Creatine monohydrate + GLP-1 — looking for input

CarlaRPh_TPA 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 CarlaRPh_TPA, 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.

hyun_seoul said:

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

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.

LabKate said:

I think this board over-worries about lean mass.

DEXA scan update relevant to lean mass:

Scanned at months 0, 6, and 12. Here are the body comp numbers:

Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.4g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.

Following on from laura_annarbor — and this may be the naive question:

Whether resistance training and protein change the ratio or only the absolute amount?

OP back with an update, since a thread like this is useless without one.

Follow-up: I dropped the cardio to two easy sessions and put the effort into three real lifting sessions. The scale slowed and the scan improved.