The Other Side of Weight Loss
When most people think about successful weight loss, they picture shrinking waistlines, better-fitting clothes, and improved overall health. And it’s true, effective weight-loss treatments including modern medications like GLP-1 receptor agonists (such as Ozempic and Wegovy) and surgeries such as gastric bypass, have transformed lives. But here’s the catch: a significant chunk of the weight people lose isn’t fat. Up to half can be lean mass, primarily muscle, which is exactly what we don’t want to lose.
So, here’s the real question for us: if we’re helping our clients lose weight, how can we make sure we’re not unintentionally harming their muscle health in the process? That’s where the nutrition coach course comes in—giving fitness professionals the knowledge and tools to support sustainable fat loss while protecting lean mass through smarter nutritional strategies.
Why Muscle Loss Matters
Muscle isn’t just for looking fit and toned; it plays a vital role in our overall health. Our muscles help regulate blood sugar, support our metabolism, keep us mobile, and prevent falls and frailty as we age. For people living with type 2 diabetes, maintaining muscle is even more critical, as they are already 2–3 times more likely to develop sarcopenia. This is a condition of progressive muscle loss linked directly to higher mortality and lower quality of life.
According to recent research by Al-Awadi, Gray, and Al-Ozairi (2025), people with type 2 diabetes lose muscle mass and strength at accelerated rates of up to 26% and 33% faster, respectively. Given these stark figures, maintaining muscle while losing weight isn’t just a good idea, it’s essential.
How Weight-Loss Solutions Impact Muscle
The popular weight-loss solutions available today such as pharmaceutical treatments and bariatric surgery are undoubtedly effective for dropping excess fat. However, they’re also notorious for stripping away muscle tissue.
Let’s talk pharmaceuticals first. Medications like GLP-1 receptor agonists (GLP-1RAs), SGLT2 inhibitors (SGLT2Is) and combinations like tirzepatide, while fantastic at controlling blood sugar and reducing cardiovascular risks, also contribute significantly to muscle loss. A striking review noted that lean body mass accounts for roughly 20–50% of total weight lost when taking these drugs. For instance, tirzepatide, a popular combined GIP/GLP-1 receptor agonist, was associated with losing around 1.6 kg of lean mass in just 28 weeks.
Now let’s consider surgery. Bariatric procedures like gastric bypass lead to rapid and dramatic weight loss, which is wonderful for managing diabetes and obesity, but again, the downside is substantial muscle loss. On average, people can lose up to 31% of their muscle mass after surgery, with most of this occurring rapidly within the first year.
Common Misconceptions About Muscle Loss
One common misconception is that muscle loss during weight loss is inevitable or insignificant compared to fat loss. Many people believe as long as the scale number drops, they’re on the right track. However, muscle loss can negatively impact metabolism, making future weight management harder.
Another myth is that aerobic exercise alone is sufficient for maintaining muscle mass. While aerobic activity is crucial for heart health and overall fitness, resistance training remains unmatched in preserving and building muscle mass during weight loss.
Lastly, there’s a widespread misunderstanding that increased protein intake alone, without exercise, can significantly protect muscle mass. In reality, protein intake is most effective when combined with regular resistance exercise, particularly in those at higher risk of muscle loss, such as individuals with type 2 diabetes.
Resistance Training: The Best Defence
So as mentioned, our first line of defence against unwanted muscle loss is resistance training. It’s hands-down the best method we’ve got for protecting and even increasing muscle strength, particularly in people with type 2 diabetes.
Recent studies, including meta-analyses cited by Al-Awadi et al., show clearly that resistance training significantly boosts muscle strength compared to no exercise or even aerobic exercise. However, there’s an intriguing phenomenon called anabolic resistance where muscles in individuals with type 2 diabetes don’t respond quite as robustly to training stimuli as muscles in healthier populations. This doesn’t mean resistance training isn’t effective, quite the opposite. It suggests trainers might need to adjust their expectations and methods.
Practical programmes, such as simple home-based resistance exercises, can deliver noticeable results. One study showed increases in arm and leg muscle mass and push-up performance after a 32-week home programme. Thus, keeping resistance training accessible and sustainable is key.
Protein Intake: The Overlooked Ally
Alongside resistance training, dietary protein emerges as the essential partner in preserving muscle. Protein helps build and repair muscle tissue and interestingly, studies suggest there’s no significant anabolic resistance to dietary protein among individuals with type 2 diabetes. This means that, even if muscles respond slightly less efficiently to exercise, they’re still highly responsive to protein intake.
How much protein is ideal? Current guidelines suggest older adults aim for about 1.2–1.6 grams per kilogram of body weight daily, especially when actively losing weight or battling chronic conditions like diabetes. However, achieving these levels can be challenging, especially since weight-loss medications often suppress appetite and many clients may face financial or practical barriers in accessing high-quality protein.
A practical solution to these challenges includes incorporating protein-rich supplements, shakes, or fortified foods, which are easier to consume even with suppressed appetite. Coaches can also suggest affordable protein sources such as beans, lentils, eggs, cottage cheese, Greek yoghurt and/or canned fish. Additionally, spreading protein intake across smaller, more frequent meals can help clients meet nutritional needs without overwhelming their appetite or budget.
What Coaches Should Do Differently
Given these insights, fitness and nutrition coaches have a clear mandate to do things differently. Encouraging rapid weight loss alone is no longer enough. Protecting muscle must be prioritised equally.
Firstly, coaches should always integrate structured resistance training into weight-loss programmes, focusing on strength improvements as much as or even more than changes in body weight. Secondly, ensuring adequate protein intake is non-negotiable. Coaches must help clients plan and monitor their protein consumption, adapting their approach for clients with lower appetites due to medications or surgeries.
Moreover, monitoring shouldn’t stop at body weight. Regular assessments of functional strength, such as grip tests or sit-to-stand tests, can provide valuable insight into a client’s muscular health over time, enabling adjustments to the programme as needed.
Rethink the Goal
Ultimately, successful weight loss isn’t merely about seeing smaller numbers on the scales. It’s about preserving and enhancing the muscle that supports our health, mobility, and independence. As coaches, reframing our goals to emphasise muscle health and strength alongside fat loss will ensure clients reap the full benefits of their weight-loss efforts safely, effectively, and sustainably.
References
Al-Awadi AA, Gray SR, Al-Ozairi E. Are strategies to increase muscle mass and strength as effective in people with type 2 diabetes? Reviews in Endocrine and Metabolic Disorders. 2025. Click here to review the full research article.
Become an Authority on Obesity & Diabetes
With over 64% of UK adults classified as overweight or obese and more than 5.8 million living with diabetes, the demand for specialised health and fitness professionals has never been greater. The Level 4 Obesity and Diabetes Management course from TRAINFITNESS equips you with the advanced knowledge and practical skills needed to support clients managing these conditions. You’ll delve into the pathophysiology of obesity and diabetes, explore effective exercise prescription strategies, and understand the psychological factors influencing behaviour change. This comprehensive programme not only enhances your expertise but also positions you to make a meaningful impact on public health, addressing conditions that cost the NHS billions annually.
Level 4 Obesity & Diabetes Management Course – Distance Study
