RetaRick_CA said:There is also a quality change that the scan cannot see.
Pushing back on RetaRick_CA here. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.
lucas_SP_BR said:I lifted three times a week throughout and still lost lean mass.
lucas_SP_BR said:...the muscle loss concern with lean mass...
This is a legitimate and well-studied concern. Let me put some numbers on it:
In STEP 1, approximately 39% of weight lost was lean mass. However, the Lundgren 2024 study showed that structured resistance training reduced this to ~25% lean mass loss.
Context matters: at BMI 35+, you're carrying excess lean mass to support the extra weight. Losing some lean mass is expected and not inherently harmful if you maintain adequate muscle function through exercise.
The solution isn't avoiding the medication — it's combining it with proper exercise and protein intake.
Dr.NutriCornell said:I think this board over-worries about lean mass.
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 | 69 | 73 |
| Body Fat (lbs) | 107 | 77 | 55 | 47 |
| Body Fat % | 41% | 33% | 28% | 20% |
| Visceral Fat (cm²) | 172 | 117 | 92 | 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 StandardsOne thing that is still open after BenResearch_OR’s answer:
Whether resistance training and protein change the ratio or only the absolute amount?
Reporting back.
Second scan under matched conditions came back with the lean number nearly a kilogram higher than the first, so a chunk of what I panicked about was hydration. Strength numbers were up throughout.