andrew_nyc 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 exactly what I could not find anywhere else. Taking it to my next appointment.
From the other side of the consultation, briefly.
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.
Dr.Martinez said: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…
OMG yes. lean mass + resistance training is the combo. Can confirm.
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Browse GL BiochemMikeFit_NJ 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…
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.9 → -0.6 (stable to slightly improved)
Femoral neck T-score: -0.11 → -0.7 (stable)
No significant bone loss despite 76 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.
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