Do GLP-1 drugs cause tendon injuries? What does the research say?

Worldwide, obesity rates have risen dramatically over the past several decades, resulting in significant burdens on individuals and health care systems in general.

Compared with their non-obese peers, obese people have higher rates of chronic disease and premature mortality and are costly to the American health care system. On average an additional $2,500 in medical costs per year With those costs increasing dramatically as the obesity category rises.

Given the difficulty of treating obesity, the introduction of GLP-1 receptor agonists has been an important inflection point in management. These medications have had a huge impact on many people who take them and have broken the endless cycle of dieting and weight cycling that represents the efforts of many who try and fail to lose weight in an attempt to improve their health.

Efficacy and popularity of GLP-1 receptor agonists

The effectiveness of these drugs is indisputable. While some who take it may only see minor weight reductions, the majority will see a significant change Average weight loss ranges between 14-20% of initial body weight. These findings have made these drugs incredibly popular and profitable for the companies that produce them, so it is not surprising that marketing campaigns for these agents have been aggressive. The result has been an increasing number of people taking these medications. By 2024, It is prescribed to 7% of people suffering from obesity These medications, the rate continued to increase.

In the general population, more than 100 million people are classified as obese and many are now seeking prescriptions for GLP-1 receptor agonists. Given that this population has Degree of overlap with endurance athletes If you’re looking to lose weight for the purposes of health and longevity, GLP-1 agonists make sense as well Used by people who train and race in endurance sports. However, in addition to those trying to lose weight, some athletes who take these medications are not obese. they May instead They try to improve body composition by maximizing fat loss while continuing their training by restricting their appetite.

With an increasing number of people taking these medications and the gradual length of time that we have now been able to observe the unintended effects that these medications may have, it is not entirely surprising that side effects of these medications will begin to appear in athletes.

New data reveals increased risk of tendon injury

The most important limitation of GLP-1 agonists is the need to take them continuously. It has become well understood that stopping these medications is associated with a return to previous weight. One-half to two-thirds of the weight lost due to a GLP-1 agonist is expected to be regained in the first year after stopping the drug.

Recently, another important side effect has been discovered, which is of particular interest to athletes. Data provided At the annual meeting of the American Academy of Orthopedic Surgeons, obese patients with or without diabetes using GLP-1 agonists were found to have significantly increased rates of tendon injuries. Tears of Rotator cuffThe Achilles tendon, peroneal tendon (a tendon in the calf), and pectoral tendon were all seen at a rate about 50% higher than in those not taking these medications.

It is important to note that although the risk of tendon rupture was about 1.5 times higher for those who took GLP-1 receptor agonists than for those who did not, this risk is still very low. About 0.3% for Achilles tendon ruptures (vs. 0.2%), 2.4% for rotator cuff tears (vs. 1.5%), and 0.8% for pectoral tendon tears (vs. 0.5%). So, this is not an epidemic Tendon injuries. However, the increase is real.

The role of muscle loss in tendon strain

The rationale behind this happening is not entirely clear. It is well understood that thanks to the appetite suppression caused by these drugs, people who take them significantly reduce their calorie intake and lose muscle mass as well as fat. This decrease in muscle mass could be explained Up to 38% of total weight loss Experienced by people on these medications.

This decrease in Muscle mass It can put more stress on nearby tendons and bones and potentially lead to an increased risk of injury, although this is just an assumption at present.

Recommendations for athletes regarding GLP-1s

However, experts in this field believe there is enough concern to not only warrant further research but to advise athletes to take steps to avoid this loss of lean body mass as much as possible. They recommend to merge Strength training 60-90 minutes per week Research has also shown that this can be effective in preventing up to 50-90% loss of lean muscle mass during calorie restriction. Plus warranty Eat enough protein It is crucial because appetite suppression often leads to insufficient intake, which compounds Muscle loss.

While this may not be the only way to prevent tendon injuries associated with GLP-1 receptor agonists, it is the best method we know of at this point. A potentially larger issue is whether these drugs are suitable for use in training endurance athletes for long-distance events such as triathlons, as Eating enough calories is crucial For successful training and racing. Given their popularity and the results seen through their use, this question is unlikely to be answered in a satisfactory manner anytime soon and should be left to the individual and the prescribing physician.