anders_CPH said:Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
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.
NurseAsh_DET said:Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.
This answered a question I did not know how to ask.
anders_CPH said:Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):
| Metric | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Skeletal Muscle (lbs) | 68 | 72 | 69 | 70 |
| Body Fat (lbs) | 85 | 74 | 58 | 46 |
| Body Fat % | 38% | 31% | 27% | 20% |
| Visceral Fat (cm²) | 145 | 120 | 80 | 55 |
Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.
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Shop Reference StandardsNurseKim_ATL 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.
Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Report rather than reply if it drifts again.