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Peter Attia, MDa longevity and wellness expert and host of the The Drive podcast discusses this in detail in his blog post, Lean mass loss on GLP-1 receptor agonists: a downside of the miracle drugs. He discusses how Ozempic causes both muscle and fat loss and does not improve body composition as much as natural weight loss methods

At steady state (weeks 4 and beyond), the trough sits higher than in the early weeks so this variability tends to improve as accumulation builds