labquiet_amy 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…

I read this differently from labquiet_amy, on substance rather than tone. 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.

Ask again with the specifics and you will get a better answer than this one.

nick_newbie said:

I lifted three times a week throughout and still lost lean mass.

Sharing my comprehensive lab data relevant to lean mass:

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.

Dr.BariatricHTX said:

I think this board over-worries about lean mass.

Body composition tracking via bioimpedance on lean mass (InBody scan every 3 months):

Note: skeletal muscle mass dipped initially then recovered with consistent resistance training + high protein. The visceral fat reduction is where the metabolic magic happens.

One thing that is still open after raj_cambridge’s answer:

What fraction of loss being lean mass is actually normal, because the numbers quoted here range from 10% to 40% and cannot all be right?

Reporting back.

Second scan under matched conditions, six months apart, same time of day: the lean number came back nearly a kilo higher than the panic scan. Strength was up throughout.