Preserving Skeletal Muscle during Pharmaco logical Weight Loss: A Practical Framework Integrating Nutrition and Eccentric Exercise

Objectives: Glucagon-like peptide-1 (GLP-1) receptor agonists and dual incretin therapies achieve clinically meaningful weight loss and improve glycemic control and cardiometabolic risk factors in routine care. Because the quality of weight loss matters, reduction in Du al-energy X-ray absorptiometry (DXA) -derived fat-free mass (FFM) during pharmacological weight loss raises concern that muscle-related compartments may also be affected and highlights an implementation gap in obesity care. › Methods: This clinical practice review used a structured narrative synthesis of literature identified through PubMed/MEDLINE, Cochrane CENTRAL, Google Scholar, Semantic Scholar, guidelines and consensus sources and reference-list screening. The search focused on pharmaco therapy-associated changes in body composition, dietary protein targets during energy restriction, and practical exercise strategies including eccentric training. Literature was considered according to direct relevance, clinical applicability, and co