pete_nash 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…
pete_nash 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.
Dr.EndoIndy said:Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.
Genuinely useful, thank you. I had the facts and not the framework. Sending this to two other people who asked me the same thing last week.
pete_nash 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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View Resultscory_ATX said:I lifted three times a week throughout and still lost lean mass.
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 | 68 | 69 | 72 |
| Body Fat (lbs) | 105 | 76 | 54 | 42 |
| Body Fat % | 40% | 31% | 27% | 22% |
| Visceral Fat (cm²) | 165 | 120 | 85 | 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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