CarlaRPh_TPA said:The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0…
I read this differently from CarlaRPh_TPA, on substance rather than tone. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.
hyun_seoul said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Physical therapist weighing in on lean mass. I work with bariatric and metabolic patients daily.
The resistance training evidence is critical here:
The Lundgren 2024 JAMA paper[1] showed that structured resistance training preserved 73% more lean mass in GLP-1 patients vs medication alone. When discussing lean mass, we MUST include the exercise component.
My minimum prescription: 3x/week compound movements (squat, deadlift, press, row), progressive overload, 7-10K steps/day, and 1.2-1.6g protein/kg/day.
[1] Lundgren JR, et al. JAMA. 2024;331(1):38-48.
LabKate said:I think this board over-worries about lean mass.
DEXA scan update relevant to lean mass:
Scanned at months 0, 6, and 12. Here are the body comp numbers:
| Baseline | Month 6 | Month 12 | |
|---|---|---|---|
| Total mass | 252 lbs | 232 lbs | 219 lbs |
| Fat mass | 122 lbs | 72 lbs | 54 lbs |
| Lean mass | 160 lbs | 147 lbs | 156 lbs |
| Body fat % | 45% | 33% | 23% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.4g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
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Browse GL BiochemFollowing on from laura_annarbor — and this may be the naive question:
Whether resistance training and protein change the ratio or only the absolute amount?
OP back with an update, since a thread like this is useless without one.
Follow-up: I dropped the cardio to two easy sessions and put the effort into three real lifting sessions. The scale slowed and the scan improved.