Evidence mapPaperPMID 39344838Full record

ReviewDiabetes, obesity & metabolism2024

Glucagon-like peptide-1 receptor agonist-based agents and weight loss composition: Filling the gaps.

Robert L Dubin, Steven B Heymsfield, Eric Ravussin, Frank L Greenway

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Diabetes, obesity & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07154719 (GLP-1R Actions on Muscle and the Skeleton), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07154719 phase4recruitingstarted 2025, after this paper: background citation

GLP-1R Actions on Muscle and the Skeleton

Ran2025Enrolled50Registered outcomes7Posted comparisons0ConditionsDrug Effect, Musculoskeletal Abnormalities, Obesity, OsteoporosisArmsLifestyle toolkit, Tirzepatide
PMID 33951361PMID 35658024PMID 10778870other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Phytocompounds That Target White Adipose Tissue for Weight Loss: A Review Spanning From Ucp1 Induction in Rodents to Human Clinical Trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Review
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Muscle health in the modern era of incretin-based therapies.European journal of clinical investigation · 2026
    Review
  13. Article
  14. Article
  15. Reply to GM Tinsley et al.; DB Ibsen et al.; and EJ Dhurandhar et al.The American journal of clinical nutrition · 2025
    Article
  16. Sarcopenic obesity and weight loss-induced muscle mass loss.Current opinion in clinical nutrition and metabolic care · 2025
    Review
  17. Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Robert L DubinPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID 0000-0002-7378-9650
Steven B HeymsfieldPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID 0000-0003-1127-9425
Eric RavussinPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID 0000-0003-2129-547X
Frank L GreenwayPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.ORCID 0000-0002-1766-6111

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Excess adiposity is at the root of type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as first-line treatments for T2D based on significant weight loss results. The composition of weight loss using most diets consists of <25% fat-free mass (FFM) loss, with the remainder from fat stores. Higher amounts of weight loss (achieved with metabolic bariatric surgery) result in greater reductions in FFM. Our aim was to assess the impact that GLP-1RA-based treatments have on FFM. We analysed studies that reported changes in FFM with the following agents: exenatide, liraglutide, semaglutide, and the dual incretin receptor agonist tirzepatide. We performed an analysis of various weight loss interventions to provide a reference for expected changes in FFM. We evaluated studies using dual-energy X-ray absorptiometry (DXA) for measuring FFM (a crude surrogate for skeletal muscle). In evaluating the composition of weight loss, the percentage lost as fat-free mass (%FFML) was equal to ΔFFM/total weight change. The %FFML using GLP-1RA-based agents was between 20% and 40%. In the 28 clinical trials evaluated, the proportion of FFM loss was highly variable, but the majority reported %FFML exceeding 25%. Our review was limited to small substudies and the use of DXA, which does not measure skeletal muscle mass directly. Since FFM contains a variable amount of muscle (approximately 55%), this indirect measure may explain the heterogeneity in the data. Assessing quantity and quality of skeletal muscle using advanced imaging (magnetic resonance imaging) with functional testing will help fill the gaps in our current understanding.

Indexed as

Diabetes Mellitus, Type 2ExenatideGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsLiraglutideWeight LossAbsorptiometry, PhotonAdiposityBariatric SurgeryBody CompositionFemaleGastric Inhibitory PolypeptideGlucagon-Like Peptide-2 ReceptorGlucagon-Like PeptidesHumansMaleExenatideGastric Inhibitory PolypeptideGlucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like Peptide-2 ReceptorGlucagon-Like PeptidesHypoglycemic AgentsLiraglutideSemaglutideTirzepatide

Identifiers

PMID39344838

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.