Dr.DermMIA said:Dr.GutHealth said: ...the muscle loss concern with lean mass...
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 286 | 231 | 226 | 216 |
| A1C (%) | 6.6 | 6.6 | 5.9 | 5.3 |
| hsCRP (mg/L) | 6.0 | 4.0 | 1.5 | 1.2 |
| Triglycerides | 216 | 186 | 146 | 106 |
Protocol: Semaglutide 2.4mg/wk, resistance training 3x/week, protein 1.4g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
MariaRD said:Right, and protein targets should be set on a reference weight rather than current weight.
That reframing is the part I needed.
Dr.DermMIA said:Dr.GutHealth said: ...the muscle loss concern with lean mass...
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.
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Shop Reference StandardsJakeBK_lifts said:I lifted three times a week throughout and still lost lean mass.
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.11 → -0.8 (stable to slightly improved)
Femoral neck T-score: -0.11 → -0.9 (stable)
No significant bone loss despite 58 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.
Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Thread quality here is what the rules are for. Keep it up.