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The cost nobody prices: keeping the muscle

Incretin drugs take roughly 6 kg of lean mass with the fat — a decade of aging, the authors say. Resistance training can put about 3 kg back, and no seller includes it.

Neil Sanders5 min read

Every price on this site buys one thing: the medication, and sometimes a consultation around it. A 2024 review in Diabetes Care argues that the medication alone is an incomplete purchase, and the argument is specific enough to cost out [1]. Set against what this market charges, it is the clearest example of something a buyer needs that no seller sells.

What comes off besides fat

The review describes semaglutide, liraglutide, tirzepatide and retatrutide as producing roughly 15 to 24 per cent weight loss in adults with overweight and obesity, alongside improvements in blood pressure, cholesterol, glucose and insulin. It then describes the other half: lean mass fell by 10% or so — roughly 6 kg — which the authors compare to a decade or more of aging.

What the review says to do about it

Supervised resistance exercise training over more than ten weeks can produce large increases in lean mass, around 3 kg, and increased strength by 25% or so in both men and women. The authors propose tailored resistance training as an adjunct to incretin therapy specifically to preserve lean mass while achieving fat loss. They also note that after a low-calorie diet, combining aerobic exercise with liraglutide improved weight-loss maintenance compared with either alone.

There is a money argument inside that clinical one. Retaining lean mass during treatment could blunt the weight and fat regain that follows stopping — and since roughly one in three people are still on therapy at a year, what happens after stopping is the outcome most buyers will actually meet.

Nobody prices it

Not one seller tracked here includes supervised resistance training in a published figure. A few include coaching, which is not the same thing, and a few include labs. The rest sell the drug and the prescription around it. That is not a criticism of their pricing — it is a description of what the price covers, and the gap belongs in a buyer’s budget rather than in a complaint.

Two practical consequences. When comparing two sellers, an inclusion list that covers coaching is worth more than the same figure without one, even though no page quantifies the difference. And when comparing a GLP-1 against its alternatives, the honest comparison is drug-plus-training against the alternative, not drug alone — the cost-effectiveness models do not separate those either. The ranked board shows which sellers publish an inclusion list at all.

Price figures are computed from this site’s own records at build time, most recently read September 2026, across 456 priced sellers. The clinical figures are cited.

Frequently asked

How much muscle do these drugs cost?
The review characterizes lean-mass loss as around 10 per cent, or about 6 kg, and compares it to a decade or more of aging. It is a narrative review, so that is an approximate magnitude rather than a pooled estimate.
Does exercise fix it?
Supervised resistance training over more than ten weeks can produce around 3 kg of lean mass and about 25 per cent more strength, and the authors propose it as an adjunct to incretin therapy.
Do any sellers include it?
None tracked here. A few include coaching and a few include labs; the rest sell the drug and the prescription around it, so training belongs in a buyer's own budget.

Sources

  1. [1] Locatelli JC, et al. (2024). Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition? Diabetes Care. PMID 38687506

Where to get it

The cheapest GLP-1

Every seller that publishes a price, ordered lowest first on the standing month-to-month rate, plus the question to ask before you pay any of them.

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