Part 2: Supporting Safe and Sustainable Weight Loss With GLP-1s – Why body composition matters

A key biomarker in remote GLP-1 medication management

GLP-1 agonists are remarkably effective in helping patients lose weight. But this can’t be done in a vacuum. “Ensuring safety and appropriate rate of weight loss is always a concern among healthcare providers who are remotely monitoring patients on GLP1 medication. Without having patients come into a physical clinic, there hasn’t been a means of checking health metrics, such as weight and blood pressure, in a way that they can be easily transferred into their electronic medical record for trending over time” said Kristin Baier, MD VP, Clinical Development at Calibrate, the leading clinician-guided and value-based obesity treatment program. Highlighting the importance of GLP-1 remote patient monitoring regarding weight management.

One data point that’s often overlooked in a patient’s journey on GLP-1s is body composition — the proportion of lean mass and fat mass within the body, which can be subdivided into muscle mass, fat mass, water percentage, and bone mass. We now know this data is more telling than Body Mass Index (BMI). In fact, research has shown that BMI is a poor indicator of overall health and does not take into consideration the difference between muscle and fat mass. BMI oversimplifies health assessments, neglecting insight into crucial factors that measuring body composition can provide. (Science Behind Body Composition, A Withings Study)

“When patients lose weight, they are losing a combination of adipose (fat) tissue and lean body mass, which includes skeletal muscle mass, organ density and bone density. Ideally, we want patients to lose adipose tissue and preserve their lean body mass,” continued Kristin Baier, MD. Monitoring body composition over time is crucial, as changes and trends can provide valuable insights into a patient’s health status — often more so than individual measurements.

Preventing muscle loss

One known side effect of GLP-1 medications is the loss of muscle mass along with body fat. If care teams only monitor patient progress using a standard scale, they won’t know if their patients are losing too much muscle mass too quickly. Some patients receive a one-time measurement of their body composition during their doctors’ office visit to determine if they’re eligible for a GLP-1 and sometimes during their annual checkup, so care teams are only seeing the data at the beginning and end of the patient journey. Other patients undergo treatment without any assessment of their body composition. By neglecting to measure aspects such as muscle mass, fat distribution, and hydration levels, healthcare providers may overlook crucial indicators that could impact treatment efficacy and patient well-being.

Muscle is important for burning calories and maintaining a healthy metabolism, which helps with long-term weight loss success. Loss of muscle mass is associated with an increased risk for lower bone density, fatigue, injuries, decreased strength, and more frequent hospitalizations. Preserving muscle is necessary not just to ensure ongoing physical movement but to protect against cancer,cardiovascular disease, and pulmonary disease. This can be tracked by using a GLP-1 remote patient monitoring to support the patient’s journey.

“By measuring body composition, we can accurately determine if this is, in fact, occurring. If we see that pounds are going down but their body fat percentage is staying the same and their muscle mass is decreasing, we can modify lifestyle components such as their type and frequency of exercise and food intake, for instance” shared Kristin Baier, MD.

Combatting GLP-1 agonist plateau

Although GLP-1 agonists tend to spark significant weight loss, most patients eventually reach a plateau in their weight and other metabolic markers like blood pressure. Focusing solely on weight or BMI can sometimes lead to short-term thinking and unsustainable weight loss strategies.

By helping patients focus less on specific weight numbers and more on changes in their body composition data, care teams can promote a more holistic approach that supports sustainable weight loss.

For example, if a patient’s body weight increases or remains stable during treatment, GLP-1 remote patient monitoring and body composition monitoring may reveal that their body fat percentage has decreased while their muscle mass has increased. Although the individual is gaining weight in this scenario, it’s attributed to the growth of muscle tissue rather than an increase in body fat. This type of weight gain, known as lean mass gain, is generally considered positive for overall health and fitness as it can improve strength and metabolic rate.

Moving Forward

In a March 2024 survey conducted by Withings, patients taking GLP-1 medication were asked about the biomarkers they’ve been monitoring throughout their health journey. Among respondents, 37% highlighted body composition as a crucial metric they actively tracked using their Withings devices during their treatment regimen.

Write-in responses highlighted the value of regular body composition tracking in supporting healthy habits and addressing concerns about muscle loss.

"[My Withings scale] encouraged daily weigh-ins, identification of more clear lean body mass decrease, [and] increased focus on protein intake and resistance exercise per HCP guidance.”

"I watch my muscle mass through theWithings scale. I don’t need my weight to decrease quickly, but I do want to keep or gain muscle.”

"I was fearful that I would lose muscle, and the scale helped me to monitor.”

"Daily reminder of weight, body composition, and BP (blood pressure) reinforced healthy eating and exercise goals."

Withings Body Pro 2 is an advanced body composition scale that accurately and reliably collects advanced patient biomarkers from the at-home setting and sends them directly to care teams via cellular connectivity.

Daily body composition analysis allows for a more personalized approach to treatment. Measuring patients’ body composition while on a GLP-1 therapy is important for assessing treatment effectiveness, monitoring metabolic health, preserving lean body mass, and ensuring overall health and safety for individuals undergoing this type of treatment.

Part 3: Discover the importance of remote monitoring devices after medication ends

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