Dr.PulmRoch said:

Distribution matters less than total but it is not nothing.

DEXA scan update relevant to protein intake:

Scanned at months 0, 6, and 12. Here are the body comp numbers:

Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.5g/kg protein. The protein intake discussion needs to include body comp data, not just scale weight.

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

How people are hitting a protein target on a genuinely suppressed appetite, because volume is the binding constraint rather than willingness?

SleepDoc_PDX said:

DEXA scan update relevant to protein intake: Scanned at months 0, 6, and 12.

Coming at SleepDoc_PDX’s question from a different direction. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.

Closing the loop on my own question.

Front-loading was the answer. Same total intake, same drug, but two thirds of the protein before midday and I am hitting the target most days now.

Dr.DermMIA said:

Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then…

True, and anyone with reduced kidney function needs that target set by a clinician rather than a forum. High protein is safe in normal kidneys and is not automatically safe in impaired ones.