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.
[1] Lundgren JR, et al. JAMA. 2024;331(1):38-48.
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:
| Baseline | Month 6 | Month 12 | |
|---|---|---|---|
| Total mass | 261 lbs | 216 lbs | 218 lbs |
| Fat mass | 121 lbs | 81 lbs | 53 lbs |
| Lean mass | 159 lbs | 152 lbs | 155 lbs |
| Body fat % | 38% | 32% | 22% |
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.
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Browse GL BiochemDr.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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