Although the goal of people resorting to popular injectable drugs for weight loss is often to reduce body mass, doctors from the United Arab Emirates warn that the number on the scale does not tell the whole story. Specialists note that when using medications such as Mounjaro, Ozempic, and Wegovy, patients should pay attention not only to excess fat but also to the loss of muscle tissue, which is critically important for maintaining strength, mobility, and long-term health.
Risks can increase in patients who significantly reduce food intake while taking these medications, especially if they suffer from protein deficiency, dehydration, or insufficient physical activity. The medical community emphasizes that the main objective should not just be rapid weight loss, but improving metabolic health while preserving muscle strength and physical functions.
Dr. Niyas Khalid, an internal medicine specialist at Burjeel Hospital in Abu Dhabi, stated: 'Never assess weight loss solely by the scale.' He clarified that before starting treatment, doctors conduct a comprehensive assessment of the patient's overall obesity profile, including metabolic status, relevant blood tests, nutritional status, and body composition.
'We collaborate closely with dietitians and nutritionists who assess body composition, often using bioelectrical impedance analysis (such as InBody) to determine fat and muscle mass. Periodic re-evaluations during treatment help us understand whether weight loss is primarily due to fat or includes excessive loss of muscle tissue. We also consider physical strength, functional capabilities, and weight loss rates,' added Dr. Khalid.
He also warned patients that rapid weight loss can be accompanied by muscle loss, especially with inadequate nutrition and physical activity. It is important to distinguish between fat loss and muscle mass loss, as the loss of muscle tissue can negatively affect physical functions, especially in the elderly and those already at risk of muscle weakness.
Dr. Amna Kiran, an endocrinologist at the International Modern Hospital in Dubai, reported that Mounjaro (tirzepatide), Ozempic, and Wegovy (semaglutide) are among the most common and recognized medications in the UAE, with Mounjaro being particularly popular due to its high effectiveness in weight loss. According to Dr. Kiran, 'an observational study in the UAE showed that Mounjaro accounted for 65.6 percent of GLP-1 based prescriptions in the studied cohort in 2024.'
However, she stressed that weight loss does not always indicate the amount of lost muscle mass, so adequate monitoring is necessary. In her regular practice, Dr. Kiran uses body weight measurement, waist circumference, and simple muscle function tests, including grip strength. While BIA can help track body composition trends, its accuracy depends on hydration and other factors. For a more precise assessment, especially in patients at risk of significant muscle loss, she prefers Dexa scanning.
Dr. Kiran also cited the results of the Surmount-1 subgroup study, which examined changes in body composition during tirzepatide treatment. 'The Surmount-1 subgroup study found that approximately 75 percent of the lost weight was fat mass, and 25 percent was muscle mass; importantly, muscle mass loss does not necessarily mean equivalent loss of skeletal muscle.' She explained that muscle mass includes more than just skeletal muscles, and measurements can be distorted by factors such as hydration levels. Therefore, doctors insist on interpreting body composition analysis results alongside clinical examinations, rather than equating every loss of muscle mass to a loss of muscle.
One of the mechanisms of action of these drugs is appetite suppression. Nevertheless, a significant reduction in food intake can make it difficult to meet the body's nutritional needs, especially if meals are skipped or consumption of protein-rich foods is ignored. Dr. Khalid noted that some patients eat significantly less than required, including protein deficiency, while others reduce fluid intake due to nausea or other gastrointestinal side effects.
He advised patients to include protein-rich foods in their diet, such as eggs, fish, lean meat, dairy products, and legumes, with individual nutrition plans developed after consulting with dietitians. Maintaining adequate hydration throughout the treatment course is also recommended. Protein and fluid needs vary depending on body composition, age, kidney function, and other clinical factors.
Furthermore, physical activity must become part of a structured weight management plan. The World Health Organization recommends at least 150 minutes of moderate physical activity per week, but these figures must be adapted to each patient's health condition and physical capabilities.
Dr. Kishan Delampadi, a consultant endocrinologist at NMC Royal Hospital Sharjah, stated that the growing popularity of these drugs should not dictate the decision to take them. He explained that these medications work by influencing appetite and satiety, helping people reduce their food intake. However, they are not suitable for everyone, and the choice depends on weight, medical history, existing conditions, medications being taken, and the person's treatment goals.
He also cautioned patients against using prescription drugs simply because someone they know achieved good results, emphasizing the need to differentiate between drugs approved for diabetes treatment and those intended for weight control. According to him, medical evaluation, a proper prescription, and regular monitoring are mandatory, and the medications should complement, not replace, a balanced diet, physical activity, and behavioral changes.
Dr. Delampadi added that side effects such as nausea, vomiting, diarrhea, or constipation can affect hydration and nutrient intake if they persist for a long time. This is especially important with age, as muscle mass and strength naturally decline. Rapid weight loss combined with poor nutrition and a sedentary lifestyle can complicate the maintenance of independence. Even young adults should take care of their muscles, rather than focusing solely on appearance or clothing size.
