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Title
Effects of Glucagon-Like Peptide-1 Receptor Agonists on Body Composition in Sarcopenic Obesity: Risk of Muscle Mass Loss, Mechanisms, and Nutritional Strategies for Muscle Preservation
This title is suitable for Q1 journals such as Obesity Reviews, Diabetes, Obesity and Metabolism, The Lancet Diabetes & Endocrinology, or Journal of Cachexia, Sarcopenia and Muscle. It covers: effects of GLP-1RAs on body composition, focus on sarcopenic obesity, risks of muscle mass loss, underlying mechanisms, and practical nutritional strategies.
Abstract
Covers: Overview of sarcopenic obesity and the rise of GLP-1RAs for weight management; key findings on muscle loss (e.g., 25-40% of weight loss as lean mass); mechanisms; nutritional strategies (e.g., high-protein intake, exercise); and future research directions. (Structured if required: Background, Objectives, Methods, Key Findings, Conclusions; 250-300 words)
Keywords
Covers: 6-8 key terms such as: GLP-1 receptor agonists, sarcopenic obesity, body composition, lean mass loss, muscle preservation, nutritional interventions, protein intake, resistance training
Introduction
Covers: Definition and epidemiology of sarcopenic obesity; clinical complications (e.g., frailty, falls, cardiovascular risks, mortality); introduction to GLP-1RAs and their success in obesity treatment; emerging concerns about muscle loss; importance of muscle preservation in therapy; literature gap (limited integrated reviews on sarcopenic obesity with nutritional focus). Suggested Figure: Figure 1: Conceptual Framework of Sarcopenic Obesity Pathogenesis and GLP-1RA Influence (diagram showing interactions between obesity, muscle decline, and treatment effects)
Methods
Covers: Description as a narrative review; search strategy (databases: PubMed, Scopus, Web of Science, Embase from inception to December 2025); keywords used (e.g., ("GLP-1 receptor agonist*" OR semaglutide OR tirzepatide OR liraglutide) AND ("sarcopenic obesity" OR "sarcopenia" OR "muscle mass loss" OR "lean mass" OR "body composition") AND (nutrition* OR protein OR "resistance training")); inclusion/exclusion criteria (human and preclinical studies, RCTs, observational, English language); article selection process (PRISMA-inspired flow even for narrative). Suggested Figure: Figure 2: Flow Diagram of Literature Search and Study Inclusion
Epidemiology and Clinical Implications of Sarcopenic Obesity
Covers: Prevalence in various populations (e.g., elderly, diabetic patients); clinical outcomes (e.g., reduced physical function, increased fall risk, metabolic issues); relevance in GLP-1RA-treated patients. Suggested Table: Table 1: Epidemiology and Clinical Outcomes of Sarcopenic Obesity Across Populations (columns: Population, Prevalence, Key Outcomes, References)
Review of Preclinical and Clinical Studies on GLP-1RAs in Sarcopenic Obesity
Covers: Summary of preclinical studies (e.g., animal models, in vitro; effects on muscle metabolism, atrophy pathways); overview of clinical studies (e.g., RCTs, observational; human data on body composition changes); integration of findings across study types; discussion of study limitations and heterogeneity. Suggested Table: Table 2: Summary of Key Preclinical and Clinical Studies on GLP-1RAs and Muscle Outcomes (columns: Study Type (Preclinical/Clinical), Authors/Year, Model/Population, Intervention (Drug/Dose), Key Findings on Muscle Mass/Body Composition, Limitations)
Effects of GLP-1 Receptor Agonists on Body Composition
Covers: Review of major trials (e.g., STEP, SURMOUNT series); quantification of fat vs. lean mass loss; comparisons across drugs (e.g., semaglutide vs. tirzepatide vs. dual/triple agonists); focus on high-risk groups (e.g., elderly, women). Suggested Table: Table 3: Overview of Clinical Trials Assessing GLP-1RA Effects on Body Composition (columns: Trial Name, Drug, Duration, Weight Loss %, Lean Mass Loss %, Measurement Method e.g., DXA) Suggested Figure: Figure 3: Summary of Lean Mass Loss Percentages in Key Trials (forest plot or bar chart)
Mechanisms Underlying Muscle Mass Loss with GLP-1RA Therapy
Covers: Physiological mechanisms (e.g., caloric restriction, reduced anabolic signaling, increased protein catabolism, gut hormone effects, inflammation, microbiome alterations); differences from traditional weight loss methods (diet/surgery). Suggested Figure: Figure 4: Mechanistic Pathways Linking GLP-1RA Therapy to Muscle Catabolism (schematic diagram of molecular and physiological processes)
Nutritional Strategies for Muscle Preservation During GLP-1RA Treatment
Covers: Evidence for high-protein diets (1.6-2.2 g/kg), protein timing/distribution, specific supplements (e.g., leucine, HMB, vitamin D); integration with resistance exercise; preliminary intervention studies. Suggested Table: Table 4: Evidence-Based Nutritional and Exercise Interventions to Prevent Muscle Loss (columns: Intervention Type, Protocol/Dosage, Supporting Evidence, Impact on Lean Mass) Suggested Table: Table 5: Practical Guidelines for Protein Intake and Timing in GLP-1RA Patients
Discussion
Covers: Synthesis of findings; study limitations; sex/age differences; comparisons with other obesity treatments (e.g., bariatric surgery, older drugs); clinical recommendations; future research needs (e.g., long-term studies, combined interventions).
Conclusions
Covers: Key takeaways on GLP-1RA efficacy with muscle risks; emphasis on nutritional strategies for safe use; call for screening sarcopenic obesity prior to treatment.

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