Evidence map›Paper›PMID 43003902›Full record

ArticleNature medicine2026

Resistance exercise to attenuate lean mass loss during tirzepatide therapy for obesity: a randomized controlled trial.

Daniel J Green, Andrew Haynes, Destiny R Underwood, Evangeline R Winterton, Abbey A Green, Robin M Daly, Elena S George, Leanne Lester, Louise H Naylor, Graham S Hillis and 2 more

Abstract read
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Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Daniel J GreenSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia. danny.green@uwa.edu.au.ORCID http://orcid.org/0000-0003-3226-2921
Andrew HaynesSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0001-7312-8265
Destiny R UnderwoodSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
Evangeline R WintertonSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
Abbey A GreenSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
Robin M DalyDeakin Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
Elena S GeorgeDeakin Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
Leanne LesterThe Healthspan Institute, University of Western Australia, Perth, Western Australia, Australia.
Louise H NaylorSchool of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
Graham S HillisMedical School, University of Western Australia, Perth, Western Australia, Australia.
P Gerry FeganThe Healthspan Institute, University of Western Australia, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0001-8100-6209
Bu B YeapThe Healthspan Institute, University of Western Australia, Perth, Western Australia, Australia. bu.yeap@uwa.edu.au.ORCID http://orcid.org/0000-0002-7612-5892

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Incretin mimetics as obesity therapy induce substantial weight and fat loss but also decrease lean soft tissue mass, possibly impairing skeletal muscle function. Here, in this two-arm randomized controlled trial of adding resistance exercise (REx) to tirzepatide (T), 120 adults with overweight or obesity were treated with tirzepatide and randomized to thrice-weekly resistance exercise training or usual activities for 40 weeks. Tirzepatide was safe, and most participants tolerated up-titration to 15 mg weekly. Adherence to resistance exercise was 91%. Weight loss achieved was similar (T = -22.61 kg, T+REx = -22.28 kg, P = 0.694). For primary outcomes, loss of total fat mass was similar (T = -17.19 kg, T+REx = -17.98 kg, P = 0.700; between-group difference = -0.77 kg, 95% confidence interval (CI): -2.14 kg to 0.60 kg), but resistance exercise reduced loss of total lean soft tissue mass (T = -4.67 kg, T+REx = -3.57 kg, P < 0.001; between-group difference = 1.09 kg, 95% CI: 0.43-1.75 kg). For related endpoints, resistance exercise reduced loss of appendicular lean soft tissue mass (T = -3.55 kg, T+REx = -2.92 kg, P < 0.001). Upper and lower body muscle strength decreased with tirzepatide (bench press -4.09 kg, lat pulldown -4.42 kg, knee extension -4.42 kg) but increased with T+REx (+4.68 kg, +8.58 kg, +5.88 kg, respectively, all P < 0.001 versus tirzepatide). In conclusion, resistance exercise training attenuated loss of total lean soft tissue mass, representing an effective adjunct to tirzepatide anti-obesity therapy. Australian New Zealand Clinical Trials Registry identifier: ACTRN12623001236684 .

Identifiers

PMID43003902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.