Creatine monohydrate + GLP-1 — 12 month update

Dr.LipidDallas 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…

This is where I part company with the consensus forming above. 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.

nancy_portland said:

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

Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.

Lumbar spine T-score: -0.8 → -0.9 (stable to slightly improved)
Femoral neck T-score: -0.10 → -0.10 (stable)

No significant bone loss despite 75 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.

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 + 1.6g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.

Following on from Dr.EM_Chicago — 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.