SarahChen_PharmD said:

Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.

Sharing my comprehensive lab data relevant to lean mass:

Protocol: Tirzepatide 15mg/wk, resistance training 4x/week, protein 1.6g/kg/day.

The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.

SarahChen_PharmD said:

Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.

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.

A narrower follow-up, since the general answer is now clear:

How would you tell the difference between that and the alternative explanation?

kate.chem said:

Physical therapist weighing in on lean mass.

Careful with the causal language. Two things moving together in a period when five things changed is not a mechanism, and stating it as one makes the thread less useful to somebody reading it later.

kate.chem said:

Physical therapist weighing in on lean mass.

True, with the qualification that this is a self-selected group. The people for whom it did not work post less, and that shapes everything we think we know.