MASHdoc_SA said:

lean mass + resistance training is the combo.

Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):

Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.

carl_compliance said:

Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.

This answered a question I did not know how to ask.

MASHdoc_SA said:

lean mass + resistance training is the combo.

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.

A1cHero_PHX said:

I lifted three times a week throughout and still lost lean mass.

Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes. Losing 69 lbs shifts your center of gravity and your core muscles need time to adjust.

Physical therapy has been essential. Core strengthening exercises (planks, dead bugs, bird dogs) daily for 10 minutes have eliminated my lower back pain. Your body is literally relearning how to carry itself.

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