From the other side of the consultation, briefly.

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.

PharmacoVig_BOS said:

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

Genuinely useful, thank you. I had the facts and not the framework. I will report back once I have actually tried it.

Clinical perspective, offered as context rather than as advice.

DEXA scan update relevant to lean mass:

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 + 1.6g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.

Dr.ObesityMed said:

DEXA scan update relevant to lean mass: Scanned at months 0, 6, and 12.

Mine went the same way, slower.

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