UAE Doctors Warn Weight-Loss Jabs Can Cost Patients Muscle, Not Just Kilos

(MENAFN- Khaleej Times) Losing weight may be the goal for people turning to popular injectable weight-loss medications, but UAE doctors are warning that the number on the weighing scale does not tell the whole story.

As medications such as Mounjaro, Ozempic and Wegov become increasingly recognised for their weight-loss benefits, specialists say patients must pay attention to what they are losing along with excess fat - particularly lean tissue and muscle, which are essential for strength, mobility and long-term health.

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For patients who significantly reduce their food intake while taking these medications, inadequate protein consumption, dehydration and insufficient physical activity can compound the risks. Doctors stress that the objective should not simply be to shed kilograms quickly, but to improve metabolic health while maintaining muscle strength and physical function.

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“Never assess weight loss by the scale alone,” said Dr Niyas Khalid, Specialist Internal Medicine at Burjeel Hospital, Abu Dhabi. He emphasised that doctors evaluate a patient's overall obesity profile before initiating treatment, including metabolic health, relevant blood investigations, nutritional status and body composition.

“We work closely with dietitians and nutritionists who perform body composition assessments, often using bioelectrical impedance analysis (e.g., InBody) to estimate fat mass and lean body mass.

“During treatment, periodic reassessments help us determine whether weight loss is predominantly fat or involves excessive lean tissue loss. We also consider physical strength, functional capacity, and the rate of weight loss.”

Dr Khalid said patients are counselled from the outset that rapid weight reduction can involve muscle loss, particularly when nutritional intake and physical activity are inadequate.

Why the type of weight loss matters

The distinction between fat and lean mass is important because losing lean tissue can have implications for physical function, particularly among older adults and those already at risk of reduced muscle strength.

Dr Amna Kiran, Endocrinologist at International Modern Hospital, Dubai, said Mounjaro (tirzepatide), Ozempic and Wegovy (semaglutide) are among the most widely used and recognised medications in the UAE, with Mounjaro gaining particular popularity because of its substantial weight-loss efficacy.

As per Dr Kiran,“A UAE observational study found Mounjaro accounted for 65.6 per cent of GLP-1-based prescriptions in its studied cohort in 2024.”

However, the amount of weight lost does not necessarily indicate how much muscle a person has lost, she said, making appropriate monitoring important.

“In routine practice, I use body weight, waist circumference and simple muscle-function assessments, including handgrip strength. BIA (bioelectrical impedance analysis) can help monitor body-composition trends, although its accuracy is influenced by hydration and other factors. Where more precise assessment is needed, particularly in patients at risk of significant muscle loss, I prefer Dexa scanning.”

Dr Kiran also pointed to findings from the Surmount-1 substudy, which examined changes in body composition during tirzepatide treatment.

“The Surmount-1 substudy found approximately 75 per cent of weight lost was fat mass and 25 per cent lean mass; importantly, lean mass loss does not necessarily mean equivalent skeletal muscle loss.”

Lean mass includes more than skeletal muscle, and measurements can be affected by factors such as hydration. Doctors therefore stress the importance of interpreting body-composition results alongside clinical assessments rather than treating every reduction in lean mass as equivalent to muscle loss.

Protein, hydration and exercise are essential

Appetite suppression is one of the ways these medications help people lose weight. But eating substantially less can also make it harder to meet the body's nutritional requirements, particularly if meals are skipped or protein-rich foods are neglected.

Dr Khalid said some patients eat much less than they need, including insufficient protein, while others reduce their fluid intake when experiencing nausea or other gastrointestinal side effects.

“We encourage patients to include protein-rich foods such as eggs, fish, lean meat, dairy products, and legumes, with individualised dietary plans prepared in consultation with dietitians. We also advise patients to stay adequately hydrated throughout treatment. Protein and fluid needs vary by body composition, age, kidney function, and other clinical factors.”

He added that physical activity should form part of a structured weight-management plan. The World Health Organisation recognises targets of at least 150 minutes of moderate-intensity physical activity per week, although these should be adapted to each patient's medical condition and physical capabilities.

Dr Kishan Delampady, Consultant Endocrinologist at NMC Royal Hospital Sharjah, said the growing popularity of these medications should not dictate whether someone takes them.

“These medicines work by influencing appetite and feelings of fullness, helping people reduce their food intake. They are not suitable for everyone, and the choice depends on an individual's weight, medical history, existing conditions, medications and treatment goals.”

He also cautioned patients against using prescription medication simply because someone they know has experienced good results, stressing the importance of distinguishing between medicines approved for diabetes and those approved for weight management.

A medical assessment, appropriate prescription and regular follow-up are essential, he said, with medication complementing rather than replacing balanced nutrition, physical activity and behavioural changes.

Dr Delampady added that side effects, including nausea, vomiting, diarrhoea or constipation, can affect hydration and nutritional intake when symptoms persist.

“This matters particularly as people get older, because muscle mass and strength naturally decline with age. Rapid weight loss accompanied by poor nutrition and inactivity can make maintaining independence more difficult. Even younger adults need to protect their muscle rather than focus exclusively on appearance or clothing size.”

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