Ozempic Is Quietly Taking Gay Men’s Muscle, Not Just Their Fat
The injection that promises a leaner body comes with a catch the marketing skips over. On GLP-1 medications like Ozempic and Wegovy, somewhere between a quarter and 40% of the weight you lose is not fat at all.
It is lean mass, and most of that is muscle. Lose 18 kilos and as many as 7 of them could come off as muscle rather than fat.
Muscle, not just fat
The figure holds up across the research. A meta-analysis of nine trials found lean tissue made up about 31% of the total weight lost on these drugs, and semaglutide’s STEP trial data ran higher again. For anyone who spent years building a body in the gym, that is a sobering trade. It is not fixed, though.
Lifting a few times a week and eating enough protein protects most of your muscle while the fat comes off. The weight loss is the easy part. Holding onto your strength takes a plan.
A community already under pressure
Gay and bisexual men report disordered eating at roughly 10 times the rate of straight men, and the pressure to be lean was everywhere long before the injectables arrived. Dr Kevin Gendreau, a gay obesity-medicine physician, told Out that the drugs are not the root problem.
“If someone already believes they need to look a certain way to be desired, rapid weight loss can pour gasoline on that fire,” he said. A smaller body can quiet the noise for a while. It does not fix where the noise comes from.
The bit nobody mentions about bottoming
There is a side effect your doctor probably skipped, too. GLP-1s commonly cause constipation, bloating and cramping, and Gendreau says that can make bottoming uncomfortable, at least until your body settles.
His advice is practical: hydrate, get enough fibre, and talk to your prescriber about your dose instead of toughing it out.
None of this is a case against a medication that genuinely helps people. It is a case for going in with your eyes open. If any of this stirs something up, the Butterfly Foundation (1800 33 4673) and QLife (1800 184 527) are there to talk.
