anna.melb_AU said:

lean mass + resistance training is the combo.

Sharing my comprehensive lab data relevant to lean mass:

Protocol: Semaglutide 2.4mg/wk, resistance training 3x/week, protein 1.4g/kg/day.

The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.

Following on from anna.melb_AU — and this may be the naive question:

Did your prescriber agree with that reading, and if not what was their objection?

Dr.PathRoch said:

Sharing my comprehensive lab data relevant to lean mass: Biomarker Baseline Month 3 Month 6 Month 9 Weight (lbs) 254 234 214 209 A1C (%) 6.9 6.4 5.9…

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

Lumbar spine T-score: -0.8 → -0.6 (stable to slightly improved)
Femoral neck T-score: -0.13 → -0.7 (stable)

No significant bone loss despite 60 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.PathRoch said:

Sharing my comprehensive lab data relevant to lean mass: Biomarker Baseline Month 3 Month 6 Month 9 Weight (lbs) 254 234 214 209 A1C (%) 6.9 6.4 5.9…

Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep). Called my pharmacist — they said it's not dangerous but may absorb faster, potentially causing more GI effects.

Sure enough, had worse nausea that day. Lesson learned: pinch the skin properly and use the right needle length for your body composition.

Dr.PathRoch said:

Sharing my comprehensive lab data relevant to lean mass: Biomarker Baseline Month 3 Month 6 Month 9 Weight (lbs) 254 234 214 209 A1C (%) 6.9 6.4 5.9…

Saving this. It is the first explanation that did not require me to already understand it.