this is likely incorrect because people are confusing lean body weight loss for muscle loss. lean body weight loss does not mean only muscle loss. lean weight includes non muscle like skin, organs, etc.

Drugs that target the GLP-1 and GIP pathways can suppress appetite, potentially leading to a significant caloric deficit.

This can lead to the body to break down muscle tissue to obtain protein for energy which could lead to a loss of lean muscle mass

However, maintaining regular exercise and consuming sufficient protein can help to minimize the impact of lean muscle mass loss

Protein is not what the body reaches for first in the absence of glucose/glycogen.

This is true but it's still extremely well established that you lose some muscle along with fat if you're in a prolonged caloric deficit without sufficient protein and strength training.

not just lost muscle mass, but also lost organ mass?

If that means visceral fat then it would be a godsend.

Obese people do not have enough muscle mass for 2/3 of their weight loss to be muscle

Obese people can actually be pretty muscular in my experience, due to their need to heft around their size. It's their endurance that isn't there since their hearts are quite weak.

It still won't get you to the 2/3 point making sense. If someone is 250 lbs and 35% BF and they lost 50 lbs, 2/3 of which was lean, they'd end up 200 lbs and 35.5% BF. That's possible, but I don't know if anyone would be recommending it at that point.

Peter Attia made a video recently using precisely that observation as the reason he avoids prescribing it except as a last resort, and only then when he can get patients to increase their protein intake and start strength training while getting a DEXA before and after to keep track of the relative changes in body fat percentage.

The problem is apparently that studies only use change in weight instead of body composition, so doctors have to be aware of that and get the patient measured themselves to make sure they're actually getting leaner instead of losing weight but getting "more obese".

> The problem is apparently that studies only use change in weight instead of body composition

Misinformation. Many of the studies track total fat, lean body mass, visceral fat, and literally dozens of other secondary outcomes/endpoints. See an example of such results here: https://clinicaltrials.gov/ct2/show/results/NCT03548935

This has already been covered yesterday in sibling comments about the NCT03548935 study and Peter Attia being in general a source of misinformation.

Here are some other semaglutide studies which track lean body mass specifically: https://clinicaltrials.gov/ct2/results?cond=Semaglutide&term...

In an actual study of this with published results on clinicaltrials.gov …

Semaglutide users lost 16% bodyweight overall but only 3.4% of their lean mass.

This is study NCT03548935 if you’d like to look it up, there are other statistics of interest in it as well.

That’s not what the research says though. Just FUD that some influencers like Attia are spreading for some reason.

the reason is to buy diet programs and coaching, this drug threatens their business model.

Yeah that was some dude on TikTok selling some diet scam stuff saying that. Or at least that’s where I saw it.

I don’t have any quantifiable data, but although I’m certain the majority of the weigh has been fat, I’m sure I’ve lost quite a bit of muscle too.