Direct Line (Free): GLP-1 Muscle Loss and Creatine, Bulking vs Cutting, One-Hour Training, & Detraining

Once a month we answer Barbell Medicine Plus subscribers’ questions on the Direct Line. This is a free look at June’s episode. We start with GLP-1 drugs and muscle: why DEXA overstates the loss, what resistance training actually does, and whether creatine is worth taking. Then whether bulking and cutting does anything the scale can’t already tell you, how to get real benefit from one training hour a week, and what happens to your muscle, strength, tendons, and bone when you take time off, including why muscle memory brings it back faster than you built it.

What we cover:

• GLP-1s and muscle: the DEXA problem, resistance training, and creatine

• Bulking vs cutting vs just maintaining, and a health-first way to choose

• Training on one hour a week: the least that still moves the needle

• How fast you lose muscle when you stop, and why it comes back fast

The full two-hour episode and every back episode are on Barbell Medicine Plus, which can bundled with Premium. Resources and full references below.

Timestamps

0:00 Intro + GLP-1 and the DEXA muscle-loss myth

3:00 Do GLP-1s spare or waste muscle?

8:03 Does creatine help on a GLP-1?

10:45 Does bulking and cutting do anything?

13:18 Health first: when to lose fat before gaining

22:30 Training on one hour a week

36:22 How fast you lose muscle when you stop

43:19 Muscle memory: why it comes back

48:25 The full episode on Plus

Resources

• Barbell Medicine coaching and templates: https://www.barbellmedicine.com
• https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/
• https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/
• Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/

https://www.barbellmedicine.com/blog/glp-1-muscle-loss/

https://www.barbellmedicine.com/blog/creatine-on-ozempic-does-it-prevent-muscle-loss/

https://www.barbellmedicine.com/blog/novice-intermediate-advanced-strength-training/

Lundgren JR, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined (S-LITE). N Engl J Med 2021;384:1719-1730. nejm.org · NEJMoa2028198

T-REX trial: tirzepatide with or without resistance training (Univ. of Western Australia). Preliminary. ANZCTR ACTRN12623001236684

Creatine + GLP-1 pilot (Univ. of Saskatchewan). Ongoing, results expected 2027. ClinicalTrials.gov NCT07625202

Momma H, et al. Muscle-strengthening activities and lower risk/mortality in major non-communicable diseases. Br J Sports Med 2022. PubMed 35228201

Wall BT, et al. 2014. Immobilization and disuse muscle atrophy (quadriceps −3.5% at 5 days, −8% at 14 days). PubMed 24168489

Gaffney CJ, et al. 2021. Grip strength loss with short-term arm immobilization. PMC8107283

Farthing JP, et al. 2009. Cross-education and preservation of the immobilized limb. PubMed 19150859

Marusic U, et al. 2021. Bed rest: strength loss outpaces size loss. PMC8325614

Yoshihara, et al. 2023. Sepsis-associated muscle wasting (−26% in a week). PMC10003568

Warren GL, et al. 2017. Strength loss and recovery after muscle injury (meta-analysis).