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A recent "The Joe Rogan Experience" episode with Bill Maher as the guest discussed weight loss drugs, especially type-2 diabetes GLP-1 agonists. The following interchange took place (J is Joe Rogan, M is Bill Maher):

J: You're taking an injection that makes you less hungry somethings going on. [Which is] Probably not good.
M: Yes
J: You're also losing a lot of connective tissue bone mass and muscle mass. My good friend Peter Attia did a study on he’s patients. He's a doctor did a study on patients that took Ozempic and one of the things they found is they lost weight, but they gain fat. They were actually had a higher percentage of body fat because they were primarily losing muscle tissue and connective tissue. They were losing so much of that that even though the they lost like 20 pounds they actually went from like 15 body fat to maybe 20 body fat or whatever the number was.

I was not able to locate the study mentioned in published literature. The closest match was this writing matching the topic and author.

  • Are there documented instances matching the description from the show for people taking Ozempic? (Layman: Does weight loss from Ozempic come mainly from muscle loss?)
  • If so, is this more general phenomenon associated of GLP-1 agonists drugs? (Layman: Do all GLP-1 drugs cause this?)

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The study linked in the question does not back up Rogan's claims from the quote. Two cohorts were mentioned, and both showed ~40% of weight loss was lean mass. This is higher than the ideal 25%, but does not at all show that they were "primarily" losing lean muscle or connective tissue. In both cohorts, total body fat percentage declined a small amount, the opposite of what Rogan claims in the quote: "went from 15 body fat to maybe 20 body far or whatever the number was."

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    Quotations would be effective: nejm.org/doi/full/10.1056/NEJMoa2032183 says indeed ' total fat mass and regional visceral fat mass were reduced from baseline with semaglutide (Table S5). Although total lean body mass decreased in absolute terms (kg), the proportion of lean body mass relative to total body mass increased with semaglutide.' (Tho where is table S5 is mystery to me.)
    – pinegulf
    Sep 6, 2023 at 7:47
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    link.springer.com/article/10.1007/s00125-019-05065-8 says ' Total fat mass (baseline 33.2 kg) was reduced by 3.4 kg and 2.6 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: –0.79 [95% CI −2.10, 0.51]). Although total lean mass (baseline 51.3 kg) was also reduced by 2.3 kg and 1.5 kg with semaglutide and canagliflozin, respectively ' This seems to say that loss of both is significant.
    – pinegulf
    Sep 6, 2023 at 7:48

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