Cause for caution with weight loss drugs like Ozempic | Peter Attia, M.D. 

We do have 2 hours Peter. Walk us through the FDA rabbit hole please!!! 🙏

Peter is a true clinical physician that never stops learning. What a wonderful mind.

Dr. Attia: I just wanted to put this comment somewhere you might read. I just finished listening to audio version your book, outlive and wanted to thank you for putting all that time and research into it. Honestly love your tone of voice. It was like a story telling, I loved the pace of it, was surprised at the end to hear at the start you were not feeling confident about reading it yourself with your own voice, I am so glad you did whoever coached you did a great job, I felt even as I started listening at the start, this book has different quality of tone and pace and authenticity than most audio book I have heard.. You do have a great tone for podcast/radio talk. As a psychiatrist and reader, the most impactful section was the one on mental health. thanks for your honestly and destigmatizing mental illness, millions are suffering for anger and rage and emotional dyscontrol and not willing to get help. I listen to any video/book form you. thanks

I love this. I’ve been on semaglutide for weight loss, but I’ve got an extensive training history and train 7+ hrs a week. When I heard the headlines that semaglutide causes significant muscle loss, my first question was around training and diet for the population reported on. Just like any other caloric restriction, your body is going to shed tissue based on an adaptive response and people that are morbidly obese are likely not to have a great diet and training regimen. I’ve done inbody scans and have seen some muscle loss along the way, but the predominant loss has been in adipose tissue. Not that anecdotal evidence can be extended across the population, but it just makes sense that a body that isn’t trained and supplied with sufficient protein is going to shed more metabolically active tissue during caloric restriction.

Have been on Ozempic for 3 months and have lost 10 kgs with another 7 kgs to lose. Have felt nauseous and tired one or two days but other then that it’s been great. I walk my dog twice a day, I swim twice a week and go to gym for weights twice a week. I eat protein and leafy green vegetables 🥗 daily on ozempic. It’s been great for me.

I'm SO HAPPY that you covered this topic because I have been bringing this to the forefront in discussions with the clinicians at our clinic since we started treating patients almost 2 years ago. My education is exercise science and nutrition, so the physicians seem to minimize the points you're mentioning and very rarely use our BIA (ONLY OPTION AVAILABLE) in our clinic. Thank you for making this available to share, Dr. Attia🙏🏼

I am on compound pharmacy Semiglutide for 8 and a half months as of now and lost 41 pounds. From a BMI or 35 to a BMI of 29. Still going strong. I had health coaches appoiments that helped me be successful with it. Is not a walk in the park but as I was educated about how to slowly go in dosage. I am still not at the maxium amount and I am not in the rush. The forst 5 months was harder to exercise but now I can go to the gym 4 times a week and is so much easier to move without the 41 pounds. My liver enzymes are finaly in normal range after 5 plus years. I tried a lot of things before and my weight did not move at all. I am happy with it and leep doing my part.

Working out and eating well my resting heart rate is around 57...it was mid 70's. I went and had a gambit of tests done and my body is healthier now than it's ever been. No cheats. Get that heart pumping with a good workout and eat fresh!!

I use Berberine for the glycemic benefits. I am tiny, but my bad cholesterol is borderline high likely from my “lazy keto” diet. I started taking it, I’ve dropped weight without doing anything extra ( I already do HIIT, intermittently fast, usually 16 hour, nothing crazy) and my bad cholesterol has dropped a few notches. That’s what I’ve done and I like it

Tried it for a few months for pre diabetes and did lose weight, but I had side effects of nausea and diarrhea. My appetite decreased substantially, but the side effects plus having a new thyroid lump concerned me. I’ve never had thyroid issues before, thank goodness my biopsy was normal. Too many side effects for me and possible health risks!

I’m amazed by your clinical experience. I have not lost any strength over my 7 months of using Mounjaro, and quite obviously that’s because I train to failure with the heaviest weights I can manage. I’m sure you advise your patients to do this, and that’s why your clinical experience astounds me. I’m female, 78 years old, have lost 30 pounds since starting Mounjaro, lift under the supervision of a trainer, and now lift once per week because of the recovery time I require.

I've lost about 30 lbs in 7 weeks. Walking, walking, walking, jogging, and eating fresh foods. It's been hard work but there's nothing like diet and exercise.

I started on Ozempic in July of 2022 at 305 lb. I am now down to 252. Not as an extreme loss as others but I've held on to almost all of my muscle. Can't bench quite as much as I could but every other muscle group moves the same amount of weight as when I was heavier. I attribute my muscle preservation to not losing weight that quickly as well as keeping my protein pretty high. I will say, I don't feel the effects of the medication very much anymore. I still eat less but it doesn't have the same dramatic hunger curbing effect it used to.

My medical philosophy professor told us that when new drugs come out: first of all they are lionized as a miraculous‘panacea’, then side effects occur and the drug becomes a ‘pariah’. Finally, the pros and cons even out so the reputation and usage (albeit with caveats), becomes mainstreamed.

No amount of warning works for ppl determined to take these drugs. They simply don’t care about side effects or surprising long term effects to actual organs in the body. As long as I’m thin kidney disease in a few years is fine.

Hyped up drugs like this are why drug advertising is illegal in my country, unfortunately social media is making those kinds of laws obsolete.

I'm on my 2nd round of Ozempic -25mg/weekly. This is as a result of my triple bypass in December, which also uncovered that I had type 2 diabetes likely for many years that I had no clue about. Prior to being prescribed Ozempic, I had already lost nearly 60 lbs and reached around 16% body fat due to changing my lifestyle, diet, incorporating steady state cardio and hitting the gym 3-4 times weekly. So I don't need or want help in the weight loss department, but I am keen on the benefits to my diabetes and heart. This warning has me now focused on monitoring for any potential muscle loss as I move forward. I can say that after my first round, my strength in the gym has continued to increase and my musculature is still growing, but now I am monitoring for the symptoms of muscle loss and upping my protein intake somewhat to hopefully mitigate any potential losses. Thanks for this video!

After my 3rd injection, I became sick for 10 days. Vomiting, constant nausea, and feeling like i was wasting away way too fast. Yes, I lost 15 lbs, but i felt like crap. In fact, 6 weeks later, I still feel crummy in general. And yes, my skin is hanging off of me in a gross way bc I've lost muscle mass. So while it worked, it wasn't worth the terrible side effects and overall crummy feeling. And this comes from a person who has been obsessed about her weight for 30 years and would previously have done anything to stay thin. Careful people.

Aside from Ozempic, the gastric surgeries are unhealthy too. My daughter had the gastric sleeve and she lost weight rapidly. The amount of muscle loss that goes with fat loss is concerning. I tried to reinforce how important strength training and eating adequate protein is during the process. The odd thing is the surgeon said to focus on cardio and walking. This made very little sense to me since her food intake was extremely limited. It sounds like this medication is similar when it comes to rapid weight loss.

I’ve been taking Wegovy for about 8 months now. I have always been a big person, even as a kid I was always much bigger than everyone. 265lbs weighing in for 9th grade football, 330 at graduation. In my mid 20s I was able to go from 375 to 285 in 18months through fasting and calorie restriction. Lots of cardio and I had a much more physical demanding job back than. Now at 36 years old my weight had crept back to 346 and I’ve struggled not losing with the same techniques I used in the past. I started taking Wegovy and at first didn’t really lose, but in 8 months I am down 26lbs and it’s starting to pick up. I didn’t have many side effects, I may have throw up a handful of times when I ate too much. What I love about it is I’m not that hungry so I can afford to spend on high quality food to eat because I’m not eating a lot of it. I hear the muscle loss argument all the time and I think it’s silly. When I was 375lbs my leg muscles were huge to move all that weight around. You’re not going to keep all that when you lose weight it’s silly to think you would unless you were training too or something. Also I’m using a composition scale now and as I’m losing I notice the percentage is starting relative to my weight so yes I’m losing muscle but it’s relative to my overall weight loss of that makes sense. I’m not working out while on this medication, I golf once a week and walk the course, and maybe do one other cardio activity each week but that’s about it. Lots of homemade food, lots of full fat milk and yogurts, real butter, olive oil, or avocado oil only. No seed oils, no fake Americanized breads, no over processed foods. If I’m craving a dessert I’ll go to an Italian bakery and buy something rather than buy some over processed Oreos for example. Just my thoughts from someone actually taking the meds. People who don’t hold onto weight so hard don’t understand how hard it can be. Some people are gifted with a great metabolism, others aren’t. I don’t have diabetes but I do get high insulin spikes after eating which is probably why I’ve always stored fat. These meds slow digestion down and make you eat less so you don’t get those spikes and don’t store fat.

Peter is the best i learn so much. It’s hard to consume 200 grams of protein let alone 150 at 59 y/o

Yeah I'm definitely down for 2 hours on the problems Peter has with the FDA.

Peter attia the man the myth the legend! What a fabulous mind we have for us to quire information

I’ve been on semaglutide for 5 month. I eat between 1500 - 1700 calories a day with about 100 grams of protein. I do CrossFit 4x week. This is a typical diet deficiency. It’s not a miracle drug. It’s just helps me stay in a healthy calorie deficit. Im not losing muscle, in fact I’m starting to see my muscle definition. It’s all about slow weight loss, eating high protein in a decent deficiency, and lifting weights.

Thank you for this short, Peter. Also, I want to give you a shout out regarding your Early program- wow! I love it! Learning so much, Peter. I feel so blessed to have access to all the knowledge, framework and strategies you have put into that program. Thank you❤

For me IF, exercise, carnivore mostly and meditation made me stay fit and drop weight. I am afraid AF of using drugs. Try my best to stay away primarily because side effects down the road that are unknown.

This caused my Dad who was put on it for type two diabetes to lose almost 40 pounds in a little over two months, but he did NOT NEED TO LOSE WEIGHT!!And yes, it’s taken about eight months to recover from being on this drug due to the loss of muscle during this short time.

Thank you, Peter. I want to lose weight without losing muscle, and I don't want to use anything other than diet and exercise. This information is nice to know for future reference.

Take the food pyramid and turn it upside down. Keep away from bread, pasta and rice. Increase intake of protein, VEGGIES, don't be afraid of healthy fat (avocados, olive oil, nuts) stop drinking alcohol. Start exercising, take the stairs, walk. In about 4 months weight will begin to fall off of you. Because these actions will fix insulin resistance. If you have a bad day or a bad weekend, just restart. You won't lose progress. This is sustainable and you do not feel deprived. Plus this diet makes your skin glow and fixes your digestive system, too! Just try it. I've seen the results of ozempic and it just isn't attractive. It's expensive and makes people look like melted candle wax in the face sometimes. It causes digestive problems too, the brain and gut are connected so I'm willing to bet that you will also be sluggish upstairs when you're on this drug. Anyday is a good day to begin a healthy journey! Good luck ❤

Take a shot every time Peter says DEXA scan or VO2 max

Just finding this video now. I'm a pharmacy assistant and right now, there's one strength of Ozempic that we can't even get in due to a shortage of it. It's mindblowing how much of it we go through actually. I lost a lot of weight a few years ago and wouldn't have wanted to lose it with something like this. Even in Canada, this medication is ridiculously expensive too.

What doctors need to do and media companies aswell, is let the public know when they are getting paid to “report” on Ozempic or any medication in general.

The constipation. Dear lord I almost went to the er it was so bad. On top of protein intake stay on top of your fiber and water intake.

For 40+ patients, most would likely also be candidates for other hormone replacement. One way to prevent catabolism is by making sure Testosterone doesn’t bottom out (also gets worse with caloric deficit)

I hope we see some studies of people resistance training and getting enough protein while taking it.

It makes me so sad that ignorance guides most inflamed conversations about those that are using Semaglutide for weight loss appetite control reasons instead of diabetes. Diabetes is serious but so is a life long battle with compulsive overeating disorders. I’ve seen first hand the massive positive impact that Ozempic has had on a loved one that has no ability to control their appetite or compulsion to eat and binge. This drug needs to be prescribed to this alternative group of people that are just as at risk of complications and death as chronic eating disorders ruin lives and health too

The thing that change was that after using it for Type II Diabetes for years , the studies realized that the drugs make the patients loss weight , then everythinng change , because some celebrities begun to use it as a drug for losing weight.

My biggest concern (other than no long-term studies) is that it has been stated by other physicians, that GLP receptors are all over the body and very little research has been done on what effect GLP-agonists have on all of these non-GI systems. Many drugs have been marketed with this blind ambition - it works, we will deal with the untoward effects with post-marketing research. Don't be eager to be their guinea pigs.

My wife used a Highly restrictive ultra low fat diet to lose weight a few years ago. She shed weight quickly but after becoming pregnant, with twins to boot, she stopped as caloric restriction isn't a good thing as your body is growing lives inside of it. Before she became pregnant, she had a ipid profile drawn. Her LDL cholesterol was 168. As you can imagine she gained a significant amount of weight back during her pregnancy and after. She decided almost two months ago to join me in a carnivore way of eating. When you see someone do something with only positive effects and lose over 60 lbs to boot, you give it a try. She's lost in the neighborhood of 20lbs now. She had a lipid panel drawn the other day prior to her annual visit to her family physician. Her LDL? 97. Her triglycerides dropped to 74. This is on a diet super high in saturatrd fats. Remember, 168 on ultra low fat, 97 on high saturated fat weighing close to or right at 40lbs more. The answer for ALL of us is if it comes in a bag, box or can don't eat it. If there's more than one ingredient, throw it out. Processed foods are terrible for us. Then, eat whatever whole foods make us feel good. You'll lose weight and gain energy in spades and you'll not have to worry about what the latest and greatest medicine that's FDA black listed in 10 years is doing to you.

You cannot oudrug your way out of a bad diet, do it the clean way no sugars and no grains is the key.

Thank You!!! I KNEW there had to be a problem with thinking this one drug could resolve our entire obesity crisis. I was just waiting to find out what that problem was.

What’s changed I think is that compounding pharmacies will now compound in certain states not in my state but in a neighboring state that’s only 1 mile away

Funny, if you tell any one of your friends that you fasted for seven days, they'll think you're crazy. But if you inject a prescription drug, and develop a dependency on it? They get jealous!

Putting the cookies down works wonders too. And it saves money

Ozempic is a pharmaceutical dream.. it’s expensive and you have to stay on it forever or you will gain all your weight and more

Here's the things that gets me though. If you are eating 200g of protein and working out intensely lifting weights, then why do you need Ozempic ?

I think what he’s saying is fairly accurate but please take into consideration visceral fat, water, bone. Also please take into consideration waist circumference which is a very solid predictive factor for some health issues. Not lastly but another point- please also look at your fasting and peak sugar levels as well as average blood sugar levels before and after taking a substance. Lastly, I think the consumption of 1g per pound of body weight is NOT necessarily a standard any longer. Maintaining steady streaming of amino acids in the blood stream contributes to anti-catabolism as well as bcaa and glutamine intake. There’s TOMS more to take into consideration. I’m no where even remotely near to this Drs level of contribution to the subject but take the above two cents into consideration

75 yo type 2 diabetic. Recently came off Ozampic for colonoscpy. The inprovement in mood, motivation, sex drive, and pooping means I stayed off it. Not improving on the bike at 100 km/week but averaging low 20 km/h. Managing diet OK but I have more hunger.

I think no matter how good the drug is, it can't be our goto for minor things like not gaining too many pounds over Christmas. I completely understand turning to Ozempic et al. as a way to combat severe obesity cases. But the first thing you try has to be better diet and more exercise.

Ozempic changed my life... for me, it completely irradiated what is typically chronic hunger and so I can sustain calorie reduction and not obsess about food. I work out and eat a high protein diet. I always have. I'll keep up for a while. We'll see what happens.

There is ALWAYS a price to pay for short cuts. There is a cost/benefit ratio people should consider because nothing like this comes without some detriment.

2:58 - the math is not accurate, it’s opposite. If I have 130 lbs of muscles and 30 lbs of fat, losing 10 lbs of muscles and 10 lbs of fat will make me much leaner (=low fat %). But the overall point is clear, agree

Seems to make sense. Sounds like it works similar oathways to Keto, activatong glucogensis via protein (either via muscle mass or what you consume) to get the quick hit glucose in your blood.

And what about the severe side effects that are surfacing everywhere lately?

Is it true this drug is helpful for alcohol addiction?

Please make a follow up video, comparing these two!

My doctor said something about the possibility of taking it, but my understanding is that once you start you've got to stay on it or you'll gain all the weight back again.

Im not taking anything that potential could make me loose muscle. I hear that is the most importanting thing to keep when aging. I want to age well outside of a look of skinny. I'll keep to my walking, workouts, and healthy eating rather I lose another pound or not.

Keeping a1c in check is far more important to cardiovascular health, in the long run, than losing some muscle mass.

I know several people they used it for weight loss and wound up in the hospital with paralysis of the stomach and got pretty messed up. I’d rather stay fifteen pounds overweight and keep on trying my best to slowly bring the pounds down naturally. After the Fhen pen scare I’m really cautious about any new miracle weight loss drug. I’m a 68 year old post menopausal and no I refuse to believe my age and make up now is my destiny but drugs aren’t without consequences especially if it can and will harm other components of your body. Be safe do your research ask questions and guide yourself accordingly.

I'm so thankful for videos like this as I learn as much as I can before starting Wegovy.

I took ozempic at .25 per week without muscle loss. I did keto Mon-Friday and ate carbs on the weekend only. In 12 weeks I dropped 15lbs fat and gained 5lbs muscle using calipers to measure. It worked great but it did make me feel like a slug as far as energy levels go. My diet was strict and my workouts were hit like Mike mentzer style. I recently tried this again with Saxenda and have not had the same outcome. I think the muscle loss is dose dependent

Awesome video! Highly useful tips and upbeat tone are truly inspiring. Thank you so much for providing your expertise! 😀

We’ll said! I’m glad that you have addressed this issue.

What happens if you stop taking the drug, does this mean the weight just returns? If that is the case does this mean you have to take it for life to maintain?

I'm a type 2 diabetic. I take a medium size dose. The highest dose ruins my GI system. I don't consider it an appetite suppressant. It helps with my blood sugar. That's my experience.

Thank you so much for your knowledgable advice, I get so many questions about that drug and now can send your video- specifically because you actually treated Patients with it and saw the muscle loss issue with your own eyes.

Thanks for sharing! Although I’ve been taking it for 3 months and I’m down 30lbs. Have 3x more energy and motivation and feel great. Just my side effects 😅

We have not seen as much muscle mass loss with GLP-1 RAs in our practice and we have been using it for over 5 years. What we think is the difference is we do not use this medication without first managing or initiating the management of the metabolic/hormonal/micronutrient issues with each individual patient. We require all patients to utilize specific amino acids complexes as adjuncts to the GLP-1 RAs. Not much muscle mass loss and we do measure via Body Comp devises, DXA, BodPod. One of the mistakes made in general practices when prescribing these types of medications is not managing metabolic stress concurrently.....

daily 500-calorie deficit works for me, diet + exercise combo works, explosive bursts of energy that was there before no longer is so I cut down on new cardio (jumping & sprints which are hard on the knees anyway), just stick to old-school running

I have listened to this guy for years! He is awesome 😎

The problem is intestinal obstruction. I took mounjaro and was so constipated became impacted and bowels just stopped. Tried to tell my doctor but didn’t listen. My blood sugar well controlled and great for that and lost some weight but constipation was horrible and upset stomach. Stopped the drug and hunger and blood sugar up again. Regular diabetic meds don’t work well. Obesity is a disease and leprosy of today in being ostracized..

Can you do a talk on Mounjaro? Type 2 diabetic who cycles 20 hours per week and watches his nutrition but blood glucose and weight loss are not improving at all. Thanks Peter!

My question is how effective is it in diabetic patients? Use over insulin and metformin? Second question - how does it impact pancreatic function and insulin sensitivity in users who aren’t type 2 diabetics. Are there set backs to one’s natural hormones and or function of insulin after use age for weight loss?

Doctors giving Ozempic for just weight loss have caused shortages for those of us who take it and need it for our diabetes. This medication was made for diabetics and should not have been prescribed just for weight loss. With these shortages we cannot get ours and have to be put on other meds that do not work as well. 😡😡😡

I am not clear on what your caution is. You mentioned that lean mass can be preserved with glp-1 drugs when sufficient protein and strenght exercises are applied. Same as with any other form of weightloss right? Combined with the outcome based data we have on glucose / CVD end points for these drugs, shouldn't the approach be to encourage these drugs for those with the disease of obesity? With a recommendation to eat enough protein and perform strength exercises instead of "cautioning" against potential lean mass loss, which is not proven to be any different compared to alternative weightloss methods?

Eat protein and resistance train. It's so easy to ameliorate the issue you're talking about. SO easy.

Isn't it also true that to maintain the benefits these drugs must be used forever? I think a lot of people don't realize that. Definitely not something for casual or one and done use.

I would love to see the GLP agonist tested against an "active placebo" i.e., one that causes the same amount of nausea. I suspect nausea is responsible for much of the class benefit of GLP agonists. Maybe test em against a little canister that produced a strong vomit smell that you whiffed before each meal? would probably beat Ozempic in a head-to-head for glycemic control and wt loss 😂

#FACTS More clinicians need to consider this position.

I'd be curious if the loss of muscle mass sets folks up for worsening metabolic health down the road unless they take compensation actions. If you hit a target body weight and go off the drug, you've now got less muscle mass to help with glycogen uptake--and all that implies.

I’m on it and kept my protein and exercise the same high level. It’s just about education.

Fasting is probably the better alternative❤

To me it’s not surprising that slashing calories to the bone causes muscle loss, your suggestions should mitigate that though, just like a normal diet.

Thank you 🙏🏼 😊could you please make a video on weight loss drugs? such as the injectables, and the pills such as contrave and metaformin. Thank you 😊

I might have missed the updates on this and I admire Mr. Attia's podcast to the core, but during one of his Tim Ferriss episodes he was praising Ozempic to the high heavens... that is not to say it was meant to be definite, I'm just really curious what the turning point was, since I know people in the pharma business administering this to their clients, i.e., doctors. If anyone can point me in the right direction, it would be very much appreciated.

That is exactly the problem. Loosing muscle is a huge problem

I’m actually trying to gain weight, lean muscle mass - way more challenging at age 55 than losing fat - and for some reason I find this video very interesting.

What kind of strength training are these patients doing? And what does their diet look like? You seem to be saying that people lose excess muscle on Ozempic because they drastically undereat calories and protein and don't do resistance training. Is that right? Or is there reason to believe there is some physiological basis for additional muscle wasting even with an Appropriate and not overly aggressive caloric deficit, adequate protein, and strength training?

Yep, I’ve been on it for 5 weeks and lost loads of muscle whilst still training heavy and forcing down protein

The sh!t works. period. Maybe a little muscle goes w/ it but it mostly takes off the fat. Taking off the fat typically reduces blood pressure, inflamation, and brings glucose under control. It also allows you to get started back working out without the weight related repetitive use injuries being as large a factor. Get a fasting blood test but lie and eat sugar instead of faster to game the test. You will test out as a diabetic or pre.... You doc will then put you on it...Once you drop your goal 40 pounds, taper off. You just reset your life! Now, don't get fat again. That's the game changer this drug is!

It has a longgggg. Half life of 5 days!! It works and it works well. However it does slow your gastrointestinal emptying.

Isn’t this the FDA with carb high food chart? As the population gets older, it would be nice to have a more holistic view of healthy bodies beyond weight and BMI. I can lose 7 pounds a day from water loss from exercise. I still feel body recouping with muscle gain and a steady long term loss of fat from better eating and regular exercise is the name of the game.

So happy I followed what you've learned about Ozempic, the findings lead me to take my mother off Ozempic and put her back on Metformin.

I would disagreee that Ozempic is safe. It slows digestion to the point that food is just sitting in your stomach in particular, but moves slowly though the digestive system. It can cause a lot of problems for anyone on it who may need surgery as they have food not moving through and just sitting in their stomach and remaining digestive system. Diabetics already have slow digestion, which makes colonoscopy prep more extensive... days of prep rather than 24 hours. It can cause or contribute tribute to bowel obstructions... None of that is not safe in my book.

This guy is super smart. Looking at all factors. Forcing the body unnaturally to go into starvation mode will never have a good outcome. Increase leptin levels naturally reduces weight. But doctors would never tell people this. No money in it.

How about for those of us that are actually diabetic and also want it for weight loss too? I was going to ask my doctor about it but never did and I know other people trying to get it but say they’ve been waiting several months because it’s on back order. I actually remember someone who was diabetic that was complaining a few years ago about not being able to find it and it was her main prescription because people were starting to take it for weight loss. My diabetes is pretty well controlled with metformin, a low carb diet and regular exercise like 5.8 A1C but my weight continually fluctuates and nowhere near where I want to be weight wise. Does it still help with taking off weight if you’re diabetic? I wonder would I still have to take metformin too.

Nothing any different than a normal diet, just makes it easier. Track your macros, ensure you are staying under your maintenance level, but do not cut so drastically that you lose muscle. 500 kcal deficit. This just makes doing that much easier. If someone going into such a caloric deficit they are losing tons of muscle, they is just a terrible approach. But let's not vilify this drug entirely, it can help people by blunting cravings, you just need to monitor your caloric intake like any diet.

weight loss takes work. Change of lifestyle and eating. Any quick fix will work until it’s no longer used. I pray for all these people and the side effects of a strong medication as this. Reminds me of when pharma started pushing pain meds.

amazing no one speaks about muscle loss