Has anyone dealt with tirzepatide and muscle preservation?

From the other side of the consultation, briefly. Take it one variable at a time. Almost every unanswerable question in these threads is unanswerable because three things changed in the same fortnight, and no amount of subsequent argument can untangle them after the fact.

Adding the clinical framing, because it changes how the question reads. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

Happy to go further on any of that.

NurseLeah_Nash said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

Right, and protein targets should be set on a reference weight rather than current weight. Setting 1.6 g/kg on a starting weight of 130kg produces a target nobody hits on a suppressed appetite.

NurseLeah_Nash said:

The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

Coming at NurseLeah_Nash’s question from a different direction. The honest range is roughly 20 to 40% of total loss as lean mass without deliberate resistance training, and roughly 10 to 20% with it plus adequate protein. Both numbers need a caveat that matters: "lean mass" on a DEXA is not muscle. It includes water, glycogen and the lean fraction of organs, and glycogen alone carries about three grams of water per gram. A large early lean drop is mostly the glycogen and water going, which is why the first scan flatters and the second is the honest one.

Moderator note: the sourcing question belongs in the vendor section and has been split out. No action needed from anybody.