Changes in Muscle Strength Following Semaglutide Treatment in Adults: A Systematic Review With Meta-Analysis of Handgrip Strength.
Semaglutide: What Happens to Muscle Strength? Not Much, For Now
Diabetes Obes Metab
by Machado LG, Siedschlag Schmidt PH, Tasca Petroski G et al.
“Changes in Muscle Strength Following Semaglutide Treatment in Adults: A Systematic Review With Meta-Analysis of Handgrip Strength. Machado LG(1), Siedschlag Schmidt PH(1), Tasca Petroski G(1), Lopes Costa GL(1), Vieira Dos Santos Ribeiro L(1), Ramos Da Cruz JV(1), De Luca Canto G(2), Hohl A(1), Ronsoni MF(1), van de Sande-Lee S(1). Author information: (1)Department of Medicine, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil. (2)Postgraduate Program in Evidence-Based Health, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, São Paulo, Brazil. AIMS: To systematically review and quantitatively synthesize within-group changes in skeletal muscle strength following semaglutide treatment in adults. MATERIALS AND METHODS: This PRISMA 2020 systematic review was registered in PROSPERO (CRD420251185935). MEDLINE, Embase, CENTRAL, LILACS and Google Scholar were searched through 20 August 2026, without language restrictions. Eligible studies included adults treated with semaglutide reporting quantitative skeletal muscle strength outcomes, including handgrip and knee extension strength. Randomized, non-randomized and uncontrolled before-after studies were included. The primary meta-analysis pooled within-group changes in handgrip strength from baseline to the longest available follow-up of semaglutide-only arms using a random-effects model. Knee extension strength was summarized descriptively. RESULTS: Sixteen reports represented eleven studies, all assessing handgrip strength; one small randomized trial also assessed knee extension strength. Ten studies (660 semaglutide-treated participants) contributed to the primary meta-analysis of uncontrolled within-group changes, showing a nonsignificant pooled handgrip strength change (-0.16 kgf; 95% confidence interval: -1.98 to 1.65), with substantial heterogeneity (I2 = 90.8%) and a 95% prediction interval from -5.96 to 5.63 kgf. Duration-stratified and sensitivity analyses were also nonsignificant. Individual study findings were heterogeneous. Certainty was very low. CONCLUSIONS: Available evidence is insufficient to determine whether semaglutide is associated with changes in handgrip strength because the principal synthesis was based on uncontrolled within-group changes, with very low certainty and significant heterogeneity. These findings do not establish strength preservation or a causal treatment effect. More robust comparative studies with standardized strength assessment and longer follow-up are needed. © 2026 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.”
Researchers just dug through every published study they could find on semaglutide and muscle strength in adults. Their focus: does semaglutide change handgrip or knee extension strength? Turns out, the answer is still up in the air.
This new systematic review and meta-analysis pooled data from eleven studies, most looking at handgrip strength before and after semaglutide treatment. Over 660 participants were included. The big result: the change in handgrip strength was basically a flat line—an average of -0.16 kgf, with a confidence interval so wide (-1.98 to 1.65 kgf) you could drive a truck through it. Translation: no clear effect, positive or negative. Individual studies were all over the place, and the overall certainty of the evidence was low.
Key takeaway:
No solid evidence yet that semaglutide affects muscle strength, at least as measured by handgrip.
Only one small trial looked at knee extension, so there’s not much to say there either.
Why does this matter? Researchers and practitioners have debated whether compounds like semaglutide—popular for weight management research—might cause muscle loss or weakness alongside fat loss. For now, the answer is “maybe, maybe not.” The data just isn’t strong enough to call it either way.
The authors call for better-designed studies, with consistent strength tests and longer follow-up. If you’re running experiments, standardizing your assessments could push the field forward.
Looking to set up your own trial or source compounds for research? Check out the vendor directory.
Bottom line: don’t expect big changes in muscle strength from semaglutide—at least not based on current evidence. The door is still wide open for more research.
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