While semaglutide has revolutionized weight management in clinical practice, emerging evidence reveals a concerning pattern: patients lose significantly more lean mass than those following diet-only interventions. Clinical trials from the STEP 1 protocol demonstrate that 40% of semaglutide-induced weight loss comes from lean muscle, compared to the expected 25% seen with caloric restriction alone. This divergence raises important questions about long-term metabolic health and functional capacity in patients undergoing incretin therapy. However, recent case series data offer a glimmer of hope. Preliminary findings suggest that structured resistance training combined with adequate protein intake (0.7–1.7 g/kg daily) may substantially preserve or even increase lean mass despite significant overall weight reduction. These findings underscore the importance of counseling patients on exercise and nutrition strategies during semaglutide treatment. Read the full article on GMJ Newsroom.
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