So in theory, people who have low testosterone and take semaglutide experience more of a loss of muscle mass. Resistance training and a high-protein diet are essential for preserving musclewhether youre on TRT, semaglutide, or both, says Lee
Still, many of these can improve over time, especially when following the advice provided by your primary care physician and registered dietitian." To help manage nausea and other gastrointestinal side effects: Follow the recommended dose escalation schedule (typically starting at 0.25 mg and gradually increasing)
FDA-approved pharmacotherapy alternatives include several options with established safety profiles: Semaglutide (Wegovy): A GLP-1 receptor agonist producing 12-15% weight loss, with cardiovascular benefits demonstrated in the SELECT trial and FDA-approved indication for reducing cardiovascular risk Liraglutide (Saxenda): A GLP-1 receptor agonist producing 5-8% weight loss [4] Phentermine-topiramate (Qsymia): FDA-approved combination producing 7-10% weight loss with established safety data Naltrexone-bupropion (Contrave): Combination targeting reward pathways and appetite, producing 5-9% weight loss [4] Orlistat (Xenical, Alli): Lipase inhibitor producing 3-5% weight loss with gastrointestinal side effects [4] Setmelanotide (Imcivree): For rare genetic obesity disorders (POMC, PCSK1, LEPR deficiency) [4] Metabolic and bariatric surgery should be considered for patients with BMI 40 kg/m or 35 kg/m with obesity-related comorbidities who have not achieved adequate weight loss with nonsurgical interventions
Most are mild, injection-site reactions, mild fluid retention, occasional joint stiffness or headache
