I lifted three times a week throughout and still lost lean mass. Not as much as I expected to, but the idea that training prevents it entirely is not what my scan says.
The question I want answered is what fraction of loss being lean mass is actually normal, because the numbers quoted here range from 10% to 40% and cannot all be right.
Tell me what I have not thought of.
Taking the question as asked, rather than the general version of it. There is also a quality change that the scan cannot see. Weight loss shifts fiber-type distribution toward Type I and improves mitochondrial density and insulin-stimulated glucose uptake per fiber — so the muscle you keep is metabolically better even though there is less of it. That does not make the loss irrelevant, but it explains why function often holds up better than the number suggests.
If somebody has the primary source to hand I would rather cite it than paraphrase it.
Dr.AddMedPHL said:There is also a quality change that the scan cannot see.
Right, and protein targets should be set on a reference weight rather than current weight. Setting 1.6 g/kg on a starting weight of 130kg produces a target nobody hits on a suppressed appetite.
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Browse GL BiochemDr.BariatricHTX said:I lifted three times a week throughout and still lost lean mass.
Same position here, arrived at the long way round. The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0 g/kg of reference body weight, and not making the deficit larger than the training can support. Cardio does not protect lean mass and in a deep deficit competes with recovery.
From the other side of the consultation, briefly.
Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the skeletal muscle fiber type distribution:
- Decreased Type IIx (glycolytic, fast-twitch) fibers
- Increased Type I (oxidative, slow-twitch) fibers
- Improved mitochondrial density and function
- Enhanced insulin-stimulated glucose uptake per fiber
This "metabolic remodeling" of muscle may contribute to improved insulin sensitivity independent of total lean mass changes. The muscle you keep becomes metabolically better, even if there's less of it[1].
[1] Pirkmajer S, et al. Front Physiol. 2023;14:1123456.