| Fat loss or muscle loss?
We are also fortunate to be living through a revolution in treatment, specifically when it comes to the GLP-1 agonists. Currently, 12% of US adults are taking a GLP-1 receptor agonist for treatment to lose weight or treat a chronic condition. But there is a problem hiding in plain sight. Clinicians have always been limited by what we can measure. For weight, the tool has always been the scale, but in the GLP-1 era, it is no longer enough. Now, the real question is – where is the weight coming from? Muscle or fat? Why it matters
If we treat obesity successfully but allow patients to lose too much muscle and bone in the process, we’re offsetting the gains from obesity reduction by an increase in catastrophic fractures. Sarcopenia, which is characterized by accelerated decline in muscle mass and function, resulting in increased risk of frailty, falls, functional decline, and mortality, may become the unintended consequence of GLP-1 treatment. How to measure what matters
DEXA estimates visceral adipose tissue, which matters enormously for assessing longer-term cardiometabolic risk. DEXA also calculates an appendicular lean mass index, which is the standard in diagnosing sarcopenia, along with grip strength and physical performance. Most importantly, regular DEXA measurements provide real feedback for interventions and changes in the care plan such as recommending more protein, more resistance training, slower dose escalation, physical therapy, or a different follow-up cadence. This will improve the way we monitor treatment, especially as DEXAs become more widespread and accessible. — By MedCity Influencer Vivek Chander |
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