Whole-Body electromyostimulation (EMS- Training) is more than just a trend – it is a revolutionary technology that offers medical, sports and commercial facilities the opportunity to provide their customers and patients with effective and time-saving options for training, prevention and therapy.
We understand the special requirements that come with using EMS technology and support operators of EMS-Studios, physiotherapy practices, rehabilitation centres and wellness facilities in optimising their services.
Find out everything you need to know as an operator to successfully implement EMS-Training in your facility. Our platform offers you a comprehensive overview of a future-oriented technology that is having a lasting impact on the health market.
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The combination of GLP-1 ‘weight loss injections’ and whole-body electro-muscle stimulation (WB-EMS) offers a time-saving solution for weight loss and maintaining muscle mass. Discover how these approaches work synergistically to enable sustainable body optimisation.
The global trend for GLP-1 (Glucagon-Like Peptide-1) receptor analogues and their use, known as ‘injection slimming’, is gaining momentum and revolutionising the weight loss landscape.
Originally developed to treat diabetes, these injectable drugs are increasingly being used as an effective method for rapid weight loss. However, despite the impressive success in reducing body weight, there are also critical voices that point to negative and/or counterproductive side effects such as the pronounced loss of fat-free and muscle mass. To counteract this effect, whole-body electrical muscle stimulation (EMS) is emerging as a complementary solution. Both methods appeal to the same target group: people who are looking for efficient, time-saving solutions for body optimisation. Both GLP-1 and EMS offer fast and visible results without the high time commitment of traditional diets or intensive training protocols. They are particularly appealing to individuals who want to improve their physical health and aesthetics, but who also want to use convenient, modern technologies to achieve their goals as efficiently as possible. The combination of both methods could therefore be particularly attractive for people who, in addition to sustainable weight reduction through maintaining or building muscle mass, also have muscle strength and function in mind.
The number of obese people is increasing worldwide
Almost one billion people worldwide are obese (BMI > 30 kg/m2); this number is expected to double by 2035 [1]. According to low estimates, the prevalence of obesity in Germany in 2022 was around 11% of the German population. The incidence of obesity increases with age, peaking after the age of 70 (Gesundheitsatlas Deutschland, published by the AOK's scientific institute). Obesity is known to be a key risk factor for conditions including high blood pressure, dyslipidaemia, type 2 diabetes mellitus, cardiovascular disease and various cancers and tumours [2-5]. A new drug therapy option for the treatment of obesity is glucagon-like peptides-1 receptor agonists (GLP-1 RA). GLP-1 RA were originally developed for the treatment of type 2 diabetes mellitus, where they play an important role. Due to their pronounced effect on the reduction of body mass, GLP-1 RA are becoming increasingly relevant for weight management in overweight and obese individuals. Active ingredients of this substance class, such as semaglutide (e.g. ‘Wegovy®’ Ozempic®) or tirzepatide (Mounjaro), which has a dual mechanism of action on the receptors of GLP-1 and GIP (glucose-dependent insulinotropic peptide) , show a weight loss of about 15% (semaglutide; STEP-1, [6]) and about 20% (tirzepatide, SURMOUNT-1, [7]) in clinical trials, i.e. in the range of bariatric surgery.
Rebound effect after weight loss
However, after discontinuing pharmacological therapy, there is a pronounced rebound effect with a rapid increase in body weight (STEP-4 [8], SURMOUNT-4 [9]), so that the drug must probably be used for life to maintain (or further reduce) body weight. A central mechanism of action of the substances plays an important role in this development. GLP-1/GIP RA reduce hunger, but not eating behaviour. An important aspect also remains mostly unmentioned: weight reduction is generated not only by a loss of fat mass but also to a very significant extent by a loss of lean body mass (LBM). The STEP-1 study (semaglutide) showed a weight loss of 15.3 kg with a reduction in LBM of almost 7 kg (45%). The proportion of LBM in weight loss with tirzepatide (SURMOUNT-1) is approximately 26 %. In both cases, the reference standard [10] was Dual Energy X-Ray Absorptiometry (DXA) and is therefore considered reliable.
Now, the fat-free mass is not directly equivalent to muscle mass, but is composed of several tissue types such as skin, bones, organs, blood vessels, etc. Adipose tissue also contains fat-free components (approx. 15 %), so that a fat reduction is generally accompanied by a reduction in fat-free mass. While about two-thirds of the reduction in fat-free mass can be explained by the loss of muscle mass [11], significant reductions have also been reported for the highly metabolically active organs (e.g. liver, kidney, heart), which are reflected in a significant reduction in resting energy expenditure (REE) [11]. Since the REE, at least in non-athletic collectives and depending on physical activity, determines 60-80% of total energy expenditure, maintaining muscle mass, which determines a relevant proportion of resting energy expenditure, is of central importance for avoiding a positive energy balance through unchanged dietary behaviour after GLP-1/GIP RA therapy.
Physical training as a solution
Various pharmacological therapy concepts for maintaining muscle mass during weight loss, which would also have to be applied consistently over the course of a lifetime, are currently in development but have yet to prove their effectiveness and safety. If we consider the parallel development in the field of ‘sarcopenia’, a safe pharmacological solution to this problem is not in sight in the foreseeable future. In contrast, maintaining lean body mass through physical training, ideally with the addition of protein or amino acids, has been shown to be effective even in the case of diet-induced energy deficiency [12, 13]. In addition, physical training, in contrast to pharmacological therapy (which may come at any time), also improves muscle strength and function, which is a unique selling point, especially for older people, the population group with the highest prevalence of obesity.
The same applies to the time-effective and joint-sparing training technology ‘whole-body electromyostimulation’ (WB-EMS). Here, too, longitudinal studies conducted under energy restriction over 16-26 weeks with and without protein supplementation show positive effects of WB-EMS application on the maintenance of muscle mass and function with simultaneous significant weight reduction [14, 15].
In conclusion, it can be said that physical training during and after GLP-1/GIP RA therapy is an absolute must. The combination with whole-body electric muscle stimulation (WB-EMS) is a perfect, target group-oriented solution for people who are looking for an effective, time-saving and holistic method for body optimisation. While GLP-1/GIP RA therapy specifically promotes the reduction of body fat, WB-EMS can ensure that the muscles are maintained and even strengthened, preventing the dreaded muscle loss during weight loss. This synergy not only enables a slimmer silhouette, but also a firmer and stronger body structure, as well as an improvement in health-related parameters and everyday competence.
For people who have little time or enthusiasm for extensive training programmes or complicated diets in their daily lives, the combination of both approaches offers a particularly attractive solution. It combines medical advances with innovative training technology to achieve fast, visible results without neglecting long-term health and physical stability. This creates a holistic approach that is specifically tailored to the needs of a modern, health-conscious target group.
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Electromyostimulation (EMS) uses electrical impulses to achieve targeted muscle contraction. From its historical use by Luigi Galvani to modern whole-body EMS, the method combines science and efficiency. It enables intensive, time-saving training by activating all major muscle groups and is used in both competitive sports and rehabilitation.
Electrical stimulation of the musculature leads to an involuntary contraction of the activated muscle fibres. Luigi Galvani already recognised this connection in the 18th century in his early experiments on frog legs. Among other things, he used the electricity from lightning strikes to cause the frog's muscles to contract (Bresadola, 1998). He connected the nerve fibres of the frog's legs to a kind of lightning conductor. Fortunately, today's form of EMS training no longer relies on the electric arcs between clouds and the earth, which have an electrical energy of several billion joules.
The first mechanical power generators designed in the 19th century to control local muscle areas are still used today as a model for modern electrostimulation. After the turn of the century, renowned researchers established the basic laws of electrostimulation with their studies on the effect on the nervous and muscular system and the definition of a terminology for electrostimulation.
Effectiveness based on physiological muscle contraction
The striated skeletal musculature ensures the supportive and targeted motor skills of humans. In contrast to smooth muscles, their contraction occurs arbitrarily via a cerebrospinal nerve impulse. This is transmitted as an action potential from the central nervous system via the spinal cord and nerve fibres to the α-motoneurons. The action potential triggers the release of the neurotransmitter acetylcholine at the motor end plates of the muscle fibres belonging to the respective α-motor neuron (motor unit). Acetylcholine binds to its receptors on the postsynaptic membrane and leads to the opening of voltage-dependent calcium channels via an end plate/action potential, thus triggering the contraction. The contraction occurs through the interaction of the myofilaments actin and myosin, which, by ‘sliding past’ each other, cause a shortening of the sarcomeres (the smallest contractile unit of the muscle) and, in the overall process, a muscle contraction [1, 2].
Whole-body electromyostimulation (EMS) is also based on triggering muscle contraction via an electrical impulse. This impulse is transmitted externally via electrodes attached to the trunk and proximal extremities. The electrical impulses emitted are low-frequency (usually 85 Hz), trigger a brief muscle twitch and, through repeated delivery of the electrical impulses, lead to a contraction of the affected muscle [3]. EMS training is customised for each individual and carried out in a 20-minute session once a week (maximum every 4 days) under personal supervision (1:1, maximum 1:2). At the beginning of the application, the individual intensity tolerance of the pulse strength must be identified and gradually approached.
The modern form of electrotherapy
Electromyostimulation has been used for many years in training and competitive sports, as well as locally in rehabilitative and physical therapy. In contrast to local application, in which the coordinative stimulus is missing and the trained strength can only be implemented with difficulty in everyday life, whole-body EMS training combines externally triggered muscle contraction with voluntary muscle contractions. The additional exercises can be performed isometrically or dynamically and increase the effectiveness of the method [3]. In this way, whole-body EMS makes use of advantageous elements from conventional electromyostimulation and combines them into an innovative concept as a whole-body measure: by simultaneously activating agonists, antagonists and deeper muscle groups, the musculature can be trained more intensely and with greater endurance. Activating all the major muscle groups prevents one-sided strain and muscular imbalances, and offers an effective and time-saving way of building muscle and stabilising the musculoskeletal system for both prevention and therapy.
Weissenfels A et al. Comparison of Whole-body electromyostimulation versus recognized back-strengthening exercise training on chronic nonspecific low back pain: a randomized controlled study.” Biomed Res Int 2019: 5745409.
Konrad KL et al. The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain – a prospective clinical intervention study. PLoS ONE 2020; 15(8): e0236780.
Kemmler W et al. Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults. A Systematic Review. Front Physiol 2018; 9: 573.
Kemmler W et al. Whole-body electromyostimulation to fight sarcopenic obesity in community-dwelling older women at risk. Results of the randomized controlled FORMOsA-sarcopenic obesity study. Osteoporos Int. 2016; 27:3261-3270
Kemmler W, von Stengel S. Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TEST-III trial. Clin Interv Aging. 2013; 8:1353-1364
Teschler M et al. Four weeks of electromyostimulation improves muscle function and strength in sarcopenic patients: a three‐arm parallel randomized trial. J Cachexia Sarcopenia Muscle. 2021; 12:843-854
Kemmler W et al. Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults. A Systematic Review. Front Physiol. 2018; 9:573
Kemmler W, Schliffka R, von Stengel S. Effects of whole-body electromyostimulation on resting metabolic rate, body composition, and maximum strength in postmenopausal women: the Training and ElectroStimulation Trial. J Strength Cond Res. 2010; 24:1880-1887
Paillard T. Muscle plasticity of aged subjects in response to electrical stimulation training and inversion and/or limitation of the sarcopenic process. Ageing Research Reviews. Ageing Res Rev. 2018; 46:1-13
Kemmler W et al. Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults, A Systematic Review. Front Physiol 2018; 9: 573.
Paillard T: Training Based on Electrical Stimulation Superimposed Onto Voluntary Contraction Would be Relevant Only as Part of Submaximal Contractions in Healthy Subjects, Front. Physiol. 2018; 9: 1428.
Seyri K, Maffiuletti N: Effect of Electromyostimulation Training on Muscle Strength and Sports Performance, Strength and Conditioning Journal 2011; 33: 70-75
Paillard T: Training Based on Electrical Stimulation Superimposed Onto Voluntary Contraction Would be Relevant Only as Part of Submaximal Contractions in Healthy Subjects. Front. Physiol. 2018; 9: 1428.
Seyri K, Maffiuletti N: Effect of Electromyostimulation Training on Muscle Strength and Sports Performance. Strength and Conditioning Journal 2011; 33: 70-75
Wirtz N, Zinner C, Dörmann U, Kleinöder H, Mester J: Effects of Loaded Squat Exercise with and without Application of Superimposed EMS on Physical Performance. Journal of Sports Science and Medicine 2016; 15: 26-33
Kemmler, Wolfgang & Teschler, Marc & Bebenek, Michael & Stengel, Simon. (2015). (Very) high Creatinkinase concentration after exertional whole-body electromyostimulation application: health risks and longitudinal adaptations. Wiener medizinische Wochenschrift (1946). 165. 10.1007/s10354-015-0394-1.
Kemmler W, Fröhlich M, Ludwig O, Eifler C, Von Stengel S, Willert S, Teschler M, Weissenfels A, Kleinöder H, Micke F, Wirtz N, Zinner C, Filipovic A, Wegener B, Berger J, Evangelista A, D’ottavio S, Sara JDS, Lerman A, Perez De Arrilucea Le Floc’h UA, Carle-Calo A, Guitierrez A and Amaro-Gahete FJ (2023) Corrigendum: Position statement and updated international guideline for safe and effective whole-body electromyostimulation training-the need for common sense in WB-EMS application. Front. Physiol. 14:1207584. doi: 10.3389/fphys.2023.1207584
Kemmler W, Fröhlich M, Ludwig O, Eifler C, Von Stengel S, Willert S, Teschler M, Weissenfels A, Kleinöder H, Micke F, Wirtz N, Zinner C, Filipovic A, Wegener B, Berger J, Evangelista A, D’ottavio S, Sara JDS, Lerman A, Perez De Arrilucea Le Floc’h UA, Carle-Calo A, Guitierrez A and Amaro-Gahete FJ (2023) Corrigendum: Position statement and updated international guideline for safe and effective whole-body electromyostimulation training-the need for common sense in WB-EMS application. Front. Physiol. 14:1207584. doi: 10.3389/fphys.2023.1207584
Verordnung zum Schutz vor schädlichen Wirkungen nichtionsierender Strahlung bei der Anwendung am Mensche (NiSV). Bundesgesetzblatt Jahrgang 2018 Teil I Nr. 4, ausgegeben zu Bonn am 5. Dezember 2018.
DIN 33961-5:2023-09 Fitness club - Requirements for equipment and operation - Part 5: Electromyostimulation training (EMS-Training)
Kemmler W, Fröhlich M, Ludwig O, Eifler C, Von Stengel S, Willert S, Teschler M, Weissenfels A, Kleinöder H, Micke F, Wirtz N, Zinner C, Filipovic A, Wegener B, Berger J, Evangelista A, D’ottavio S, Sara JDS, Lerman A, Perez De Arrilucea Le Floc’h UA, Carle-Calo A, Guitierrez A and Amaro-Gahete FJ (2023) Corrigendum: Position statement and updated international guideline for safe and effective whole-body electromyostimulation training-the need for common sense in WB-EMS application. Front. Physiol. 14:1207584. doi: 10.3389/fphys.2023.1207584
Empfehlung der Strahlenschutzkommission mit wissenschaftlicher Begründung: Anwendungen elektrischer, magnetischer und elektromagnetischer Felder (EMF) zu nichtmedizinischen Zwecken am Menschen. Verabschiedet im Umlaufverfahren am 12. August 2019, Bekanntmachung im BAnz AT 04.03.2020 B6
Jaskanwal Deep Singh Sara, Nazanin Rajai, Ali Ahmad, Logan Breuer, Thomas Olson, Wolfgang Kemmler, Takashi Nagai, Nathan Schilaty, Amir Lerman, "Physical training augmented with whole body electronic muscle stimulation favorably impacts cardiovascular biomarkers in healthy adults – A pilot randomized controlled trial," International Journal of Cardiology, Volume 419, 2025, 132706, ISSN 0167-5273,
The ICNIRP limits are recognised worldwide as guidelines for exposure to electromagnetic fields and are used in many countries and regions as a basis for national and international regulations. Whole-body EMS devices require higher field strengths and must exceed the ICNIRP limits to be effective. Therefore, they cannot be offered as consumer products because they do not meet basic requirements for product safety. The safety of the devices must therefore be proven by meeting medical technology standards and the devices must be certified accordingly.
Due to the way they work (electrical muscle stimulation), EMS devices also fall under Appendix 1 of the MPBetreibV and are therefore to be considered legally as medical devices, regardless of their intended use. This means that they are subject to the strict requirements of the Medical Device Directive and must be tested and labelled accordingly in order to be placed on the market and operated.
In the USA, EMS devices, regardless of their area of application, must be approved by the FDA. Manufacturers are required to provide strict safety, performance and efficacy evidence. This applies to medical as well as fitness and wellness applications.
ICNIRP Guidelines: Guidelines for Limiting Exposure to Electromagnetic Fields (2000, 2010, 2020).
European Directive: Directive 2013/35/EU on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (electromagnetic fields).
General Product Safety Directive: Directive 2001/95/EC on general product safety.
German Medical Device Operating Regulation: MPBetreibV, Annex 1 (Germany).
EU Medical Device Regulation: Regulation (EU) 2017/745 (Medical Device Regulation – MDR).
FDA Guidance Document: Class II Special Controls Guidance Document: Electrical Muscle Stimulators.
FDA 510(k) Process: Premarket Notification Requirements.