Dr.LipidDallas 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…
This is where I part company with the consensus forming above. 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.
nancy_portland said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.8 → -0.9 (stable to slightly improved)
Femoral neck T-score: -0.10 → -0.10 (stable)
No significant bone loss despite 75 lbs of weight loss. Key factors: adequate calcium (1200mg/day), vitamin D (5000 IU/day), resistance training 3x/week, and adequate protein. Weight-bearing exercise is critical for maintaining bone density during rapid weight loss.
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 | 278 lbs | 223 lbs | 215 lbs |
| Fat mass | 118 lbs | 78 lbs | 50 lbs |
| Lean mass | 156 lbs | 149 lbs | 152 lbs |
| Body fat % | 39% | 35% | 24% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.6g/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 Dr.EM_Chicago — 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.