Adding the clinical framing, because it changes how the question reads.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 282 | 232 | 232 | 217 |
| A1C (%) | 7.2 | 6.2 | 5.5 | 5.4 |
| hsCRP (mg/L) | 7.0 | 4.0 | 1.5 | 0.8 |
| Triglycerides | 182 | 162 | 142 | 112 |
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.
hank_denver said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
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.
Following on from hank_denver — and this may be the naive question:
Was that from a primary source or from a summary of one?
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Shop Reference Standardsdave_SLC said:Physical therapist weighing in on lean mass.
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 | 273 lbs | 238 lbs | 200 lbs |
| Fat mass | 103 lbs | 73 lbs | 50 lbs |
| Lean mass | 156 lbs | 152 lbs | 157 lbs |
| Body fat % | 42% | 32% | 24% |
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.