julia.endo 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…
Thank you — that is the clearest version of this I have read, and I have read a lot of them.
Clinical perspective, offered as context rather than as advice.
Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the skeletal muscle fiber type distribution:
- Decreased Type IIx (glycolytic, fast-twitch) fibers
- Increased Type I (oxidative, slow-twitch) fibers
- Improved mitochondrial density and function
- Enhanced insulin-stimulated glucose uptake per fiber
This "metabolic remodeling" of muscle may contribute to improved insulin sensitivity independent of total lean mass changes. The muscle you keep becomes metabolically better, even if there's less of it[1].
[1] Pirkmajer S, et al. Front Physiol. 2023;14:1123456.
Dr.ObesityLA 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…
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 254 | 249 | 224 | 209 |
| A1C (%) | 7.9 | 6.4 | 5.9 | 5.6 |
| hsCRP (mg/L) | 9.0 | 5.0 | 1.5 | 1.0 |
| Triglycerides | 234 | 154 | 114 | 104 |
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.
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Browse GL Biochemdenise_HTX said:There is also a quality change that the scan cannot see.
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.8 → -0.9 (stable to slightly improved)
Femoral neck T-score: -0.14 → -0.10 (stable)
No significant bone loss despite 55 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: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Tagging this one for the weekly digest.