Palavras-chave
Perda de peso
Composição corporal
Massa magra
Obesidade
Como Citar
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Resumo
Objetivo: Analisar os efeitos dos agonistas do receptor de GLP-1 sobre a composição corporal durante a perda de peso, com ênfase nas alterações da massa magra e suas repercussões clínicas, metabólicas e funcionais. Revisão bibliográfica: Os agonistas do receptor de GLP-1 consolidaram-se como importantes terapias no tratamento da obesidade e do diabetes mellitus tipo 2, promovendo redução significativa do peso corporal por meio da diminuição do apetite, aumento da saciedade e menor ingestão calórica. Embora a perda ponderal ocorra predominantemente pela redução da massa adiposa, estudos recentes demonstram que parte da redução de peso também envolve a massa magra. Dessa forma, a preservação da massa muscular tornou-se um aspecto relevante, visto que a perda excessiva de tecido magro pode comprometer a funcionalidade, a capacidade física e a saúde metabólica. Estratégias como treinamento resistido, ingestão proteica adequada e acompanhamento multiprofissional podem contribuir para minimizar esses efeitos. Considerações finais: Os agonistas do receptor de GLP-1 apresentam elevada eficácia na redução do peso corporal e melhora metabólica, com predominância da perda de gordura. Entretanto, a redução concomitante da massa magra reforça a importância do monitoramento da composição corporal e da adoção de medidas para preservar a função muscular durante o tratamento.
Referências
ALISSOU M, et al. Impact of semaglutide on fat mass, lean mass and muscle function in patients with obesity: The SEMALEAN study. Ann Endocrinol. 2025;86(6):101860.
ARGYRAKOPOULOU G, et al. The effect of obesity pharmacotherapy on body composition, including muscle mass. Int J Obes. 2024;48:1452-1464.
BLUNDELL J, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obes Metab. 2017;19:1242-1251.
CHRYSAVGIS L, et al. The influence of glucagon-like peptide-1 receptor agonists and other incretin hormone agonists on body composition. Int J Mol Sci. 2025;26:12130.
DRUCKER DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018;27:740-756.
GARVEY WT, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28:2083-2091.
IORRA F, et al. Effects of GLP-1 receptor agonists on muscle mass, strength, and quality in MASLD: a systematic review. Liver Int. 2026;46:e70643.
KADOUH A, et al. GLP-1 analog modulates appetite, taste preference, gut hormones, and regional body fat stores in adults with obesity. J Clin Endocrinol Metab. 2020;105:1552-1563.
KARAKASIS P, et al. Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: systematic review and network meta-analysis. Metabolism. 2025;164:156113.
KARIMI MA, et al. Comparative effectiveness of semaglutide versus liraglutide, dulaglutide or tirzepatide: a systematic review and meta-analysis. Front Pharmacol. 2025;16:1438318.
LINGE J, et al. Muscle mass and glucagon-like peptide-1 receptor agonists: adaptive or maladaptive response to weight loss? Circulation. 2024;150:1288-1298.
LIU QK. Mechanisms of action and therapeutic applications of GLP-1 and dual GIP/GLP-1 receptor agonists. Front Endocrinol. 2024;15:1431292.
LOOK M, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27:145-154.
McCARTHY D, et al. Weight loss strategies and preservation of lean body mass. Nutr Rev. 2021;79:605-617.
MCCRIMMON RJ, et al. Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial. Diabetologia. 2020;63:473-485.
MOHEBI R, et al. Cardiovascular disease projections in the context of rising obesity and diabetes prevalence. J Am Coll Cardiol. 2022;79:1234-1245.
MOIZ A, et al. Mechanisms of GLP-1 receptor agonist-induced weight loss: a review of central and peripheral pathways in appetite and energy regulation. Am J Med. 2025;138(6):934-940.
NEELAND IJ, et al. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes Obes Metab. 2024;26:1785-1794.
PANDEY A, et al. Effect of liraglutide on thigh muscle fat and muscle composition in adults with overweight or obesity: results from a randomized clinical trial. J Cachexia Sarcopenia Muscle. 2024;15:1072-1083.
ROCHIRA V, et al. The effect of tirzepatide on body composition in people with overweight and obesity: a
systematic review of randomized, controlled studies. Diseases. 2024;12:204.
SATTAR N, et al. Tirzepatide and muscle composition changes in people with type 2 diabetes (SURPASS-3 MRI): a post-hoc analysis of a randomised, open-label, parallel-group, phase 3 trial. Lancet Diabetes Endocrinol. 2025;13(6):482-493.
SARWER DB, et al. The psychosocial burden of obesity. Endocrinol Metab Clin North Am. 2018;47:1-12.
STEFANAKIS K, et al. The impact of weight loss on fat-free mass, muscle, bone and hematopoiesis health: implications for emerging pharmacotherapies aiming at fat reduction and lean mass preservation. Metabolism. 2024;161:156057.
TINSLEY GM, et al. Fundamental body composition principles provide context for fat-free and skeletal muscle loss with GLP-1 receptor agonist treatments. J Endocr Soc. 2024;8:bvae123.
VOLPE S, et al. Oral semaglutide improves body composition and preserves lean mass in patients with type 2 diabetes: a 26-week prospective real-life study. Front Endocrinol. 2023;14:1240263.
VOZZA A, et al. Predictive factors of body weight loss in patients with type 2 diabetes treated with GLP-1 receptor agonists: a 52-week prospective real-life study. Front Endocrinol. 2025;16:1674308.
WILDING JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989-1002.
ZHAO L, et al. Tirzepatide for weight reduction in Chinese adults with obesity: the SURMOUNT-CN randomized clinical trial. JAMA. 2024.
ZHAO X, et al. GLP-1 receptor agonists: beyond their pancreatic effects. Front Endocrinol. 2021;12:721135.