Dr.RaviCardio said: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: Food…
OMG yes. lean mass + resistance training is the combo. Can confirm.
Dr.NutriCornell said:Right, and protein targets should be set on a reference weight rather than current weight.
This is exactly what I could not find anywhere else. Sending this to two other people who asked me the same thing last week.
Dr.RaviCardio said: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: Food…
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 | 73 | 67 | 71 |
| Body Fat (lbs) | 97 | 81 | 59 | 47 |
| Body Fat % | 39% | 33% | 28% | 21% |
| Visceral Fat (cm²) | 152 | 117 | 87 | 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.
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Shop Reference Standardsdave_SLC said:I lifted three times a week throughout and still lost lean mass.
Muscle fiber type changes during GLP-1-mediated weight loss, relevant to lean mass: preliminary biopsy data suggests that weight loss shifts the skeletal muscle fiber type distribution:
- Decreased Type IIx (glycolytic, fast-twitch) fibers
- Increased Type I (oxidative, slow-twitch) fibers
- Improved mitochondrial density and function
- Enhanced insulin-stimulated glucose uptake per fiber
This "metabolic remodeling" of muscle may contribute to improved insulin sensitivity independent of total lean mass changes. The muscle you keep becomes metabolically better, even if there's less of it[1].
[1] Pirkmajer S, et al. Front Physiol. 2023;14:1123456.