Dr.NutriCornell said:lean mass + resistance training is the combo.
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.
mike_mod said:Right, and protein targets should be set on a reference weight rather than current weight.
Genuinely useful, thank you. I had the facts and not the framework. Adding it to my notes with a link back to this thread.
Dr.NutriCornell said:lean mass + resistance training is the combo.
Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):
| Metric | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Skeletal Muscle (lbs) | 68 | 72 | 72 | 70 |
| Body Fat (lbs) | 100 | 80 | 58 | 46 |
| Body Fat % | 38% | 31% | 27% | 20% |
| Visceral Fat (cm²) | 145 | 120 | 80 | 55 |
Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.
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Shop Reference Standardsfiona_glasgow 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 | 245 lbs | 210 lbs | 212 lbs |
| Fat mass | 115 lbs | 65 lbs | 47 lbs |
| Lean mass | 153 lbs | 152 lbs | 149 lbs |
| Body fat % | 38% | 32% | 21% |
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.