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Resistance exercise remains the most effective non-pharmacological intervention for preserving lean mass during periods of caloric restriction, and a 2022 systematic review and meta-analysis published in Obesity Reviews confirmed that resistance training significantly attenuates lean mass loss during hypocaloric periods, with the most pronounced effects seen when combined with adequate protein intake.7 Clinical note The protein guidance remains unchanged and, if anything, more relevant than ever: a target of 1.2 to 1.6 grams of protein per kilogram of body weight per day during active weight loss continues to be one of the most commonly under-met targets among GLP-1 patients, largely because appetite suppression makes reaching these targets without deliberate planning genuinely difficult.8 As emerging pharmacological options for muscle preservation move closer to clinical practice, they should be understood as additive to this foundation, not a substitute for it

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