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Life sciences · Journal article
Revista Fisio&terapia. · October 23, 2026
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Tirzepatide, a dual GLP-1 and GIP receptor agonist, has revolutionized the pharmacotherapy of obesity by promoting rapid and substantial weight loss. However, robust clinical trials (the SURMOUNT program) reveal that 25% to 40% of the lost body mass may consist of lean body mass (LBM), leading to secondary sarcopenia and a decline in the basal metabolic rate. Concurrently, pronounced hypophagia, delayed gastric emptying, and the depletion of glycogen stores impose severe bioenergetic and hemodynamic limitations on exercise. This article presents a 12-week block periodization model—grounded in neuromechanical and metabolic evidence—specifically designed to mitigate the loss of muscle protein and ensure digestive and vascular tolerance in individuals using tirzepatide. The protocol is structured into three mesocycles: Structural Accumulation (60%–70% of 1RM), Mechanical Tension and Muscle Retention (70%–80% of 1RM), and Neural Consolidation (75%–85% of 1RM). These are integrated with scheduled active deloads, strict management of proximity to failure (1–2 repetitions in reserve, or RIR), and controlled time-under-tension. It is concluded that high-mechanical-tension stimuli, combined with moderate volume and extended rest intervals, preserve the myofibrillar pool without triggering hypercortisolemia or adverse gastrointestinal symptoms.