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native, moderated, evidence-firstA common worry on GLP-1/GIP agonists is lean mass loss along with fat. SURMOUNT body-comp sub-analyses suggest the proportion of lean mass loss is roughly similar to lifestyle-only weight loss, but absolute lean loss can be larger because total loss is bigger. Resistance training + adequate protein (1.6-2.2g/kg) appears protective.
SURMOUNT-1 (NEJM 2022, ~2,500 participants without diabetes) reported up to ~22.5% body-weight reduction at 72 weeks on the 15mg dose vs ~2.4% placebo. Dual GIP/GLP-1 agonism appears to outperform GLP-1-only on weight outcomes. Open questions: muscle mass preservation, long-term cardiovascular endpoints.