Dr.DermMIA said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):
| Metric | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Skeletal Muscle (lbs) | 75 | 71 | 68 | 75 |
| Body Fat (lbs) | 97 | 73 | 57 | 45 |
| Body Fat % | 43% | 33% | 26% | 22% |
| Visceral Fat (cm²) | 162 | 127 | 82 | 62 |
Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.
oliver_london said:Right, and protein targets should be set on a reference weight rather than current weight.
Bookmarking. The distinction being drawn above is the one nobody else makes.
Dr.DermMIA said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
OMG yes. lean mass + resistance training is the combo. Can confirm.
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Shop Reference StandardsA1cHero_PHX said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the skeletal muscle fiber type distribution:
- Decreased Type IIx (glycolytic, fast-twitch) fibers
- Increased Type I (oxidative, slow-twitch) fibers
- Improved mitochondrial density and function
- Enhanced insulin-stimulated glucose uptake per fiber
This "metabolic remodeling" of muscle may contribute to improved insulin sensitivity independent of total lean mass changes. The muscle you keep becomes metabolically better, even if there's less of it[1].
[1] Pirkmajer S, et al. Front Physiol. 2023;14:1123456.
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