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My read on past studies is that one area of muscle mass loss that is problematic is around the heart.

Obviously it’s not a problem if an obese person’s quads shrinks 2x because they lift 2x weight every day.

I would think any drastic change to body composition would have its risks, and should be mitigated through healthy diet and exercise. I suspect the detractors are quick to overemphasize such risks because users of weight loss drugs aren't 'earning' it. My counterargument would be that it's better to be underexercised and normal weight than to be underexercised and overweight. And I suspect being normal weight makes exercise more pleasant.

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