The aim of this study is to use advanced MRI scans to track changes in both muscle and fat in the body and heart over a 12-month period in individuals starting semaglutide. By doing so, we hope to gain a clearer understanding of how semaglutide affects muscle health and function. Our goal is to ensure the medication supports long-term well-being, particularly for people who may be at higher risk of muscle loss.

This study involves (3) in-person study visits. At each visit, participants will be asked to:

• Undergo magnetic resonance imaging (MRI) while resting and during exercise to take pictures of their heart, abdomen, and legs.
• Complete tests to assess balance, sit-to-stand, walking speed, and handgrip strength.
• Complete questionnaires related to demographics, health information, physical activity, and nutrition.
• Have a blood sample collected from a vein in your arm.
• Have your blood levels assessed through three finger pricks.
• Complete three days of food records.

Inclusion Criteria:

• Adults 18-80 years of age
• Starting semaglutide for type 2 diabetes or weight loss
• Able to safely undergo an MRI scan (including meeting the physical requirements for MRI equipment)

Exclusion Criteria:

• Current use of semaglutide for more than 2 weeks
• Major recent heart issues or other severe health conditions
• Concerns related to MRI use (including magnetic implants, pacemaker, severe claustrophobia)
• Dependence on a mobility aid (unable to participate in exercise MRI)

Individuals who are starting semaglutide and are able to attend study visits at the Mazankowski Alberta Heart Institute.