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During GLP-1associated weight loss, lean-mass changes are typically adaptive and preventable , not degenerative. GLP-1 Body Composition Changes: What Clinical Trials Show About Muscle Loss Clinical trials and body-composition sub-studies of semaglutide and tirzepatide consistently demonstrate: Fat mass accounts for most weight lost during treatment. Lean mass may decrease , particularly without resistance training or adequate protein intake. In many patients, the proportion of lean mass relative to total body weight is preserved or improved , because fat loss exceeds lean loss. Key clinical insight: GLP-1/GIP therapies improve overall body composition by preferentially reducing fat massnot by causing muscle breakdown. Lean mass refers to all the non-fat tissues in the bodyprimarily skeletal muscle , but also organs, bones, connective tissue, and body waterthat support metabolism, movement, and overall physical function

Any consideration of tirzepatide in BED must involve comprehensive psychiatric assessment and close monitoring by providers experienced in eating disorder treatment

Management of glucose-related faintness: If hypoglycaemia is confirmed or strongly suspected, immediate treatment with 1520 grams of fast-acting carbohydrate (such as glucose tablets, 150200ml of fruit juice, or 45 jelly babies) is recommended, followed by a longer-acting carbohydrate snack once symptoms resolve