The gap between semaglutide's 15% and tirzepatide's 21% weight loss is exactly why Novo is scrambling to acquire next gen pipeline assets like Metsera. That 6% efficacy difference translates to billions in market share when you're dealing with a $100B addressable market, and physicians are already gravitating toward the higher efficacy option. Your point about muscle loss risk without strength training is critical though, maintaning lean mass during rapid weight loss is what separates sustainable outcomes from metabolic disaster.