Dr.GutHealth 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…
I read this differently from Dr.GutHealth, 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.
SleepFixSam said:I lifted three times a week throughout and still lost lean mass.
Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes. Losing 51 lbs shifts your center of gravity and your core muscles need time to adjust.
Physical therapy has been essential. Core strengthening exercises (planks, dead bugs, bird dogs) daily for 10 minutes have eliminated my lower back pain. Your body is literally relearning how to carry itself.
Dr.ReproEndo 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 | 281 lbs | 211 lbs | 208 lbs |
| Fat mass | 111 lbs | 81 lbs | 43 lbs |
| Lean mass | 149 lbs | 148 lbs | 155 lbs |
| Body fat % | 42% | 34% | 22% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.5g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
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Shop Reference StandardsOne thing that is still open after LarryQC_SD’s answer:
What fraction of loss being lean mass is actually normal, because the numbers quoted here range from 10% to 40% and cannot all be right?
Reporting back.
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.