This study is questionable because, where I live, TB is not a disease that happens to just anyone; it usually happens to people in poorly sanitized places with lower socioeconomic status. But pharma giants are going to publish ghost studies; they simply have too much money not to use it to further their drug empire.

Severely cutting calories while staying sedentary trashes the immune system, disrupts hormones, impairs reproductive function, and strips away bone density and muscle?

If this happens to high-performing athletes, there is no reason to believe sedentary folks are immune. The research behind Relative Energy Deficiency in Sport breaks down these exact mechanisms: https://en.wikipedia.org/wiki/Relative_energy_deficiency_in_...

GLP medications blunt your appetite so you eat less, but you still end up feeling completely drained because your body lacks fuel. The goal should never be just blindly slashing calories. You have to feed your body what it needs rather than solely cutting what it craves, and GLP drugs cannot distinguish between nutrient-dense meals and the junk food binges you are trying to avoid.

They do not fix metabolism, either. Any claimed "metabolic boost" has never been proven beyond a minor 100 kcal increase in resting metabolic rate (RMR). Most people pushing that claim rely on an older study where glucagon raising RMR was merely an interpolation by the authors. To put that in perspective, a 100 kcal bump is less than two slices of bread, which sit around 130 kcal.

Being healthy is not just about avoiding excess body fat. Look at retired sumo wrestlers: they carry significant weight, yet their health markers crater once they stop training while keeping their diet identical. Real body fat reduction requires higher activity levels, but most GLP users fixate entirely on scale weight. Crashing your intake on high doses also sets you up for serious bile and gallbladder complications down the road.

Give it a few years, and we will look back on handing GLP prescriptions to people who are only 10 to 20 kg overweight as a major mistake. You do not have to gorge yourself to gain weight. Dropping into a sedentary lifestyle reduces muscle mass, lowers your RMR, and tanks your daily energy expenditure, pulling your maintenance baseline down with it. Once your maintenance drops, running a tiny surplus of just 100 kcal a day for four years will easily pack on 20 kg of fat.