DEXA scan longitudinal data — 12 months on GLP-1 + lifting

Dr.CardioMD said:

Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.

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.

dave_SLC said:

Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.

Bookmarking. The distinction being drawn above is the one nobody else makes. I will report back once I have actually tried it.

Dr.CardioMD said:

Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.

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.

DataDave said:

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

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

Lumbar spine T-score: -0.10 → -0.9 (stable to slightly improved)
Femoral neck T-score: -0.14 → -0.10 (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.

Moderator note: the sourcing question belongs in the vendor section and has been split out. Tagging this one for the weekly digest.