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Nevertheless, even the most effective marketed incretin, the GLP-1/GIP dual agonist tirzepatide, produces a maximum HbA1c reduction of ~2.6%, with fewer than half of participants in the SURPASS trials reaching normoglycemia (HbA1c 10%), vehicle-treated animals lost ~40% of body weight over 3 months, consistent with prior reports showing comparable reductions from ~40 g at week 10 to ~25 g by week 20 19

So far, the available evidence suggests that the muscle mass lost during weight loss with incretin RAs is comparable to other interventions inducing weight loss, such as diet and bariatric surgery, and that it is an adaptive process, comparable to the reduction in LV mass upon arterial blood pressure lowering (84)