Dr.RaviCardio said:

lean mass + resistance training is the combo.

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.

LindaRN_retired said:

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

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Sending this to two other people who asked me the same thing last week.

Dr.RaviCardio said:

lean mass + resistance training is the combo.

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.

JakeBK_lifts said:

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

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.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part.