Attia’s Sunday newsletter of the above title is a worthwhile read for some. His closing summary captures the key point. (emphasis mine)
“Whatever underlies the decoupling of lean mass gains or preservation with apitegromab, bimagrumab, and others in their family, and whatever the fate of enobosarm as a muscle-sparing adjuvant for GLP-1-RA users, the most important intervention for building strong muscles will remain resistance training [which] also strengthens tendon and bone, which bimagrumab and apitegromab do not. And it improves metabolic health, possibly independent of the muscle gain. Muscle strength is more closely associated with risk of mortality than lean body mass or muscle volume. And whether you’re on a muscle-building drug or not, expressing strength is not just a matter of muscle mass, but of the learned skill of controlling that muscle, built one rep at a time.”
Really a great overview of this class of meds. In particular:
No functional advantage over placebo, even with diet and physical activy prescribed
myostatin inhibition acually decreases in old people, yet they are the ones at greater risk of muscle loss
Fitter and non-frail nursing home residents have higher myostatin levels than their cpunterparts. Myostatin and levels increase rather than decrease after a physical exercise program
The news is not good for some but of less concern to me even though the negative forces are with me, and growing I suppose. I thoroughly enjoy resistance training – for how it makes me feel day-to-day and the actual experience in the gym.