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. 2025 Aug 16;29(10):100652.
doi: 10.1016/j.jnha.2025.100652. Online ahead of print.

Weighing the risk of GLP-1 treatment in older adults: Should we be concerned about sarcopenic obesity?

Konstantinos Prokopidis  1 , Robin M Daly  2 , Charlotte Suetta  3
Affiliations

Weighing the risk of GLP-1 treatment in older adults: Should we be concerned about sarcopenic obesity?

Konstantinos Prokopidis et al. J Nutr Health Aging. .

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been pivotal for obesity treatment, achieving 15-25 % weight loss over 12-24 months, but questions remain about the potential influence of concomitant losses in muscle mass. Furthermore, low adherence, driven by high costs and side effects, results in up to two-thirds of users discontinuing treatment within a year, although up to a half reinitiate treatment. Given that cessation of treatment often leads to significant weight regain, there are concerns that older adults may be at risk for sarcopenic obesity; a condition characterized by excessive adiposity and low skeletal muscle mass which is prevalent in 10-20 % of older adults. The risk for sarcopenic obesity may be further exacerbated by weight cycling related to repeated treatment cessation which may concomitantly exacerbate fat mass gains while reducing muscle mass. This mini-review examines the risk of sarcopenic obesity as an unintended consequence of GLP-1 RA cessation in older adults, highlighting the need for raising awareness and preventative strategies.

Keywords: Ageing; GLP-1 receptor agonists; Sarcopenic obesity; Weight cycling; Weight loss.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Illustration of weight regain following GLP-1 RA cessation and the potential risk for sarcopenia and sarcopenic obesity in individuals with obesity.
See this image and copyright information in PMC

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