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This primer aims to address whether muscle-related changes associated with weight loss treatments such as GLP-1 RAs may be maladaptive (ie, adversely affecting muscle health or function), adaptive (ie, a physiologic response to weight loss maintaining or minimally affecting muscle health or function), or perhaps an enhanced response to weight loss (ie, improved muscle health or function after treatment). Based on contemporary evidence with the addition of studies using magnetic resonance imaging, skeletal muscle changes with GLP-1 RA treatments appear to be adaptive: changes in muscle volume z-score indicate a change in muscle volume that is commensurate with what is expected given aging, disease status, and weight loss achieved, and the improvement in insulin sensitivity and muscle fat infiltration likely contributes to an adaptive process with improved muscle quality, lowering the probability for loss in strength and function. Nevertheless, factors such as older age and prefrailty may influence the selection of appropriate candidates for these therapies because of risk for sarcopenia. Several pharmacologic treatments to maintain or improve muscle mass designed in combination with GLP-1\u2013based therapies are under development. For future development of GLP-1\u2013based therapies (and other therapies) designed for weight loss, as well as for patient-centered treatment optimization, the introduction of more objective and comprehensive ways of assessing muscle health (including accurate and meaningful assessments of muscle quantity, composition, function, mobility, and strength) is important for the substantial numbers of patients who will likely be taking these medications well into the future.<\/jats:p>","DOI":"10.1161\/circulationaha.124.067676","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T14:00:38Z","timestamp":1728914438000},"page":"1288-1298","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":195,"title":["Muscle Mass and Glucagon-Like Peptide-1 Receptor Agonists: Adaptive or Maladaptive Response to Weight Loss?"],"prefix":"10.1161","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8375","authenticated-orcid":true,"given":"Jennifer","family":"Linge","sequence":"first","affiliation":[{"name":"AMRA Medical AB, Link\u00f6ping, Sweden (J.L.)."},{"name":"Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Sweden (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-9023","authenticated-orcid":true,"given":"Andreas L.","family":"Birkenfeld","sequence":"additional","affiliation":[{"name":"Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Germany (A.L.B.)."},{"name":"Department of Diabetology, Endocrinology, and Nephrology, University Clinic T\u00fcbingen, Eberhard Karls University T\u00fcbingen, Germany (A.L.B.)."},{"name":"German Center for Diabetes Research (DZD), Neuherberg, Germany (A.L.B.)."},{"name":"Department of Diabetes, Life Sciences &amp; 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