Whole-Body EMS in combination with GLP-1 – a sustainable Approach to Weight Loss

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The combination of GLP-1 ‘weight loss injections’ and whole-body electro-muscle stimulation (WB-EMS) offers a time-saving solution for weight loss and maintaining muscle mass. Discover how these approaches work synergistically to enable sustainable body optimisation.

The global trend for GLP-1 (Glucagon-Like Peptide-1) receptor analogues and their use, known as ‘injection slimming’, is gaining momentum and revolutionising the weight loss landscape.

Originally developed to treat diabetes, these injectable drugs are increasingly being used as an effective method for rapid weight loss. However, despite the impressive success in reducing body weight, there are also critical voices that point to negative and/or counterproductive side effects such as the pronounced loss of fat-free and muscle mass. To counteract this effect, whole-body electrical muscle stimulation (EMS) is emerging as a complementary solution. Both methods appeal to the same target group: people who are looking for efficient, time-saving solutions for body optimisation. Both GLP-1 and EMS offer fast and visible results without the high time commitment of traditional diets or intensive training protocols. They are particularly appealing to individuals who want to improve their physical health and aesthetics, but who also want to use convenient, modern technologies to achieve their goals as efficiently as possible. The combination of both methods could therefore be particularly attractive for people who, in addition to sustainable weight reduction through maintaining or building muscle mass, also have muscle strength and function in mind.

 

The number of obese people is increasing worldwide

Almost one billion people worldwide are obese (BMI > 30 kg/m2); this number is expected to double by 2035 [1]. According to low estimates, the prevalence of obesity in Germany in 2022 was around 11% of the German population. The incidence of obesity increases with age, peaking after the age of 70 (Gesundheitsatlas Deutschland, published by the AOK's scientific institute). Obesity is known to be a key risk factor for conditions including high blood pressure, dyslipidaemia, type 2 diabetes mellitus, cardiovascular disease and various cancers and tumours [2-5]. A new drug therapy option for the treatment of obesity is glucagon-like peptides-1 receptor agonists (GLP-1 RA). GLP-1 RA were originally developed for the treatment of type 2 diabetes mellitus, where they play an important role. Due to their pronounced effect on the reduction of body mass, GLP-1 RA are becoming increasingly relevant for weight management in overweight and obese individuals. Active ingredients of this substance class, such as semaglutide (e.g. ‘Wegovy®’ Ozempic®) or tirzepatide (Mounjaro), which has a dual mechanism of action on the receptors of GLP-1 and GIP (glucose-dependent insulinotropic peptide) , show a weight loss of about 15% (semaglutide; STEP-1, [6]) and about 20% (tirzepatide, SURMOUNT-1, [7]) in clinical trials, i.e. in the range of bariatric surgery.

 

Rebound effect after weight loss

However, after discontinuing pharmacological therapy, there is a pronounced rebound effect with a rapid increase in body weight (STEP-4 [8], SURMOUNT-4 [9]), so that the drug must probably be used for life to maintain (or further reduce) body weight. A central mechanism of action of the substances plays an important role in this development. GLP-1/GIP RA reduce hunger, but not eating behaviour. An important aspect also remains mostly unmentioned: weight reduction is generated not only by a loss of fat mass but also to a very significant extent by a loss of lean body mass (LBM). The STEP-1 study (semaglutide) showed a weight loss of 15.3 kg with a reduction in LBM of almost 7 kg (45%). The proportion of LBM in weight loss with tirzepatide (SURMOUNT-1) is approximately 26 %. In both cases, the reference standard [10] was Dual Energy X-Ray Absorptiometry (DXA) and is therefore considered reliable.

Now, the fat-free mass is not directly equivalent to muscle mass, but is composed of several tissue types such as skin, bones, organs, blood vessels, etc. Adipose tissue also contains fat-free components (approx. 15 %), so that a fat reduction is generally accompanied by a reduction in fat-free mass. While about two-thirds of the reduction in fat-free mass can be explained by the loss of muscle mass [11], significant reductions have also been reported for the highly metabolically active organs (e.g. liver, kidney, heart), which are reflected in a significant reduction in resting energy expenditure (REE) [11]. Since the REE, at least in non-athletic collectives and depending on physical activity, determines 60-80% of total energy expenditure, maintaining muscle mass, which determines a relevant proportion of resting energy expenditure, is of central importance for avoiding a positive energy balance through unchanged dietary behaviour after GLP-1/GIP RA therapy.

 

Physical training as a solution

Various pharmacological therapy concepts for maintaining muscle mass during weight loss, which would also have to be applied consistently over the course of a lifetime, are currently in development but have yet to prove their effectiveness and safety. If we consider the parallel development in the field of ‘sarcopenia’, a safe pharmacological solution to this problem is not in sight in the foreseeable future. In contrast, maintaining lean body mass through physical training, ideally with the addition of protein or amino acids, has been shown to be effective even in the case of diet-induced energy deficiency [12, 13]. In addition, physical training, in contrast to pharmacological therapy (which may come at any time), also improves muscle strength and function, which is a unique selling point, especially for older people, the population group with the highest prevalence of obesity.

The same applies to the time-effective and joint-sparing training technology ‘whole-body electromyostimulation’ (WB-EMS). Here, too, longitudinal studies conducted under energy restriction over 16-26 weeks with and without protein supplementation show positive effects of WB-EMS application on the maintenance of muscle mass and function with simultaneous significant weight reduction [14, 15].

Conclusion:

In conclusion, it can be said that physical training during and after GLP-1/GIP RA therapy is an absolute must. The combination with whole-body electric muscle stimulation (WB-EMS) is a perfect, target group-oriented solution for people who are looking for an effective, time-saving and holistic method for body optimisation. While GLP-1/GIP RA therapy specifically promotes the reduction of body fat, WB-EMS can ensure that the muscles are maintained and even strengthened, preventing the dreaded muscle loss during weight loss. This synergy not only enables a slimmer silhouette, but also a firmer and stronger body structure, as well as an improvement in health-related parameters and everyday competence.

For people who have little time or enthusiasm for extensive training programmes or complicated diets in their daily lives, the combination of both approaches offers a particularly attractive solution. It combines medical advances with innovative training technology to achieve fast, visible results without neglecting long-term health and physical stability. This creates a holistic approach that is specifically tailored to the needs of a modern, health-conscious target group.

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References:

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