Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Indication assessment · §2

Sarcopenia and lean-mass preservation during weight reduction — evidence across compounds

Every compound the Institute assesses in sarcopenia and lean-mass preservation during weight reduction, with its certainty rating.

Document identifier
CEI-IN-29/2
Series
Indication assessment
Version
2.2
Published
24 Jul 2025
Last reviewed
24 Jul 2025
Next review
24 Jul 2027
Identifier
10.71829/cei.ind.29
Certainty
Not rated
Cycle
2025 Q3
ICD-11
FB32.Y
Category
Musculoskeletal

§2Evidence across compounds

Every compound the Institute assesses in this indication, with the effect as recorded, the certainty rating and the contributing trials. Effects are reported on the anchor outcome where the contributing trials measured it and on the outcome the trial actually reported where they did not.

Table 1. Compounds assessed in sarcopenia and lean-mass preservation during weight reduction, ordered by certainty.

CompoundEffect as recordedInterval as reportedCertaintyTrials
SemaglutideGLP-1 receptor agonist (acylated, long-acting)Approximately 39 % of total mass lost was lean mass in the DXA substudysubstudy n = 140; not powered for a comparative conclusionLow1
TirzepatideDual GIP and GLP-1 receptor agonist (acylated)Approximately 25 % of total mass lost was lean mass in the body-composition substudysubstudy n = 160Low1
CJC-1295Growth-hormone-releasing hormone analogue with…No randomised human evidence identifiedVery low0
GHRP-2Growth-hormone secretagogue, ghrelin receptor agonist…No randomised human evidence identified for a body-composition outcomeVery low0
IGF-1 LR3Recombinant insulin-like growth factor 1 analogueNo randomised human evidence identified for this analogueVery low0
IpamorelinGrowth-hormone secretagogue, selective ghrelin receptor…No randomised human evidence identifiedVery low0
Estimates in this table are not on a common scale and must not be subtracted from one another. Where a comparison between two compounds has been made directly, it appears in a synthesis and not here.
Compounds assessed in Lean-mass preservationPoint estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.00.20.40.60.8Standardised direction and relative magnitudeCompoundEffect as recordedSemaglutideLow certaintyApproximately 39 % of total mass…TirzepatideLow certaintyApproximately 25 % of total mass…CJC-1295Very low certaintyNo randomised human evidence…GHRP-2Very low certaintyNo randomised human evidence…IGF-1 LR3Very low certaintyNo randomised human evidence…IpamorelinVery low certaintyNo randomised human evidence…
Moderate or high certaintyLow or very low certainty
Figure 1. Illustrative. Compounds assessed in this indication, plotted on a common standardised axis so that direction and relative magnitude can be compared at a glance. The estimates are not on a common natural scale and the intervals are the Institute's standardised representation of the reported precision rather than published confidence intervals.

§2.1Syntheses bearing on this indication

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine 2021;384(11):989–1002. doi:10.1056/NEJMoa2032183 · PMID 33567185
  2. Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet 2021;397(10278):971–984. doi:10.1016/S0140-6736(21)00213-0 · PMID 33667417

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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