GenomicsKate said:

The honest range is roughly 20 to 40% of total loss as lean mass without deliberate resistance training, and roughly 10 to 20% with it plus adequate…

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

Adding the clinical framing, because it changes how the question reads.

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.

PharmHunterJen said:

Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months): Metric Baseline Month 3 Month 6 Month 9 Skeletal Muscle (lbs) 73…

PharmHunterJen said:

...the muscle loss concern with lean mass...

This is a legitimate and well-studied concern. Let me put some numbers on it:

In STEP 1, approximately 39% of weight lost was lean mass. However, the Lundgren 2024 study showed that structured resistance training reduced this to ~25% lean mass loss.

Context matters: at BMI 35+, you're carrying excess lean mass to support the extra weight. Losing some lean mass is expected and not inherently harmful if you maintain adequate muscle function through exercise.

The solution isn't avoiding the medication — it's combining it with proper exercise and protein intake.

denise_HTX said:

There is also a quality change that the scan cannot see.

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

Moderator note: a couple of off-topic posts removed. Carry on.