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The consequences of excessive lean mass loss include: Reduced resting metabolic rate muscle is metabolically active tissue, so losing it lowers the number of calories your body burns at rest Impaired physical function particularly concerning in older adults, where sarcopenia (age-related muscle loss) is already a risk Potential for weight regain a lower metabolic rate after weight loss can create conditions favorable for regaining weight if the drug is stopped Bone density reduction significant weight loss can also reduce bone mineral density, increasing fracture risk What we know from other GLP-1 drugs For context, the "ideal" ratio is debated, but most clinicians consider it acceptable if lean mass loss accounts for less than ~25% of total weight lost