I am a licensed physician and have evaluated the above patient. This letter certifies the medical necessity of a specific therapeutic program to treat a diagnosed condition. It is not a statement about general health, fitness, or wellness.
The patient is under care for sarcopenia (skeletal-muscle loss), ICD-10 M62.84, arising as a recognized consequence of GLP-1 receptor-agonist pharmacotherapy prescribed for obesity (E66.9). In published trials of these agents, a substantial fraction of total weight lost — commonly 25–40% — is lean tissue rather than fat, which accelerates skeletal frailty, suppresses resting metabolic rate, and predisposes to functional decline.
Progressive resistance training, coupled with adequate dietary protein, is the recognized non-pharmacologic countermeasure to pharmacologically-induced lean-mass loss. It is prescribed here as treatment of the patient's diagnosed sarcopenia — to preserve and restore appendicular lean mass and physical function during medical weight loss — 2–3 supervised sessions per week, progressive overload, for 6 months with reassessment at 12 weeks. I certify that this program reflects my independent professional medical judgment and would not be recommended in the absence of the diagnosed condition. Had the clinical criteria not been met, this request would have been declined at the same review fee.