Stark bleiben trotz GLP-1: Praktisches Assessment der Muskelgesundheit

Muscle assessment needs multidimensional measures

Muscle health includes mass, strength, and function. Calf circumference and handgrip strength are rapid practical assessments; gait speed and chair-stand-based tests additionally reflect function, prognosis, and longitudinal response to nutrition and exercise interventions.

GLP-1 therapy requires muscle-focused monitoring

GLP-1 receptor agonists induce weight loss, but body-composition data remain limited and heterogeneous. Loss of fat-free mass can be substantial, especially in older adults with pre-existing sarcopenia risk; therefore, benefit-risk assessment and monitoring of muscle parameters are essential.

Muscle preservation depends on anabolic support

Muscle preservation requires adequate energy and protein intake plus physical activity, particularly resistance training. In older adults, anabolic resistance means stronger and repeated anabolic stimuli are needed; excessive caloric restriction increases the risk of using protein for energy instead of muscle maintenance.

The continuing education session “Stark bleiben trotz GLP-1: Praktisches Assessment der Muskelgesundheit,” organized by Klinik Barmelweid and delivered by Dr. troph. Carla Wunderle, focuses on the clinical relevance of skeletal muscle as a dynamic organ system and on practical approaches to assessing muscle health. Dr. troph. Wunderle explains that skeletal muscle is essential not only for movement, thermoregulation, and nutrient storage, but also as an endocrine organ, and she emphasizes that muscle loss is consistently associated with poorer prognosis across clinical populations. The presentation identifies older adults, patients with chronic disease, hospitalized and critically ill patients, as well as individuals receiving GLP-1 receptor agonists, as groups at increased risk for loss of muscle mass and function. Regarding GLP-1-based therapy, she notes that the current evidence is heterogeneous: some studies report substantial loss of lean body mass during weight reduction, whereas others show preserved or even improved muscle function despite decreases in muscle mass. A central message is that muscle health assessment should extend beyond muscle mass alone and include muscle strength and physical performance, with feasible bedside tools such as calf circumference, handgrip strength, gait speed, chair stand testing, and the SARC-F questionnaire. Dr. troph. Wunderle also outlines key supportive strategies, including adequate energy and protein intake, distribution of protein across the day, moderate caloric deficits during intentional weight loss, and resistance training to counteract anabolic resistance in older adults. In the introductory industry contribution, Julia Flautner from Abbott Nutrition presents nutritional products containing protein, vitamin D, and HMB, and describes HMB as a supplement intended to support muscle protein synthesis, reduce protein breakdown, and improve muscle function.