Risks Of Obesity Treatment

Obesity treatment, whether through diet, bariatric surgery or drugs, has the disadvantage that it leads to muscle loss, which can have adverse effects, particularly among the elderly.

The New York Times (NYT) and Healthline have written articles about the adverse consequences of obesity treatment, and we pass on some of the messages from their articles.

No matter how we lose weight, whether it is by limiting food intake, by bariatric surgery, or by using the new obesity-reducing drugs such as semaglutide, for most it involves muscle loss – a gradual reduction in muscle mass, strength, and function. This particularly applies to older people. And the more muscle older people lose, the higher the risk of becoming frail and falling and sustaining broken bones – which can have serious consequences in the oldest age groups. That is why it is so important that older people maintain their muscle mass so that they can remain mobile and independent.

A large weight loss over a short period, which can occur when starting semaglutide, can lead to a drastic loss of muscle mass with serious consequences for health. Currently, our knowledge of the effects of semaglutide in people over 65 years of age is limited, because most of the patients who have participated in studies have been younger than 65 years.

However, we know that the elderly are more prone to side effects from the digestive tract in the form of nausea and vomiting than younger people, which affects the absorption of nutrients. In addition, lethargy is a side effect that is more frequent in the elderly, and blood pressure can drop, increasing the risk of dizziness and falls. People with osteoporosis, a condition most pronounced among the elderly, may be particularly vulnerable to the use of such medications. The combination of increased bone fragility and increased risk of falling makes them a particularly vulnerable risk group.

How can we counteract these consequences of obesity treatment? Experts say that older people who lose weight must carry out strength training and have a satisfactory intake of proteins 7 to prevent muscle wasting.

Perhaps we also have to change our attitudes about our weight as we get older. Many people dream of and imagine that they will become as slim as when they were 20, which has its price as described, and which can be dangerous to your health when you are 75.

It must be added that experts and studies do not fully agree on the significance of the marked weight reduction on the loss of muscle mass and health risks. Some experts believe that the advantages outweigh the disadvantages.

  1. Blum D. The Risks of Taking Drugs Like Ozempic When You’re Over 65. The New York Times. Published July 17, 2023. www.nytimes.com 
  2. Cassata C. Ozempic Can Cause Major Loss of Muscle Mass and Reduce Bone Density. Healthline. Published May 2, 2023. www.healthline.com 
  3. Ida S, Kaneko R, Imataka K, et al. Effects of Antidiabetic Drugs on Muscle Mass in Type 2 Diabetes Mellitus. Curr Diabetes Rev. 2021;17(3):293-303. doi:10.2174/1573399816666200705210006 DOI 
  4. Nuijten MAH, Eijsvogels TMH, Monpellier VM, Janssen IMC, Hazebroek EJ, Hopman MTE. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2022 Jan;23(1):e13370. doi: 10.1111/obr.13370. DOI 
  5. Warren M, Chaykin L, Trachtenberg D, Nayak G, Wijayasinghe N, Cariou B. Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: Pooled analysis of the SUSTAIN 1-5 trials. Diabetes Obes Metab. 2018 Sep;20(9):2291-2297. doi: 10.1111/dom.13331. DOI 
  6. Sardeli AV, Komatsu TR, Mori MA, Gáspari AF, Chacon-Mikahil MPT. Resistance Training Prevents Muscle Loss Induced by Caloric Restriction in Obese Elderly Individuals: A Systematic Review and Meta-Analysis. Nutrients. 2018 Mar 29;10(4):423. doi: 10.3390/nu10040423. DOI 
  7. Kim JE, O’Connor LE, Sands LP, Slebodnik MB, Campbell WW. Effects of dietary protein intake on body composition changes after weight loss in older adults: a systematic review and meta-analysis. Nutr Rev. 2016 Mar;74(3):210-24. doi: 10.1093/nutrit/nuv065. DOI 
  8. Advisory Board. Another semaglutide side effect is loss of muscle mass. Last updated March 23, 2023. www.advisory.com