Dr.BariatricHTX said:

Right, and protein targets should be set on a reference weight rather than current weight.

That reframing is the part I needed. Sending this to two other people who asked me the same thing last week.

LindaRN_retired said:

Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the…

Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep). Called my pharmacist — they said it's not dangerous but may absorb faster, potentially causing more GI effects.

Sure enough, had worse nausea that day. Lesson learned: pinch the skin properly and use the right needle length for your body composition.

rachel_ABQ said:

Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.

My endo's protocol for lean mass plateau: if weight loss stalls for 6+ weeks at current dose, we go through this checklist before titrating up:

1. Food diary review — is intake creeping up?
2. Protein check — minimum 100g/day
3. Activity audit — steps + resistance training
4. Sleep quality — poor sleep kills GLP-1 efficacy
5. Stress/cortisol management

Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.

Moderator note: the sourcing question belongs in the vendor section and has been split out.