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GLP-1 receptor agonists target fat over muscle for weight loss

owenhaskins

A research team from the School of Public Health, in the LKS Faculty of Medicine of the University of Hong Kong (HKUMed), who assessed the impact of glucagon-like peptide-1 (GLP-1) receptor agonists in weight loss through genetic studies, revealed that GLP-1 receptor agonists reduce weight by reducing more fat mass than muscle mass.

The research team provides genetic evidence that GLP-1 receptor agonists are associated with a reduction in both fat and muscle, and the relative reduction is greater in fat than in muscle. Credit: Diabetes, Obesity and Metabolism (2025). DOI: 10.1111/dom.16171
The research team provides genetic evidence that GLP-1 receptor agonists are associated with a reduction in both fat and muscle, and the relative reduction is greater in fat than in muscle. Credit: Diabetes, Obesity and Metabolism (2025). DOI: 10.1111/dom.16171

"This study highlights the use of genetics in understanding medication effects, especially when corresponding clinical experimental evidence is limited," said Professor Ryan Au Yeung Shiu-lun, Assistant Professor in the School of Public Health, HKUMed. "Genetic insights can guide us in making informed decisions about treatments and their impact on health."


To study how GLP-1 receptor agonists affect muscle and fat, the HKUMed research team used genetic data of more than 800,000 European participants from different genome-wide association studies (GWAS). They identified a specific genetic variant (rs877446) linked to lower BMI that mimicked the effect of GLP-1 receptor agonists.


The team examined the effect of this variant on different types of lean mass, including appendicular lean mass, whole-body fat-free mass, and trunk fat-free mass, as well as various measures of body fat, such as whole-body fat mass, trunk fat mass, trunk fat percentage, body fat percentage, and waist-to-hip ratio.


The research team found that participants with genetic makeup mimicking the effect of GLP-1 receptor agonists leads to reductions in both lean mass (whole-body fat-free mass and trunk fat-free mass) and body fat (whole-body fat mass, trunk fat percentage and body fat percentage). Specifically, for each unit reduction in BMI, whole-body fat mass decreases by about 7.9 kg, while muscle mass reduces by about 6.4 kg.


This indicates that GLP-1 receptor agonists lead to greater reduction in overall body fat than that in muscle mass, resulting in an overall body fat percentage decrease of around 4.5%. This supports the effectiveness of GLP-1 receptor agonists in reducing fat more than muscle.


This study clarifies the controversy regarding the effect of GLP-1 receptor agonists on body composition as a weight-management medication, and showcases how a genetic approach can enhance our understanding of how medications work.


"The availability of large-scale human genetic association data allows us to gain valuable insights into drug target effects in a timely and cost-efficient manner. This approach can greatly inform further clinical studies and improve patient outcomes," remarked Dr Dipender Gill, Clinical Research Fellow in the Department of Epidemiology and Biostatistics at the School of Public Health of Imperial College London, a senior author of the study.


The findings were reported in the paper, ‘Relative effects of genetically proxied glucagon‐like peptide‐1 receptor agonism on muscle and fat mass: A Mendelian randomization study’, published in Diabetes, Obesity and Metabolism. To access this paper, lease click here

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