Dr.RenalNash said:There is also a quality change that the scan cannot see.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.
Dr.RheumBOS said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
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 | 279 lbs | 214 lbs | 216 lbs |
| Fat mass | 119 lbs | 79 lbs | 51 lbs |
| Lean mass | 157 lbs | 150 lbs | 153 lbs |
| Body fat % | 40% | 30% | 25% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.4g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
LarryQC_SD said:I think this board over-worries about lean mass.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 254 | 239 | 224 | 204 |
| A1C (%) | 7.9 | 6.4 | 5.9 | 5.6 |
| hsCRP (mg/L) | 9.0 | 5.0 | 1.5 | 1.0 |
| Triglycerides | 224 | 174 | 114 | 104 |
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.
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Browse GL BiochemA narrower follow-up, since the general answer is now clear:
Whether resistance training and protein change the ratio or only the absolute amount?
Reporting back.
Second scan under matched conditions, six months apart, same time of day: the lean number came back nearly a kilo higher than the panic scan. Strength was up throughout.