Fat and lean mass changes during incretin-based therapy with structured exercise and nutritional support: A retrospective real-world pilot study
- Design
- Case series · 11 participants · Intermediate outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclearUNKNOWN: 11 adults on incretin therapy at one centre; age, BMI and diabetes status are not reported in the abstract.
- Could weight loss explain it?
- Not applicableNot applicable: the outcome is body-composition change during weight loss itself; the unseparated confounder is the co-delivered exercise and nutrition program, not weight change.
- Study tier
- Study tier 4VERY_LOW: single-centre retrospective chart review of 11 participants without a control group; the authors call it hypothesis-generating.
- Assessment
- Version 4 · Two reviewers differed; settled by a recorded ruling · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This chart review followed 11 adults at one centre who took GLP-1 or GIP/GLP-1 drugs for 9-12 months alongside supervised exercise and nutrition support. Body weight fell by 4.99 kg and fat mass by 4.37 kg on average, while lean mass did not change significantly (-0.62 kg). With no comparison group and so few people, the drugs cannot be separated from the exercise and nutrition program, and the authors call the findings hypothesis-generating.
01Findings
What the study reported
- Drugs
- Glp-1 receptor agonists, Gip/glp-1 receptor co-agonists
- Dose
- various
- Comparator
- none (no control group; pre-post comparison)
- Treatment duration
- 9-12 months
- Primary outcome
- change in fat mass and lean mass by DXA
- Effect
- body weight -4.99 kg and fat mass -4.37 kg (both significant); lean mass -0.62 kg, not significant (p = 0.397); 87.58% of weight reduction attributed to fat mass
- 95% confidence interval
- 95% CI: -7.65 to -2.34 (body weight)
- P value
- p = 0.002 (body weight); p < 0.001 (fat mass); p = 0.397 (lean mass)
- Follow-up
- Not stated
- Adverse events
- not reported in abstract
- Limitations
- Single-centre retrospective chart review of 11 adults with no control group; the drugs cannot be separated from the exercise and nutrition program, and the authors call the findings hypothesis-generating.
Who was studied
- Obesity status
- not reported in abstract
- Diabetes status
- not reported in abstract
- Cvd status
- not reported in abstract
- Ckd status
- not reported in abstract
- Baseline condition
- adults on incretin-based therapy offered a supervised exercise and nutrition program
- Sample size
- 11
- Inclusion exclusion
- adults with 9-12 months of incretin-based therapy offered supervised exercise and nutritional support at one centre
Study quality details
- Study design
- Case series
- Sample size
- 11
- Randomization
- no
- Blinding
- n/a
- Comparator
- none (no control group; pre-post comparison)
- Follow up duration
- not stated
- Outcome type
- intermediate
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- UNKNOWN
- Statistical precision
- CI reported: 95% CI: -7.65 to -2.34 (body weight)
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- Four authors are affiliated with Apeiron Life, California, where the study was conducted, and declare this as a potential conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[BACKGROUND] Incretin-based therapies are highly effective for weight reduction, but changes in lean mass during treatment remain a clinical concern. This study evaluated changes in fat mass and lean mass in individuals receiving structured exercise and nutritional support during incretin-based therapies. [METHODS] In this single-center retrospective observational chart-review study, 11 adults who underwent 9-12 months of incretin-based therapy and were offered a program providing supervised exercise and individualized nutritional support were analyzed. No control group was included. Treatments included glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor co-agonists. Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Data were assessed for parametric assumptions, and pre- and post-intervention comparisons were performed using paired-samples t tests. [RESULTS] Significant reductions were observed in body weight (mean change: -4.99 kg [95% CI: -7.65 to -2.34]; p = 0.002) and fat mass (-4.37 kg [95% CI: 6.36 to -2.39]; p < 0.001), corresponding to a mean total weight reduction of 4.71% and a mean fat mass reduction of 11.06%, respectively. Lean mass did not change significantly (-0.62 kg [95% CI: 2.20 - 0.95]; p = 0.397). At the aggregate cohort-level, weight reduction composition analysis indicated that 87.58% of total weight reduction was attributable to fat mass, and 12.42% to lean mass. [CONCLUSION] Incretin-based therapy delivered within a structured exercise and nutritional support program was associated with fat-dominant weight reduction without a statistically significant change in lean mass. These findings are hypothesis-generating and warrant confirmation in adequately powered prospective controlled studies.