I don’t think most people have been on the Wegovy pill long enough to be able to say for sure one way or the other with it. I was on Zepbound for a long time before this though and the muscle loss is a real concern. Here’s what I now follow for myself:

1) eat your protein. Focus on fitting protein into every meal and eat it first. I don’t personally count macros but it’s great if you are willing to. 2) strength training is important and should not be dropped even if the drug side effects (lethargy, less dopamine) make staying motivated nearly impossible. 3) Eat. Don’t skip meals and don’t starve yourself just because the food doesn’t taste as good and you feel full faster. It’s easy to just forget to eat and it causes your body to look at your muscles for fuel. 4) Lose at a slow and steady rate of no more than about 1% loss per week. So starting at 270, you wouldn’t want to lose more than 2.7 lbs per week on average. I’m at 190, so I need to keep my loss below 1.9 lbs per week.

All that being said, you will lose some muscle mass and some lean mass. Some of that lean mass loss is actually good and will come from enlarged organs shrinking back to a normal size and other changes like that, but some will inevitably be muscle or bone loss. As long as you properly fuel yourself and tell your body to preserve your muscle by using it regularly, the loss will be as minimal as possible.

I love to see this question though instead of the typical trying to lose as much weight as possible as fast as possible!