DUAL GIP/GLP-1 AGONISM AND LEAN MASS PRESERVATION: AN INTEGRATIVE REVIEW OF TIRZEPATIDE AND A PROPOSED AMAZONIAN DIETARY MODEL
DOI:
https://doi.org/10.56238/revgeov17n3-035Keywords:
Body Composition, Lean Mass, Obesity, Tirzepatide, Nutritional InterventionAbstract
Tirzepatide, a dual GIP and GLP-1 receptor agonist, represents a significant therapeutic advance in the management of obesity and type 2 diabetes mellitus, promoting substantial weight reduction with a predominant impact on visceral fat. However, evidence indicates concomitant loss of lean body mass during treatment, which may compromise basal metabolic rate and the long-term sustainability of clinical outcomes. This study aims to analyze the effects of tirzepatide on body composition, with emphasis on lean mass preservation, and to propose an Amazonian Dietary Model adapted to regional specificities. This is an integrative literature review, including randomized clinical trials and systematic reviews published between 2021 and 2026. Findings indicate that the quality of weight loss depends on adequate protein intake and structured nutritional intervention. The proposed model operationalizes protein targets consistent with scientific recommendations, incorporating regional food sources and contributing to functional and metabolic preservation during pharmacological therapy.
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References
BROWN, A. Nutritional guidance gaps during GLP-1 receptor agonist therapy: preserving lean mass and parallels with bariatric surgery. International Journal of Obesity, 2025. Disponível em: https://www.repository.cam.ac.uk/bitstreams/57395f7e-a78f-4525-bd93-940dfa3ce76b/download. Acesso em: 12 fev. 2026.
CARIOU, B. Effect of tirzepatide on body fat distribution pattern in people with type 2 diabetes. Diabetes, Obesity and Metabolism, 2024. Disponível em: https://www.sochob.cl/web1/wp-content/uploads/2024/05/Effect-of-tirzepatide-on-body-fat-distribution-pattern-in-people-with-type-2-diabetes.pdf. Acesso em: 12 fev. 2026.
COSTA, L. M. et al. Selenium bioavailability from Brazil nuts: implications for antioxidant status and thyroid function. Nutrients, 2021. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC9498495/. Acesso em: 18 fev. 2026.
JOHNSON, B. Dietary supplement considerations during glucagon-like peptide-1 receptor agonist treatment: a narrative review. 2025. Disponível em: https://www.sochob.cl/web1/wp-content/uploads/2025/09/Dietary-supplement-considerations-during-glucagon-like-Peptide-1-receptor-agonist-treatment-A-narrative-review.pdf. Acesso em: 12 fev. 2026.
LOOK, M. Body composition changes during weight reduction with tirzepatide: DXA substudy of SURMOUNT-1. Diabetes, Obesity and Metabolism, 2025. Disponível em: https://dom-pubs.onlinelibrary.wiley.com/doi/pdf/10.1111/dom.16275. Acesso em: 12 fev. 2026.
MALHOTRA, A. Tirzepatide for the treatment of obesity and obstructive sleep apnea. New England Journal of Medicine, 2024. Disponível em: https://mediacenteratypon.nejmgroup-production.org/NEJMoa2404881.pdf. Acesso em: 12 fev. 2026.
OLIVEIRA, R. S. et al. Polyphenolic profile and antioxidant potential of Amazonian fruits: implications for cardiometabolic health. Food Research International, 2023. Disponível em: https://www.sciencedirect.com/science/article/pii/S240584402309268X. Acesso em: 18 fev. 2026.
ROCHIRA, V. The effect of tirzepatide on body composition in people with overweight and obesity: a systematic review of randomized controlled studies. Diseases, 2024. Disponível em: https://www.sochob.cl/web1/wp-content/uploads/2024/09/The-Effect-of-Tirzepatide-on-Body-Composition-in-People-with-Overweight-and-Obesity-A-Systematic-Review-of-Randomized-Controlled-Studies.pdf. Acesso em: 12 fev. 2026.
SATTAR, N. SURPASS-3 MRI substudy: supplementary appendix on body composition outcomes. The Lancet Diabetes and Endocrinology, 2025. Disponível em: https://eprints.gla.ac.uk/347387/2/347387Suppl.pdf. Acesso em: 12 fev. 2026.
SILVA, M. P. et al. Nutritional composition and lipid profile of Amazonian freshwater fish species. Journal of Food Composition and Analysis, 2022. Disponível em: https://www.researchgate.net/publication/376481801_Lipid_quality_of_Amazonian's_native_fish_overview_and_market_outlook_of_Brazilian_fish_farming. Acesso em: 18 fev. 2026.
SPRECKLEY, M. Lean mass preservation and protein intake strategies during GLP-1 based pharmacotherapy. BMJ Nutrition, Prevention and Health, 2025. Disponível em: https://nutrition.bmj.com/content/early/2025/03/02/bmjnph-2025-001206.full.pdf. Acesso em: 12 fev. 2026.
WARDEH, R. Tirzepatide as a dual GIP and GLP-1 receptor agonist in diabetes and obesity: metabolic implications. Hormone and Metabolic Research, 2024. Disponível em: https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0043-1775966.pdf. Acesso em: 12 fev. 2026.