The lean mass loss concern is more nuanced than commonly portrayed: the SEMALEAN study (n=115) showed lean mass declined initially but stabilised after 7 months, handgrip strength improved by +4.5 kg at 12 months, and sarcopenic obesity prevalence decreased from 49% to 33%.

Evidence (2)

Impact of Semaglutide on fat mass, lean mass and muscle function: The SEMALEAN study

Lean mass declined initially but stabilised; handgrip strength improved; sarcopenic obesity prevalence dropped from 49% to 33%.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12673431/

Weight loss with GLP-1 medicines does not result in a disproportionate loss of muscle mass or function

2026 study showing GLP-1 medicines predominantly reduce fat; relative muscle mass and strength improve.

https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(26)00082-0

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