Weight Loss for Optimum Health : Complications for the Elderly

"While there may be many important benefits of weight loss metabolically, we need, particularly in older adults, to think about muscle and how important it is for the older adult population."

"Losing muscle mass and strength with aging is a natural phenomenon -- everyone though has a threshold where it causes a problem."

John Batsis, associate professor of medicine, Division of Geriatric Medicine, Department of Nutrition, University of North Carolina Chapel Hill 

Ozempic in a pharmacy in Niesky, Germany.  Florian Gaertner / Photothek via Getty Images

 

Weight-loss drugs' recent popularity has revealed a problem with respect to unhealthy weight loss for people over age 65; there is the very real risk of vital muscle being lost along with unwanted fat. When an individual loses weight it is an inevitability that the lost weight does not represent fat alone, since roughly a quarter of that weight loss typically includes the loss of lean mass, such as muscle and bone, essential for metabolism and the prevention of age-related injury.

And this is the situation that pertains with respect to weight loss achieved from prescribed GLP-1 medications such as Ozempic and Wegovy. The loss of muscle for younger adults may not immediately cause problems. For people over age 65 the situation is not quite the same, since muscle mas is critical for the maintenance of strength and mobility. Falls among older adults is a risk that muscle weakness factors into. 

According to the U.S. Centers for Disease Control and prevention, muscle weakness is associated with older adults sustaining critical falls, recognized as the leading causes of injury and death for older age groups. There is insufficient data as yet for certainly around just how much of a problem this situation poses for older adults taking GLP-1 medications for weight loss, according to experts. 

 

A clinical trial of semaglutide -- the active ingredient in Ozempic and Wegovy -- saw researchers study lean muscle mass loss in a subgroup of 140 participants. Participants were seen on average to lose roughly15 pounds of fat throughout the 68-week trial of participants whose mean age was 52. Very few GLP-1 studies sought variances between older and younger adults, which included how loss of fat and muscle may vary between age groups.

A spokesman for Ozempic and Wegovy manufacturer Novo Nordisk, Martin Havtorn Peterson, noted that though semaglutide reduced lean mass, patients also lost even greater amounts of fat, helping to improve their overall body composition. "There has not been a safety signal identified in relation to loss of muscle mass", he contended.  On the other hand, pharmaceutical companies are actively searching out how next-generation weight loss drugs may overcome this challenge.

Versanis Bio's experimental drug bimagrumab purposes to aid people lose weight while preserving muscle mass. Ely Lilly & Co. acquired Versanis in July. Lilly is studying bimagrumab in combination with its own drug tirzepatide in anticipation that the combination "could be the next major step in innovative treatments for those living with cardiometabolic diseases, like obesity", stated Lilly's vice-president for diabetes, obesity and cardiometabolic research.

Loss of muscle mass among elderly can lead to falls. Photo: Shutterstock

"[For older adults who may be taking weight loss medications, increasing protein intake, resistance exercises and other measures may help mitigate the loss of lean muscle]."

John Batsis, associate professor of medicine