Dr.RaviCardio said:There is also a quality change that the scan cannot see.
That reframing is the part I needed. Taking it to my next appointment.
Clinical perspective, offered as context rather than as advice.
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:
Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.
Dr.PulmRoch said:Training does two things here and only one of them is on the scale.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 288 | 233 | 218 | 213 |
| A1C (%) | 7.3 | 6.8 | 6.1 | 5.5 |
| hsCRP (mg/L) | 8.0 | 5.0 | 1.5 | 1.4 |
| Triglycerides | 218 | 158 | 148 | 98 |
Protocol: Semaglutide 1.7mg/wk, resistance training 3x/week, protein 1.2g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
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Shop Reference StandardsDr.Martinez 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…
Physical therapist weighing in on lean mass. I work with bariatric and metabolic patients daily.
The resistance training evidence is critical here:
The Lundgren 2024 JAMA paper[1] showed that structured resistance training preserved 73% more lean mass in GLP-1 patients vs medication alone. When discussing lean mass, we MUST include the exercise component.
My minimum prescription: 3x/week compound movements (squat, deadlift, press, row), progressive overload, 7-10K steps/day, and 1.2-1.6g protein/kg/day.
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