julia.endo said:

Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the…

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.

PurityPaulOR said:

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

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

julia.endo said:

Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the…

OMG yes. lean mass + resistance training is the combo. Can confirm.

emily_PDX said:

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

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:

1. Food diary review — is intake creeping up?
2. Protein check — minimum 100g/day
3. Activity audit — steps + resistance training
4. Sleep quality — poor sleep kills GLP-1 efficacy
5. Stress/cortisol management

Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Tagging this one for the weekly digest.