Recommending resistance exercise and adequate protein intake (1.0-1.2 g/kg of ideal body weight daily) can help preserve lean mass during active weight loss
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The underlying biology has shifted, the body has begun to defend its new lower set point, and the medication's effect has been overlaid by an adaptive response that the medication does not, on its own, fully overcome
Wegovys value proposition centers on MACE risk reduction (MI, stroke, CV death) in obesity with known heart disease, aligning weight management with secondary prevention priorities
This confirms the mechanism relies entirely on vagal afferent GLP-1R signaling
However, it reframes obesity as a complex medical condition shaped by genetics, hormones, brain circuits, and environment, a framing reinforced by recent narrative reviews of the expanding role of GLP-1 receptor agonists, which may help chip away at stigma
