Weight Research / 25.05.2026

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Do GLP-1 Drugs Cause Muscle Loss? What Patients Should Know Before Starting Ozempic, Wegovy, or Zepbound

In the STEP 1 trial of semaglutide, the drug that became Wegovy, patients lost an average of 15% of their body weight over 68 weeks. About 39% of that loss came from lean tissue rather than fat. That number has fueled a wave of concern about "muscle loss" on Ozempic, Wegovy, and Zepbound. But lean tissue is not the same as skeletal muscle. It also includes water, organs, bone, and connective tissue, and most of what's lost during weight reduction tracks proportionally with the body getting smaller. In the same trial, relative lean mass actually went up. Whether a patient holds onto skeletal muscle and strength depends less on the drug itself and more on protein intake, resistance training, and how fast the weight comes off. This article is for educational purposes only and does not replace medical advice. Do not start, stop, or change a prescription medication without speaking with a licensed clinician.