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What's the mechanism of all three

The loss of skeletal muscle mass has been associated with calorie-restricted diets and rapid weight loss in general, as well as with use of incretin mimetic agents such as semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro)

Although this observation appears inconsistent with leptins inhibitory effect on insulin secretion, it can be explained by the restoration of leptin sensitivity after surgery