Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean. I want to know whether that ratio is bad, normal, or simply what happens.
What would genuinely help is knowing 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.
Happy to be told the question itself is wrong.
This one has a reasonably settled answer, so here it is. 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 g/kg of reference body weight, and not making the deficit larger than the training can support. Cardio does not protect lean mass and in a deep deficit competes with recovery.
Dr.LipidDallas 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…
Right, and protein targets should be set on a reference weight rather than current weight. Setting 1.6 g/kg on a starting weight of 130kg produces a target nobody hits on a suppressed appetite.
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Browse GL Biochemnancy_portland said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
This matches mine closely enough to be worth saying so. The honest range is roughly 20 to 40% of total loss as lean mass without deliberate resistance training, and roughly 10 to 20% with it plus adequate protein. Both numbers need a caveat that matters: "lean mass" on a DEXA is not muscle. It includes water, glycogen and the lean fraction of organs, and glycogen alone carries about three grams of water per gram. A large early lean drop is mostly the glycogen and water going, which is why the first scan flatters and the second is the honest one.
Clinical perspective, offered as context rather than as advice.
Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):
| Metric | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Skeletal Muscle (lbs) | 69 | 71 | 72 | 71 |
| Body Fat (lbs) | 91 | 75 | 53 | 45 |
| Body Fat % | 39% | 32% | 26% | 21% |
| Visceral Fat (cm²) | 146 | 111 | 81 | 56 |
Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.