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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide body composition: SURMOUNT-1 DEXA substudy data

Tirzepatide body composition: SURMOUNT-1 DEXA substudy data

MikeFit_NJ Wed, Jun 3, 2026 at 6:53 AM 12 replies 270 viewsPage 1 of 3
MikeFit_NJ
Senior Member
1,567
6,543
Apr 2024
New Jersey
Jun 3, 2026 at 6:53 AM#1
There's way too much doom and gloom about muscle loss on GLP-1s. Yes, you will lose SOME lean mass on any caloric deficit. But the amount is largely within your control. I'm 9 months into tirz, down 62 lbs, and my DEXA scans tell a good story: DEXA Results: | Metric | Baseline | 9 months | Change | |--------|----------|----------|--------| | Total weight | 268 lbs | 206 lbs | -62 lbs | | Fat mass | 112 lbs | 58 lbs | -54 lbs | | Lean mass | 148 lbs | 141 lbs | -7 lbs | | Body fat % | 41.8% | 28.2% | -13.6% | That's 87% fat loss and only 13% lean mass loss. The typical ratio on caloric restriction alone without exercise is 25-35% lean mass loss. So I'm doing significantly better than baseline. Here's my protocol — stealing nothing, doing everything the research says:
36 6LeilaHI, marcus_mpls, DeniseRN_TPA and 33 others
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marcus_mpls
Member
234
1,123
Nov 2024
Minneapolis, MN
Jun 3, 2026 at 8:44 AM#2
THE PROTOCOL: Protein: 1g per pound of GOAL body weight (I target 180g/day). Non-negotiable. I eat protein first at every meal. If I can't eat enough whole food protein (common on tirz when appetite is crushed), I supplement with whey isolate or fairlife shakes. Resistance Training: 4 days/week, upper/lower split - Monday: Upper (bench, rows, OHP, pulldowns) - Tuesday: Lower (squat, RDL, leg press, leg curl) - Thursday: Upper (DB press, cable rows, lateral raises, curls/tris) - Friday: Lower (deadlift, Bulgarian splits, leg extension, calves) Progressive overload is KEY. I track every set, every rep, every weight. If I'm not progressing (or at minimum maintaining) my lifts, something is wrong. Current lifts (all at 206 lbs bodyweight): - Bench: 245 lbs (was 255 at 268 lbs — barely dropped) - Squat: 315 lbs (was 335 — slight decrease but I also have less mass to move) - Deadlift: 405 lbs (was 405 — no change 💪) Creatine: 5g daily. Helps with strength, cell hydration, and there's emerging data on lean mass preservation. Sleep: 7-8 hours minimum. GH release during sleep is critical for muscle protein synthesis. Tirz actually improved my sleep quality (probably because it helped my sleep apnea). Cardio: Light. 2-3x per week, 20-30 min walking/cycling. NOT doing excessive cardio that could eat into recovery.
Last edited: Jun 3, 2026 at 1:44 PM
35 5oliver_london, tane_welly, Dr.PathRoch and 32 others
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KristenIndy
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2,678
May 2024
Indianapolis, IN
Jun 3, 2026 at 10:34 AM#3
This is great but you were clearly an experienced lifter before starting tirz. What about people who've never lifted? I'm 5'7" 220 lbs, never been in a gym. Terrified of the "ozempic body" thing.
Last edited: Jun 3, 2026 at 3:34 PM
34 4Dr.GutHealth, amsterdam_pete, LondonLisa and 31 others
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marcus_mpls
Member
234
1,123
Nov 2024
Minneapolis, MN
Jun 3, 2026 at 12:24 PM#4
Honestly? Starting to lift while on tirz is even BETTER than my situation. Because you're a beginner, you'll experience "newbie gains" — your body can build muscle even in a caloric deficit because the stimulus is novel. Recomposition is very possible for untrained individuals. Start with a basic program like Starting Strength or GZCLP. Learn the compound movements. Focus on form first, weight second. Get your protein in. The "ozempic body" thing happens when people: 1. Eat 800 calories/day 2. Do zero resistance training 3. Get maybe 40g protein 4. Lose 80+ lbs rapidly That's not the drug's fault. That's a failure of protocol.
33 3Dr.PathRoch, mona_PHX, andrew_nyc and 30 others
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jason_sac26
New Member
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Jan 2026
Sacramento, CA
Jun 3, 2026 at 11:25 PM#5
Physical therapist and recreational lifter here. Want to add some nuance: The lean mass loss on DEXA includes water, glycogen, and organ mass — not just skeletal muscle. When you lose weight, your heart doesn't need to work as hard (less cardiac muscle mass needed), your liver shrinks (less fat storage), etc. So the 7 lbs of "lean mass" lost in your case probably includes ~3-4 lbs of non-muscle tissue. Your actual skeletal muscle loss might be as low as 3-4 lbs, which over 62 lbs of weight loss is exceptional. Additional tips: - Don't drop volume during a cut. Maintain training volume, reduce intensity slightly if needed - Time your tirz injection so that your heaviest training days aren't during peak nausea (usually days 1-2 post-injection) - If you can't eat enough protein due to suppressed appetite, liquid sources are your friend (shakes, bone broth, Greek yogurt) - Consider leucine supplementation (3-5g/day) if protein is marginal — it's the key amino acid for muscle protein synthesis
32 2Dr.PulmRoch, maya_sedona, stefan_berlin and 29 others
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