MASHdoc_SA said:The honest range is roughly 20 to 40% of total loss as lean mass without deliberate resistance training, and roughly 10 to 20% with it plus adequate…
Thank you — that is the clearest version of this I have read, and I have read a lot of them. I will report back once I have actually tried it.
From the other side of the consultation, briefly.
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.
LipidDoc_ATL said:Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
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.
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Shop Reference StandardsZaraB_AL said:There is also a quality change that the scan cannot see.
OMG yes. lean mass + resistance training is the combo. Can confirm.
Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Thread quality here is what the rules are for. Keep it up.