Are GLP-1 Medications Safe for Polio Survivors?

Question: For the past 12 months, I have been taking Mounjaro for type 2 diabetes and weight loss. I am 69 years old, have post-polio syndrome, and weigh 215 lbs., down from a maximum of about 250 lbs. My objective is to reduce my weight to around 180. I have felt better in general from taking the weight loss drug, and my rate of falls has decreased significantly.

At my last appointment with my weight-loss doctor, testing indicated that I had lost about 15 pounds of muscle mass. The doctor’s suggestion was to increase my protein intake and exercise. They suggested swimming and resistance training. I have seen a physical therapist regarding exercise and am careful about how much I exercise to avoid overdoing it. My A1C has recently been reduced to the high end of normal. However, the loss of muscle mass has me concerned.

Answer from Daniel Ryan, MD: Congratulations on your impressive weight loss, the improvement in your A1C, and the significant reduction in falls. These are meaningful achievements that reflect your dedication and likely contribute to you feeling better overall.

Regarding your question about the use of GLP-1 receptor agonists like Mounjaro (tirzepatide) in post-polio patients, I am not aware of any specific studies examining these weight loss medications in individuals with a history of polio or post-polio syndrome. The available research on these drugs has generally focused on broader populations with obesity and/or type 2 diabetes, without targeted analysis in neuromuscular conditions like post-polio syndrome.

As you noted, rapid weight loss—regardless of the method—commonly leads to an initial loss of lean muscle mass before fat loss predominates. This can be minimized in any patient by ensuring adequate protein intake (typically 1.2–1.6 g/kg body weight daily, adjusted for kidney function) and incorporating resistance/strength training. There are several phone apps that are very helpful in tracking protein, carbohydrates, and fats. In post-polio patients, we must be particularly cautious to avoid overuse weakness, where excessive exercise can temporarily worsen neuromuscular fatigue. Your approach of working closely with a physical therapist is excellent—gentle, progressive resistance training and swimming/aquatic exercise (which reduces joint loading while providing resistance) are often ideal choices.

At age 69 with obesity, it’s also reasonable to consider whether low testosterone could be contributing to muscle loss or difficulty maintaining strength. If not already evaluated, you might discuss this with your primary physician, who could refer you to a urologist experienced in men’s health or an endocrinologist for appropriate testing and management if indicated.

Some patients and clinicians have explored creatine monohydrate supplementation (typically 3–5 g daily) to support muscle strength and function, with a generally favorable safety profile. However, this should only be considered after discussion with your primary care physician to ensure it aligns with your overall health and medications.

Your progress is encouraging, and continuing to balance weight loss benefits with muscle preservation through nutrition, carefully tailored exercise, and medical oversight appears to be the best path forward.

Post-Polio Health (Vol. 42, No. 1, Winter 2026)