes, high blood pressure, heart disease, sleep problems, and other chronic health conditions. It helps you manage blood and fluid more efficiently, helps you sleep better, gives you more energy as well as a wide variety of other health benefits.
Why Do You Lose Muscle When You Lose Weight?
While losing or maintaining a healthy weight undoubtedly provides health benefits, one of the drawbacks of rapid weight loss is that it can also result in loss of muscle mass. Cleveland Clinic estimates that most people who go through a weight management program experience a 10 to 20% loss in muscle mass.
With the rise of GLP-1 receptor agonists, including medications such as Ozempic, these impacts have become even more pronounced. GLP-1s undoubtedly have helped a lot of people lose weight who previously struggled to do so. Because these medications often suppress appetite and lead to rapid weight loss, some people may also lose muscle mass if they don’t consume enough protein or perform resistance exercise.
“GLP-1 medications have been a game changer for many people,” says Jennifer L. Horawski, M.D., an orthopaedics and sports medicine specialist with the University of Miami Health System. “I’ve seen patients improve their blood sugar, blood pressure, and quality of life after years of struggling with obesity. But I’ve also seen patients lose weight so quickly that they become noticeably weaker because they’re barely eating.”
Can You Lose Weight Without Losing Muscle?
The key then, says Dr. Horawski, is to go about weight loss or weight maintenance in a responsible manner that helps you preserve muscle mass at the same time. This involves a combination of factors, including eating the right foods, regular exercise and changing your attitude about your weight and body in general. But with the right approach, it can be done.
Here’s what she recommends:
Focus on Body Composition, Not Just the Scale
One key contributor to weight-related muscle loss is as much a mental issue as a physical one, says Dr. Horawski. When people are only focused on the number on the scale, they don’t see the true impact that it’s having on their bodies.
“What I care about is body composition,” she says. “I want patients losing fat while holding onto as much muscle as possible. Muscle affects everything — from metabolism and balance to joint health and recovery from injury. That’s why weight loss has to be approached as more than simply eating less. Nutrition, strength training, sleep, and consistency all matter if you want results that actually last.”
How Much Protein Do You Need to Preserve Muscle?
To achieve the right body composition, of course, it helps to eat the right foods rather than focusing on eating less.
“I recommend including a quality protein source with every meal rather than trying to make up for it all at dinner. That tends to be easier to stick with and does a better job supporting muscle throughout the day,” says Dr. Horawski. “I’m also not a fan of extreme calorie restriction. Patients may lose weight quickly at first, but they’re often exhausted, hungry, and more likely to lose lean muscle. A moderate calorie deficit is slower, but it’s much easier to maintain and usually leads to better long-term results.”
Why Strength Training Is Essential During Weight Loss
Of course, one of the best ways to maintain muscle as you’re losing weight is to challenge those muscles through regular strength training.
“If someone only has time for one type of exercise, I’d rather they strength train than spend hours doing cardio,” says Dr. Horawski. “Resistance training is what tells your body that muscle is still needed. That doesn’t mean you have to become a bodybuilder. Two or three full-body sessions each week can make a tremendous difference.”
Can GLP-1 Medications Cause Muscle Loss?
If you’re using GLP-1s, they can be a remarkably effective way to achieve your ideal weight. But it’s important to view them as just one piece of your healthy routine rather than the sole contributor.
“I encourage patients to build every meal around protein, continue lifting weights even if it’s just a couple of days each week, and stay active outside the gym,” says Dr. Horawski. “The medication helps create the calorie deficit, but preserving muscle still depends on giving your body a reason to keep it.”
How Older Adults Can Maintain Muscle While Losing Weight
Another challenge is for people who are losing weight or trying to maintain an ideal weight as they grow older. There’s no question that the body changes as you age and maintaining your current muscle mass and level of fitness becomes more challenging.
“The good news is that muscle remains remarkably responsive to exercise, even later in life,” says Dr. Horawski. “I’ve worked with patients in their 60s and 70s who become noticeably stronger after starting resistance training. It’s one of the few interventions that consistently improves strength, function, and independence regardless of age.”
The Bottom Line on Healthy Weight Loss
The bottom line is that if you can combine moderate, controlled weight loss, nutrient-dense eating, and regular strength training, you can meet your weight goals without sacrificing muscle in the process.
“The goal shouldn’t be to become the lightest version of yourself. It should be to become the strongest, healthiest version of yourself,” says Dr. Horawski. “That’s what leads to better health years down the road — not just a lower number on the scale.”
Written by Wyatt Myers. Reviewed by Jennifer L. Horawski, M.D.,
Tags: Dr. Jennifer Horawski, Ozempic muscle loss, sports medicine, strength training for weight loss, Weight loss side effects
