“increase in hip and pelvic fractures with semaglutide that was 4 times as high as that with placebo”

https://www.nejm.org/doi/full/10.1056/NEJMe2507452?query=TOC&cid=DM2406464_Non_Subscriber&bid=-1277228401

“maximum loss of fat-free mass as measured by DXA had occurred by 1 year after the start of a weight-loss intervention, but by 8 years fat mass was regained without regain of fat-free mass”

Areas of active research. We don’t know if strength training offsets these effects but we do know most people will not voluntarily do exercise.