For years, we’ve been obsessed with one number:
The number on the scale.
Lose weight? Great.
Lose more weight? Even better.
But that number doesn’t tell us what we’re losing.
Fat?
Water?
Muscle?
As medications like Zepbound (tirzepatide) help people lose substantial amounts of weight in record time, but researchers are asking a question that I think deserves a lot more attention:
Can we lose fat without sacrificing too much muscle?
Muscle does far more than help us lift heavy things.
It helps us move, maintain our balance, stay independent as we age, regulate blood sugar, recover from illness, and perform countless everyday activities we rarely think about…until they’re difficult and force us to think about them.
That’s why body composition may ultimately matter more than body weight.
In this episode of Causes or Cures, I spoke with Dr. Richard Pratley, lead author of a new randomized, double-blind, placebo-controlled clinical trial investigating an experimental medication called apitegromab.
Unlike weight-loss drugs, apitegromab isn’t designed to make people lose more weight.
Instead, researchers wanted to see whether people taking tirzepatide could hold on to more lean mass while they were losing weight.
The idea centers around a protein called myostatin.
Think of myostatin as one of the body’s natural brakes on muscle growth. Apitegromab blocks that brake, allowing researchers to test whether muscle can be better preserved during weight loss.
The results were encouraging.
Participants receiving apitegromab preserved more lean mass than those receiving placebo while losing similar amounts of weight.
But here’s where I appreciated Dr. Pratley’s perspective.
Preserving lean mass isn’t the same thing as preserving strength.
More lean mass on a scan doesn’t automatically mean someone can climb stairs more easily, avoid falls, or live independently longer.
Those are the questions researchers still need to answer.
The conversation also made me think about how we talk about obesity treatment in general.
Sometimes it feels as though we’ve become so focused on losing weight that we’ve forgotten to ask what kind of weight we’re losing.
Because not all weight is created equal.
The goal shouldn’t simply be to make the number on the scale smaller.
The goal should be improving health.
That includes protecting the tissues we actually want to keep. Preserving muscle isn’t a “side note” to weight loss. It’s part of successful weight loss.
The conversation also brought this question to mind: If we need one medication to lose weight and another to help preserve muscle, are we actually solving a problem, or creating a more complicated one?
If this research teaches us anything, it’s that the future of obesity treatment may be less about chasing a lower number on the scale, and more about preserving the parts of our bodies that help us stay healthy for decades to come.
And, at the least, I think it’s a conversation worth having.
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Don’t forget to catch this podcast with a researcher who looked into whether listening to music reduces cognitive decline and helps prevent Alzheimers!
Work with Me? Perhaps it’s a good match. ;)
You can contact Dr. Eeks at bloomingwellness.com.
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