Can creatine supplements preserve muscle during weight loss?

When people with elevated weight lose weight with any currently available treatment modality (lifestyle changes, weight loss medications, or bariatric surgery), about 1/3 of the weight is lost as muscle, and 2/3 of the weight is lost as fat. If we can maintain muscle while losing fat during a weight loss journey, we might improve metabolic health and metabolism, and reduce the risk of excessive muscle loss (sarcopenia) that can happen with highly effective weight loss medications or bariatric surgery.

So, today’s question is: can creatine supplements help preserve muscle during weight loss?

First of all, what is creatine? It’s a compound naturally produced in the body and stored in muscles, where it helps generate energy during high-intensity exercise and helps increase strength and performance by increasing phosphocreatine stores. Creatine has long been a popular supplement to enhance athletic performance and strength amongst gym-goers and athletes.

Despite the online/social media hype around taking creatine during a weight loss journey, we really don’t have data to tell us whether creatine has any benefit in people with obesity who are losing weight. Studies showing benefit of creatine to muscle mass are mostly in healthy adults who are not trying to lose weight. These studies have overall shown benefit only in people who are actively engaging in resistance training, and even with resistance training, the benefit of creatine in healthy adults is small. For people who are not lifting weights or doing high-intensity exercise, creatine supplementation doesn’t appear to offer meaningful benefits.

Note that creatine does not:

Directly burn fat
Suppress appetite
Improve body composition (fat vs muscle) in sedentary individuals

It’s also important to note that creatine may cause temporary water retention, which can lead to a slight increase on the scale – something to keep in mind if you’re tracking weight closely.

BOTTOM LINE: Currently, there isn’t evidence to support a role for creatine supplements during a weight loss journey. The small benefit of creatine to muscle mass in people lifting weights or doing high-intensity training has been shown in people who are not actively losing weight, and has not been adequately studied in people with obesity who are losing weight. Regardless of whether you’re on a weight loss journey or not, it is clear that any benefit of creatine requires lifting weights or doing high intensity exercise. To preserve muscle during weight loss, focus on physical activity (a combination of resistance and aerobic activity), and ensuring that you are getting adequate protein intake. Ask your health care team to help you set up a physical activity and nutrition program that’s right for you!

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