3rd Edition of International Obesity and Metabolism Conference 2027

Abstract

Effective obesity management with GLP-1 therapy should extend beyond total weight reduction to encompass body composition, nutritional adequacy, muscle health, and physical activity. Appetite suppression and gastrointestinal symptoms may reduce overall food and protein intake, underscoring the importance of individualized medical nutrition therapy and dietitian-led monitoring. This presentation describes two clinical cases from Hospital Putrajaya, Malaysia.

In a 29-year-old woman, weight decreased from 78.5 to 72.6 kg over five months, while body fat percentage declined from 49.1% to 43.3%. Bioimpedance-estimated skeletal muscle mass increased from 21.7 to 22.4 kg. Follow-up included protein-focused dietary counselling and encouragement of resistance and aerobic exercise. Semaglutide was initiated during the observation period.

In a 54-year-old woman receiving tirzepatide, weight decreased from 139.0 to 138.1 kg over three months, while estimated skeletal muscle mass increased from 35.0 to 35.4 kg. However, dietary assessment identified a protein intake of 28 g/day, compared with a prescribed target of 63 g/day. Individualized meal planning and supplementation advice were provided. Coexisting lymphedema and elevated extracellular water limited interpretation of the apparent increase in muscle mass.

These cases illustrate the value of integrating GLP-1 therapy with medical nutrition therapy, serial body composition assessment, and clinical interpretation of hydration status. Dietitian involvement supported the identification of nutritional inadequacies, individualized protein planning, food selection, symptom management and coordination of resistance exercise. Although both cases demonstrated favourable changes in weight and body composition, neither establishes that nutrition intervention caused muscle gain.

A multidisciplinary approach incorporating assessment of body composition, dietary intake, hydration status, and physical activity may provide a more comprehensive framework for obesity management beyond weight loss alone.