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Obesity disrupts bone metabolism and leads to increased bone resorption, but GLP-1RAs can inhibit this damage and improve bone health by increasing the OPG/RANKL ratio, reducing osteoclast activity, and promoting bone formation

This divergence suggests that net muscle outcomes may depend on contextual factors, including energy and protein availability, physical activity, and baseline sarcopenia riskvariables that are rarely examined mechanistically alongside pharmacological exposure

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