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Based on the observation that a large proportion of lean tissues lost during weight loss seems to be from our adipose tissue, and the proportion of total lean mass increased after weight loss in STEP 1 and SUSTAIN 8 trials, its unlikely that using semaglutide to support weight loss leads to clinically meaningful reductions in muscle and other lean tissues

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Effects of lifestyle and educational bridging programs before bariatric surgery on postoperative weight loss: a systematic review and meta-analysis