Endocrinology ·
Resistance exercise preserved lean mass during tirzepatide treatment in randomized trial
In a 40-week randomized trial of 120 adults with overweight or obesity, adding resistance exercise to tirzepatide reduced loss of lean soft tissue and improved muscle strength compared with tirzepatide alone. Weight loss and fat-mass loss were similar between groups.
- Exercise reduced lean-mass loss during tirzepatide treatment.
- Weight and fat-mass loss were similar between groups.
- Strength improved with exercise and declined without it.
- Resistance training adherence was 91% over 40 weeks.
In this two-arm randomized controlled trial, 120 adults with overweight or obesity received tirzepatide and were assigned to resistance exercise training three times weekly or usual activities for 40 weeks. The primary outcomes included changes in fat mass and lean soft tissue mass. Exercise adherence was 91%; most participants tolerated tirzepatide up-titration to 15 mg weekly, and the treatment was reported as safe.
Weight loss was similar with tirzepatide alone and with added exercise (−22.61 kg and −22.28 kg, respectively; P=0.694). Total fat-mass loss also did not differ significantly. Total lean soft tissue loss was lower with exercise (−3.57 kg versus −4.67 kg; between-group difference 1.09 kg, 95% CI 0.43–1.75; P<0.001), as was appendicular lean soft tissue loss. Strength increased in the exercise group but declined with tirzepatide alone across the reported upper- and lower-body tests.
The findings suggest that structured resistance exercise can attenuate lean-mass loss and support strength during tirzepatide-associated weight loss, without reducing weight loss. The trial lasted 40 weeks and enrolled 120 participants; the results do not establish longer-term effects or generalizability beyond the studied population. The registry identifier is ACTRN12623001236684.
In practice
For adults with overweight or obesity receiving tirzepatide, this 40-week randomized trial supports resistance exercise as an adjunct that may reduce loss of lean soft tissue and improve measured muscle strength. Weight loss was similar with and without exercise, so the observed lean-mass benefit did not appear to come at the cost of less weight reduction. The findings do not establish long-term effects or apply beyond the studied population, and the trial size was limited; they support consideration of structured resistance exercise but do not establish a universal regimen.
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Nature Medicine: Resistance exercise to attenuate lean mass loss during tirzepatide therapy for obesity: a randomized controlled trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.