SarahChen_PharmD said:There is also a quality change that the scan cannot see.
This answered a question I did not know how to ask. Adding it to my notes with a link back to this thread.
Clinical perspective, offered as context rather than as advice.
Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes. Losing 44 lbs shifts your center of gravity and your core muscles need time to adjust.
Physical therapy has been essential. Core strengthening exercises (planks, dead bugs, bird dogs) daily for 10 minutes have eliminated my lower back pain. Your body is literally relearning how to carry itself.
JenPlateau said: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: Food…
DEXA scan update relevant to lean mass:
Scanned at months 0, 6, and 12. Here are the body comp numbers:
| Baseline | Month 6 | Month 12 | |
|---|---|---|---|
| Total mass | 257 lbs | 227 lbs | 194 lbs |
| Fat mass | 97 lbs | 77 lbs | 44 lbs |
| Lean mass | 150 lbs | 152 lbs | 151 lbs |
| Body fat % | 42% | 32% | 23% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.6g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.
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Browse GL Biochempete_manc_UK 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…
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.
Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. No action needed from anybody.