TOPLINE

In a small retrospective study of participants in a commercial weight management program, most of the weight lost while taking incretin-based drugs, alongside supervised exercise and nutritional support, came from fat, with no significant change observed in lean mass.

METHODOLOGY

• Incretin-based obesity drugs work well for weight loss but can also cost patients lean mass, which has prompted interest in pairing them with exercise and nutritional support.
• Researchers reviewed the records of adults in a commercial weight management program who were started on an incretin-based drug alongside a supervised exercise and dietitian program and compared their fat and lean mass on DEXA scans before and after the program.
• They analyzed the data of 11 adults (mean age, 53.46 years; 81.8% men; median baseline BMI, 28.7) who received either semaglutide (n = 3) or tirzepatide (n = 8); the program set weekly targets of 150-300 minutes of moderate or 75-150 minutes of vigorous aerobic activity, plus at least two supervised strength training sessions, along with individualized diet advice.
• The primary outcomes were changes in body weight, fat mass, and lean mass.
• The median follow-up period was 277 days.

TAKEAWAY

• After the intervention, participants lost an average of 4.99 kg (4.71% of starting weight; P = .002).
• Fat mass decreased significantly by 4.37 kg, or 11.06% (P < .001). Lean mass decreased by 0.62 kg, or 0.94%, which was not statistically significant (P = .397).
• BMI, total body fat percentage, fat mass index, and visceral fat also decreased significantly.
• Further analysis showed that most of the weight lost (87.6%) came from fat mass, with lean mass accounting for only 12.4% of the reduction.

IN PRACTICE

"These findings support further investigation of structured exercise and nutritional support as potential strategies for minimizing lean mass loss during incretin-based weight reduction," the authors wrote.

SOURCE

The study was led by Meral Kucuk Yetgin, School of Public Health-Bloomington, Indiana University, Bloomington. It was published online in Obesity Pillars.

LIMITATIONS

As the study was a small, retrospective review without a control group, it could not show whether the exercise and nutritional support made a difference. The sample was too small to compare outcomes with semaglutide vs tirzepatide. Only 11 of the 25 individuals screened were analyzed, and they differed from the excluded individuals in terms of several baseline measures, including body weight and body composition.

DISCLOSURES

The study received no external funding. Several authors were affiliated with Apeiron Life, where the study was conducted.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.