Dr.KarenChen said: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…
I read this differently from Dr.KarenChen, on substance rather than tone. 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.
sarah_TO said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):
| Metric | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Skeletal Muscle (lbs) | 75 | 71 | 72 | 73 |
| Body Fat (lbs) | 92 | 77 | 61 | 45 |
| Body Fat % | 41% | 33% | 26% | 20% |
| Visceral Fat (cm²) | 172 | 127 | 92 | 62 |
Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.
CarlaRPh_TPA said:I think this board over-worries about lean mass.
Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Lumbar spine T-score: -0.11 → -0.6 (stable to slightly improved)
Femoral neck T-score: -0.13 → -0.7 (stable)
No significant bone loss despite 78 lbs of weight loss. Key factors: adequate calcium (1200mg/day), vitamin D (5000 IU/day), resistance training 3x/week, and adequate protein. Weight-bearing exercise is critical for maintaining bone density during rapid weight loss.
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Shop Reference StandardsOne thing that is still open after Dr.EndoEP’s answer:
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?
Closing the loop on my own question.
Follow-up: I dropped the cardio to two easy sessions and put the effort into three real lifting sessions. The scale slowed and the scan improved.