Tirzepatide body composition: SURMOUNT-1 DEXA substudy data

roxy_nash 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…

Thank you for spelling out the reasoning rather than just the conclusion.

Clinical perspective, offered as context rather than as advice.

Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.

Lumbar spine T-score: -0.10 → -0.7 (stable to slightly improved)
Femoral neck T-score: -0.14 → -0.8 (stable)

No significant bone loss despite 67 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.

sean_dublin said:

Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

MikeFit_NJ said:

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…

Sharing my comprehensive lab data relevant to lean mass:

Protocol: Tirzepatide 10mg/wk, resistance training 5x/week, protein 1.5g/kg/day.

The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.

Moderator note: a couple of off-topic posts removed. Thread quality here is what the rules are for. Keep it up.