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Retatrutide appeared to induce lean mass loss in similar proportions to GLP-1RAs alone, whereas PTT-A has shown robust fat reduction without significant decrease in muscle mass, highlighting the potential of selective multi-agonists to preserve skeletal muscle during weight loss [66, 67]

States are pulling back coverage largely due to cost: monthly Medicaid spending on Wegovy alone exceeded $192 million in late 2024, and total GLP-1 spending across the program exceeded $3.5 billion in a single year

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This pathway operates independently of fat mass reduction, meaning patients may experience anti-inflammatory benefits even during early treatment phases