Originally published on Forbes. Dr. Ghiyam was featured as an expert contributor.

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As GLP-1 medications become more common (an estimated one in eight U.S. adults are now taking them, according to KFF), understanding their full impact on the body has become increasingly important.

For some people, loss of muscle tone or strength has emerged as an unexpected challenge while taking these medications.

The Relationship Between GLP-1s and Muscle Loss

The connection between muscle loss and GLP-1s isn’t as straightforward as it might seem. Research shows that roughly a quarter of weight loss in people taking GLP-1s comes from lean mass, which includes body water, organs, and muscle. However, recent studies suggest this muscle loss may be proportionate to total weight loss and doesn’t necessarily impact strength negatively.

“Weight loss on its own will cause muscle loss,” says Disha Narang, M.D., a board-certified endocrinologist and director of obesity medicine at Endeavor Health. This happens regardless of whether GLP-1s are involved. “That’s just the nature of weight loss.”

The good news? Proper nutrition and resistance training can help offset weight-loss related muscle loss.

Understanding Why Muscle Loss Happens on GLP-1s

Manikya Kuriti, M.D., a board-certified endocrinologist in Louisville, Kentucky, explains that muscle loss is often part of a broader pattern people report: experiencing weight loss in unexpected places.

“When you have that much weight loss suddenly, you will see weight loss in places that originally you aren’t used to,” says Dr. Kuriti.

The type of GLP-1 medication matters too, though the difference likely comes down to how much total weight you’re losing, according to Daniel Ghiyam, M.D., a board-certified family medicine physician in Los Angeles and founder of the longevity practice MedPodLA.

A recent preprint study compared people taking tirzepatide (the active ingredient in Zepbound) with those taking semaglutide (the active ingredient in Wegovy) and found that tirzepatide was associated with greater lean body mass loss.

“It’s true, tirzepatide produces more total weight loss on average,” says Dr. Ghiyam. But this isn’t evidence that the drug is worse for muscle loss. “When patients are losing weight faster, and their mobility is already limited, they move less, eat less protein, and lose more lean mass.”

Protecting Your Muscle While Taking GLP-1s

Dr. Ghiyam describes muscle as your “metabolic currency” because it helps you burn calories while keeping you strong.

Protecting that currency comes down to two key strategies: strength training and adequate nutrition.

The key to success with strength training? Find exercises you’ll actually stick with. If the idea of going to the gym sounds terrible to you, don’t waste money on a membership. Instead, find a different strength or resistance-training routine that fits your lifestyle.

When it comes to nutrition, Dr. Kuriti recommends prioritizing whole foods whenever possible. The healthiest approach isn’t just about eating more protein. It includes vegetables, fruits, and other foods that support a well-rounded diet as part of your overall health journey.

Dr. Kuriti also cautions that protein supplements aren’t right for everyone. While someone in their 30s and 40s might benefit from a protein supplement, someone in their 60s and 70s faces a higher risk of protein supplements causing stress on kidney function. Always check with your doctor before adding supplements to your routine.

The Importance of Ongoing Support

Getting a GLP-1 prescription isn’t the end of your health journey. Dr. Narang sees a troubling pattern: people on GLP-1s whose nutrition doesn’t match their level of weight loss because they haven’t gotten proper follow-up care. In some cases, people are eating just one meal a day.

“You can’t be eating that little,” Dr. Narang says. “You can’t be chronically malnourished just because you’re on one of these medications.”