Aesthetic clinics are pairing GLP-1 with nutrition, hormone tracking and resistance training to maintain structure and prevent muscle mass decline.
Courtesy of Vyacheslav at Adobe Stock
GLP-1 has long been associated with weight loss—at least since it was discovered that it had implications beyond diabetes management and migrated into aesthetic practices. However, the drug is now being used by lean individuals, or patients who've never been overweight in their life. Unlike how obese individuals may use this drug as a prelude to cosmetic procedures, many individuals are finding that GLP-1 has longevity benefits for cardiovascular, kidney and liver optimization. For this preventive cellular health biohack, aesthetic physicians are conducting ongoing monitoring, since muscle loss is not the intended outcome but rather a symptom among all users that recent studies indicate needs further clinical investigation.
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GLP-1 has long been associated with weight loss—at least since it was discovered that it had implications beyond diabetes management and migrated into aesthetic practices. However, the drug is now being used by lean individuals, or patients who've never been overweight in their life. Unlike how obese individuals may use this drug as a prelude to cosmetic procedures, many individuals are finding that GLP-1 has longevity benefits for cardiovascular, kidney and liver optimization. For this preventive cellular health biohack, aesthetic physicians are conducting ongoing monitoring, since muscle loss is not the intended outcome but rather a symptom among all users that recent studies indicate needs further clinical investigation.
GLP-1’s Expanding Role in Cardiovascular Health, Longevity and Metabolic Optimization
Evidence affirms the benefits of GLP-1, exceeding the needs of diabetic individuals, with particular reductions in cardiovascular events and mortality. In a 2023 trial conducted by Cleveland Clinic, patients treated with semaglutide lost about 9.4% of their body weight, but also experienced improvements in factors related to cardiovascular disease. Michael Lincoff, MD, who led the study, found that semaglutide reduced the risk of non-fatal stroke by 20%, likely due to GLP-1’s effects on weight loss and decreased ectopic fat deposition [1].
Long-term use of GLP-1 agonists has been shown to reduce blood pressure as well, along with lowered cholesterol levels and fatty acid synthesis in the liver [2]. As GLP-1 is continuing to see more therapeutic effects beyond obesity management, it calls for continued research on their clinical advantages. Similar to how people take omega-3 to prevent heart disease and other health issues that may arise with age, GLP-1 may become a preventive measure for many people, considering its aspects.
As individuals reap these benefits, however, management from health professionals looks different than their protocol for obese patients. When monitoring overweight individuals, doctors typically track side effects and help prevent weight regain through continued use of the medication, proper diet and exercise to ensure muscle mass is not lost. Muscle mass decline is a concern for fit patients taking it as well due to appetite suppression—potentially more because weight loss is not the initial goal for them but is an effect and could lead to sarcopenia.
In an August 2025 study conducted by the University of Utah, researchers found that Ozempic-induced weight loss decreased lean mass by about 10%. As mice lost weight in the study, some muscles shrank slightly, but not enough to explain the full loss of lean mass, and others stayed the same size [3]. The senior author on the study urged that clinical trials should check for changes in muscle strength not just for Ozempic but also future weight-loss drugs [3].
While GLP-1 drugs offer metabolic and longevity benefits, they can unintentionally reduce muscle mass—even in lean individuals—making clinical monitoring and muscle-preserving strategies essential.Courtesy of paulus at Adobe StockHow a Beverly Hills Rejuvenation Center Uses GLP-1 to Support Longevity in Fit Individuals
Arvind Chakravarthy, MD, MBA has used GLP-1 for its implication on atty liver reversal, visceral fat reduction and improved insulin sensitivity, even in those with a normal BMI but abnormal biomarkers. “I’ve been prescribing GLP-1 receptor agonists since 2019, beginning in metabolic care, and evolving toward advanced longevity and body-composition optimization,” he says.
“In my view, the ‘fit but not metabolically flexible’ individual has become the new clinical frontier.”
Chakravarthy is chief longevity officer for the Beverly Hills Rejuvenation Center and board-certified ER physician practicing regenerative and metabolic medicine. As he tracks GLP-1 for its metabolic benefits in already lean individuals, he says clinical boundaries remain critical. In patients with BMI less than 23 or body fat less than 15%, use should be anchored to biomarkers and not cosmetic intent, even in aesthetic settings that blend medical practice with beauty.
“This isn’t about chasing weight; it’s about tuning the internal environment for cellular longevity,” he says.
When gearing up to prescribe GLP-1 for fit individuals, the primary concerns he monitors actively through a person’s use is muscle catabolism and mitochondrial fatigue, as the drug suppresses appetite, which could exacerbate lack of nutrition. These two factors tend to happen when muscle tissue breaks down into smaller components, such as amino acids for energy production.
Five Pillars of Care for Safe GLP-1 Use: Tracking Nutrition, Hormones and Biological Age in Fit Individuals
Gut microbiome dysbiosis and nutrient malabsorption are also a concern, he says, and dysbiosis can occur when there is an imbalance of the gut's microbial community; beneficial bacteria are reduced, harmful bacteria overgrow or the overall diversity of microorganisms decreases. It is caused by a poor diet. Consequently, nutrient malabsorption happens when the body has trouble absorbing nutrients from food in the digestive tract, which can lead to malnutrition.
Prolonged use raises the concern for hormonal suppression, neurotransmitter adaptation and receptor desensitization, he adds. The main risk in lean users using GLP-1, besides malnutrition and hormonal regulation issues, is sarcopenia, Chakravarthy says, the progressive loss of muscle mass.
“When people use GLP-1s who are already fit, they are very likely going to lose the thing that made them look physically strong in the first place: volume; not fat, per se, but structure,” says Kiara DeWitt, RN, BSN, CPN, the founder and CEO of Injectco.
Maintaining muscle isn’t just about strength—it’s about preserving the sculpted foundation beneath your skin.Courtesy of Julian at Adobe StockTo track these components, including hormone levels, protein and nutrition intake, as well as sleep patterns to ensure these risks do not occur in fit individuals taking GLP-1, Chakravarthy’s rejuvenation center scans body composition and measures testosterone, estradiol, IGF-1 and thyroid panels. The center also monitors fasting insulin levels and albumin. C-reactive protein and mitochondrial markers to calculate biological age, not chronological age, are also monitored.
In fact, Chakravarthy implemented five pillars of care at the center that uniquely monitor GLP-1 users who are not necessarily using it for diabetes or weight loss.
1. Lifestyle Foundations (nutrition; sleep; exercise; stress management) 2. Gut & Liver Health (detoxification and microbiome balance) 3. Hormonal Optimization (thyroid; adrenal; sex hormones) 4. Regenerative & Peptide Therapies (cellular repair and optimization with cell factor and peptides) 5. Testing & Iteration (continuous biomarker tracking and personalization)
Plastic surgery offices follow checkmarks unique to fit individuals, too. Daniel Maman, MD, board-certified plastic surgeon and founder of Maman Plastic Surgery, says tracking protein intake and adequate calories is important in his practice when it comes to GLP-1 use, and notes emerging clinical guidance stressing that pairing GLP-1s with high-protein diet and consistent resistance training preserves muscle and bone.
This is especially important, as appetite suppression and slowed gastric emptying can make it hard to hit the recommended 1.6 g protein and adequate calories—risking hair shedding, dull skin, fatigue and slower wound healing, aside from muscle loss, Maman says.
Layered Solutions: Managing the Cosmetic Consequences of GLP-1 Therapy in Fit Patients
Maman tracks protein intake, as well as creatine use, if appropriate and structured resistance training up to four times a week. He says if these individuals pursue cosmetic treatments after use, as many do to restore volume, weight should be stabilized around 3–6 months before body-contouring.
DeWitt, who prescribes GLP-1 at Injecto, has found just as overweight individuals seek restoration of volume and sculpting treatments to finish and complete the weight loss, individuals who were already fit experience similar affects, like ozempic face: deflation in the cheeks, temples receding and the body’s muscles looking deflated.
“This is where the aesthetic side needs to make some noise,” she says. “Sculpted does not equal depleted, but those lines get crossed quickly when someone chases that hyper-lean aesthetic with chemicals.”
She notes that while improving internal numbers is the goal, losing external symmetry can be the result. Jawline refinement, buccal fat removal, neck lift, even non-surgical thread lifts all come into play for individuals seeking aesthetics after GLP-1 to “finish the job,” whether they were previously overweight or fit. It becomes an orbit, however, she says.
“The reality is GLP-1s for an already lean body come with aesthetic consequences that can be hard to surgically unwind cleanly. You are now in a layering game; add filler, add collagen stimulators, add lift and then hope it looks natural, and for those that are actually going in looking for that sculpted aesthetic, what’s lost is often more than what you had before you started,” DeWitt says.
Chakravarthy adds, “I’d like to see industry guidelines align with the Five Pillars—moving from disease treatment toward functional optimization. Used wisely, GLP-1s can help extend not just lifespan, but healthspan—when anchored to muscle, mitochondria, and measurable data.”
While GLP-1 drugs offer metabolic and longevity benefits, they can unintentionally reduce muscle mass—even in lean individuals—making clinical monitoring and muscle-preserving strategies essential.Courtesy of paulus at Adobe Stock
While GLP-1 drugs offer metabolic and longevity benefits, they can unintentionally reduce muscle mass—even in lean individuals—making clinical monitoring and muscle-preserving strategies essential.Courtesy of paulus at Adobe Stock
Maintaining muscle isn’t just about strength—it’s about preserving the sculpted foundation beneath your skin.Courtesy of Julian at Adobe Stock
