The field of obesity management has seen rapid advances in the past decade. Until recently, the only guideline-endorsed options for obesity management were lifestyle intervention and bariatric surgery. The emergence of pharmacological interventions, in particular glucagon-like peptide-1 (GLP-1) agonists, has radically changed the obesity management landscape [1]. In this perspective, we wish to highlight one clinically important aspect that is generally neglected in obesity management research: the importance of maintenance of muscle mass.

In virtually all existing obesity management trials, the effectiveness of the intervention is evaluated only through assessment of absolute and relative losses of total body weight [1]. To some extent, this focus is appropriate because loss of body weight is generally desirable and can drastically reduce morbidity and mortality in individuals with obesity. However, in addition to the kilograms lost, it is important to pay attention to the origin of the lost kilograms. It needs to be taken into account whether losses of body weight are attributable to loss of fat mass alone, fat and muscle mass, or even muscle mass alone.

肥胖管理领域在过去十年中取得了快速进展。直到最近，唯一获得指南认可的肥胖管理选择是生活方式干预和减肥手术。药物干预措施的出现，特别是胰高血糖素样肽-1 (GLP-1) 激动剂，从根本上改变了肥胖管理的格局[1]。从这个角度来看，我们希望强调肥胖管理研究中通常被忽视的一个临床重要方面：维持肌肉质量的重要性。

在几乎所有现有的肥胖管理试验中，干预措施的有效性仅通过评估总体重的绝对和相对损失来评估[1]。在某种程度上，这种关注是适当的，因为减轻体重通常是可取的，并且可以大大降低肥胖个体的发病率和死亡率。不过，除了减掉的公斤数外，还要注意减掉的公斤数的来源。需要考虑体重减轻是否仅归因于脂肪量的减少、脂肪和肌肉量的减少，或者甚至仅归因于肌肉量的减少。