hans_munich said:There is also a quality change that the scan cannot see.
Thank you for spelling out the reasoning rather than just the conclusion. Sending this to two other people who asked me the same thing last week.
Adding the clinical framing, because it changes how the question reads.
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.8 → -0.7 (stable to slightly improved)
Femoral neck T-score: -0.12 → -0.8 (stable)
No significant bone loss despite 65 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.
Dr.BariatricHTX said:Training does two things here and only one of them is on the scale.
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 | 248 lbs | 218 lbs | 195 lbs |
| Fat mass | 98 lbs | 68 lbs | 45 lbs |
| Lean mass | 151 lbs | 147 lbs | 152 lbs |
| Body fat % | 41% | 33% | 24% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.4g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
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Browse GL BiochemDr.Martinez 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…
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:
Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.
Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Thread quality here is what the rules are for. Keep it up.