Transforming Care: Implications of Glucagon Like Peptide-1 Receptor Agonists on Physical Therapist Practice.
Julie Mulcahy, Anna DeLaRosby, Todd Norwood
PMID 40305684WHAT IT FOUND
Physical therapists should screen for GLP-1 medication use to adjust exercise loading and prevent muscle loss.
Weight loss reduces joint pain but risks lean mass decline. Resistance training and high protein intake are critical to maintain function during treatment.
Key findings
01GLP-1 medications cause significant weight loss but also carry a risk of lean muscle mass reduction, which can decrease strength and increase fall risk.
02Weight loss from GLP-1s improves symptoms of osteoarthritis but does not necessarily stop the progression of the disease, and may even increase progression risk in patients with diabetes.
03Therapists must update screening protocols to identify GLP-1 users, as side effects like fatigue and weight changes are expected medication effects rather than new red flags requiring referral.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so the selection of evidence may be biased. The recommendations are based on extrapolation from bariatric surgery data and general exercise physiology, not direct trials of PT interventions in GLP-1 users. Evidence on bone health and osteoarthritis progression is conflicting and emerging. The review does not account for individual variability in response to GLP-1 medications.
Declared interests
No conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that weight loss on GLP-1s equates to improved musculoskeletal health. A significant portion of the weight lost may be lean muscle, which can worsen function and increase fall risk if not actively managed with resistance training and adequate protein.