kate.chem 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…
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.
Dr.RheumBOS said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 276 | 241 | 226 | 211 |
| A1C (%) | 6.6 | 6.6 | 5.7 | 5.3 |
| hsCRP (mg/L) | 6.0 | 4.0 | 1.5 | 1.2 |
| Triglycerides | 226 | 156 | 136 | 106 |
Protocol: Semaglutide 1.7mg/wk, resistance training 3x/week, protein 1.2g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
LipidDoc_ATL said:I think this board over-worries about lean mass.
DEXA scan update relevant to lean mass:
Scanned at months 0, 6, and 12. Here are the body comp numbers:
| Baseline | Month 6 | Month 12 | |
|---|---|---|---|
| Total mass | 247 lbs | 237 lbs | 194 lbs |
| Fat mass | 97 lbs | 67 lbs | 44 lbs |
| Lean mass | 150 lbs | 146 lbs | 151 lbs |
| Body fat % | 40% | 32% | 23% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.6g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
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Shop Reference StandardsFollowing on from anders_CPH — and this may be the naive question:
Whether resistance training and protein change the ratio or only the absolute amount?
Reporting back.
Follow-up: I dropped the cardio to two easy sessions and put the effort into three real lifting sessions. The scale slowed and the scan improved.