Dr.GutHealth said:DEXA scan update relevant to lean mass: Scanned at months 0, 6, and 12.
Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep). Called my pharmacist — they said it's not dangerous but may absorb faster, potentially causing more GI effects.
Sure enough, had worse nausea that day. Lesson learned: pinch the skin properly and use the right needle length for your body composition.
Dr.EM_Chicago said:Right, and protein targets should be set on a reference weight rather than current weight.
Thank you for spelling out the reasoning rather than just the conclusion.
Dr.GutHealth said:DEXA scan update relevant to lean mass: Scanned at months 0, 6, and 12.
Dr.GutHealth said:...the muscle loss concern with lean mass...
This is a legitimate and well-studied concern. Let me put some numbers on it:
In STEP 1, approximately 39% of weight lost was lean mass. However, the Lundgren 2024 study showed that structured resistance training reduced this to ~25% lean mass loss.
Context matters: at BMI 35+, you're carrying excess lean mass to support the extra weight. Losing some lean mass is expected and not inherently harmful if you maintain adequate muscle function through exercise.
The solution isn't avoiding the medication — it's combining it with proper exercise and protein intake.
Janoshik Analytical — Independent Testing
Trusted third-party HPLC & mass spectrometry analysis. Verify peptide purity with the lab the community relies on. Independent. Accurate. Transparent.
Verify Your PeptidesGL Biochem (Shanghai) Ltd. — Direct Manufacturer
Est. 1998. The synthesis house behind the vials you send for testing. ISO 9001 and cGMP certified, 1,500+ staff, batch-specific COA with every order.
Browse GL Biochemnancy_portland said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
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.