Dr.SleepRoch 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 Dr.SleepRoch, 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.
rachel_ABQ said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 277 | 232 | 237 | 197 |
| A1C (%) | 7.7 | 6.7 | 5.8 | 5.4 |
| hsCRP (mg/L) | 7.0 | 3.0 | 2.5 | 1.3 |
| Triglycerides | 217 | 167 | 137 | 117 |
Protocol: Tirzepatide 10mg/wk, resistance training 5x/week, protein 1.5g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
Dr.PeteFamMed said:I think this board over-worries about lean mass.
My endo's protocol for lean mass plateau: if weight loss stalls for 6+ weeks at current dose, we go through this checklist before titrating up:
- Food diary review — is intake creeping up?
- Protein check — minimum 100g/day
- Activity audit — steps + resistance training
- Sleep quality — poor sleep kills GLP-1 efficacy
- Stress/cortisol management
Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.
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Browse GL BiochemA narrower follow-up, since the general answer is now clear:
Whether resistance training and protein change the ratio or only the absolute amount?
Reporting back.
Second scan under matched conditions came back with the lean number nearly a kilogram higher than the first, so a chunk of what I panicked about was hydration. Strength numbers were up throughout.