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Some lean mass loss (~2030%) happens with every form of weight loss diet, lifestyle, bariatric surgery, or GLP-1s

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For some people, it might offer a small boost that helps with weight loss when its part of a bigger picture that includes consistent nutrition, movement, sleep, and stress management

In patients with established cardiovascular disease people who have already had a heart attack, stroke or coronary or peripheral artery disease semaglutide is now FDA-approved to reduce the risk of another heart attack or stroke or death from heart disease

GLP-1 medications target these underlying mechanisms rather than simply reducing body weight, making them potentially valuable for metabolically unhealthy individuals across all BMI categories

However, context matters: Higher dose, higher effect: Semaglutides greater efficacy likely comes with proportionally more GI effects