Injectable D-Ribose as a Metabolic Support Strategy in Patients Undergoing Rapid Weight Loss Induced by GLP-1 Receptor Agonists

The increasing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide, liraglutide and tirzepatide, has significantly improved weight loss outcomes in patients with obesity and metabolic disorders. However, rapid weight reduction may be associated with loss of lean body mass, fatigue and symptoms related to reduced cellular energy availability. D-ribose, a naturally occurring pentose involved in the synthesis of adenine nucleotides, plays a key role in the formation of adenosine triphosphate (ATP), the primary cellular energy molecule. In conditions characterized by energetic depletion, D-ribose supplementation has been proposed as a metabolic support strategy to accelerate ATP resynthesis and improve cellular energy balance. This narrative review aims to analyze the biochemical rationale and potential clinical applications of D-ribose, particularly in injectable form, as an adjunctive strategy in patients undergoing rapid weight loss associated with GLP-1 receptor agonist therapy. Available evidence suggests that D-ribose may contribute to improved energy metabolism, reduced fatigue and enhanced mitochondrial function in conditions associated with ATP depletion. Although most studies involve oral supplementation, injectable administration may theoretically provide faster systemic availability. Further clinical studies are required to evaluate the safety, efficacy and therapeutic relevance of injectable D-ribose in patients undergoing rapid pharmacologically induced weight loss. Objective: he aim of this study is to review the biochemical rationale and current scientific evidence regarding the potential role of D-ribose as a metabolic support strategy for cellular energy recovery in patients undergoing rapid weight loss associated with GLP-1 receptor agonist therapy. Conclusion: The available evidence suggests that D-ribose presents a consistent biochemical rationale as a metabolic support strategy in conditions associated with cellular energy depletion. In patients undergoing rapid weight loss induced by GLP-1 receptor agonists, D-ribose may represent a promising adjunctive approach to support mitochondrial function, improve energy metabolism and potentially mitigate symptoms of fatigue and reduced physical performance. However, controlled clinical trials are required to validate the efficacy and safety of injectable D-ribose in this specific clinical context.