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This is the same physiologic process seen when someone stops lifting weights: muscle size decreases because the stimulus is gonenot because muscle is being destroyed. Common Misconception: GLP-1 Drugs Burn Muscle Reality: Muscle loss during GLP-1associated weight loss is driven by reduced mechanical load and insufficient protein/calories , not by a toxic or catabolic drug effect. When Lean-Mass Loss Becomes True Muscle Wasting True muscle wasting is uncommon with GLP-1 therapy and is usually related to undernutrition , not the medication itself

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However, SGLT2is lose their effectiveness for glucose lowering as the GFR falls below 60 mL/min per 1.73 m [51]

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