GLP-1s to Enhance Lasting Optimal Weight

Inclusion Criteria: * BMI 30-37 kg/m2 or BMI 27-\<30 kg/m2 with at least 1 weight-related comorbidity * community dwelling * able to provide own transportation to study visits * willing to provide informed consent * willing to take terzepatide for 9 months * agree to all study procedures/assessments * approved for participation by the study physician Exclusion Criteria: * dependent on a cane or walker or needing assistance with any activity of daily living * history of mild cognitive impairment or dementia or cognitive impairment on Montreal Cognitive Assessment (MoCA score \<22) * evidence of depressive symptoms (Center for Epidemiologic Studies Depression scale score =\>16 * use of \>1 tobacco product/day or 4/week or vaped \>1/week in past year * excessive alcohol use in past month (\>7 drinks/week for women; \>14 drinks/week for men) * weight loss or gain \>5% in past 3 months * vegan or other severe dietary restriction * history of binge eating disorder * regular participation in high intensity aerobic or resistance exercise training \>150 mins/week * severe arthritis, fracture, chronic injury, or other musculoskeletal disorder that prevents walking independently * joint replacement or other orthopedic surgery in past 6 months or planned in next 12 months * osteoporosis (self report or DXA t-score \<= -2.5 on total hip and/or femoral neck) * uncontrolled hypertension (systolic \>160 OR diastolic \>100 mmHg) upon repeated assessments * type 1 diabetes * uncontrolled ty…