Way of life modifications could also be mandatory alongside weight reduction with GLP-1s in rheumatology

Key takeaways:

• Rapid weight reduction and weight achieve is a priority for GLP-1 receptor agonist use in rheumatology.
• A slower, steadier weight reduction routine with life-style interventions and GLP-1s could also be preferable.

Conventional weight reduction methods like weight loss program and train could also be mandatory in people with rheumatic circumstances taking glucagon-like peptide-1receptor agonists, based on a speaker.

“These medications lead to rapid weight loss, but when you stop taking them you get weight regain,” mentioned Brian J. Andonian, MD, MHSc, assistant professor of drugs and member of the Duke Molecular Physiology Institute at Duke University. “That weight regain is going to be adipose tissue primarily. We are really good at building fat, we are not so good at building muscle.”

Speaking on the Cleveland Clinic Basic and Clinical Immunology for the Busy Clinician symposium, Andonian informed attendees this proof factors towards a extra long-term strategy to weight administration.

“This is a signal that lifestyle interventions are really important,” he mentioned. “Using them together with GLP-1s is really important. Ultimately weight loss drugs really need to have a lifestyle component.”

The “biggest news” in weight reduction, in rheumatology and past, includes GLP-1 receptor agonists and gastric inhibitory polypeptide (GIP) agonists, based on Andonian.

“We all know these medications are working and our patients are losing a lot of weight,” he mentioned.

Data have proven the contributions of extra weight to arthritis and autoimmunity, elevating the significance of weight reduction in rheumatology affected person populations, based on Andonian.

“It is really the adiposity that is the concern, not just the BMI,” he mentioned.

Andonian famous research exhibiting GLP-1s use in sufferers with osteoarthritis haven’t solely improved ache and joint parameters, but additionally Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) response.

“It is much more than we can achieve with diet alone,” he mentioned.

Andonian added {that a} rising physique of information can be demonstrating the advantages of GLP-1 and GIP medicines in psoriatic illness. However, the mechanism by which these responses are generated stays unsure.

“There are a lot of question marks,” he mentioned.

Evidence is mounting that these medicines might act on T cells, intraepithelial lymphocytes and Natural Killer T cells, however extra analysis is required to elucidate these mechanisms, based on Andonian.

However, he cautioned that not all weight reduction is created equal.

“Intentional weight loss can be good,” Andonian mentioned. “Unintentional weight loss, not so much.”

Additionally, there may be “conflicting evidence” in regards to the quantity of fats vs. the quantity of muscle mass misplaced when taking these medicines, he added.

“The concern with our patients is that they have sarcopenia, or loss of muscle mass with poor muscle function, from inflammatory diseases,” Andonian mentioned. “To combat sarcopenia, strength or resistance training is currently the best therapy we have. Ultimately, more research is needed on effects of GLP-1 medications and lifestyle interventions on skeletal muscle in our patients.”

For extra data:

Brian J. Andonian, MD, MHSc, may be reached at [email protected].

Published by:

Sources/Disclosures

Source:

Andonian B. Obesity, Metabolism & Inflammation: The GLP-1 Revolution and What’s Next? Presented at Basic and Clinical Immunology for the Busy Clinician, Feb. 28 to March 1, 2026; hybrid assembly.

Disclosures:
Andonian stories no related monetary disclosures.

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