For how we live.
Pooled randomised data show incretin drugs shed lean mass in about the same proportion as lifestyle weight loss. The evidence gap is people who train seriously, and it has not been filled.
A 2026 meta-analysis of 86 randomised trials found body mass, waist circumference and maximal oxygen uptake still better than baseline more than six months after training stopped. Not everything held.
A 2026 meta-analysis of 19 trials found training at maximal fat-oxidation intensity cut body weight by 3.66 kg. Head-to-head trials against interval training find no consistent winner on body fat.
Pooling 2,906 participants, researchers ranked how antidiabetic drugs affect fat versus lean body mass. Exercise blunted liraglutide's muscle loss; metformin, insulin, and DPP4 inhibitors barely moved either measure.
Bimagrumab targets fat, not appetite. Paired with semaglutide in 507 adults with obesity, the combination out-performed either drug alone at 48 weeks — with its own separate set of side effects.