Semaglutide and lean mass: DEXA scan longitudinal data

BenResearch_OR 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.

Worth separating that from semaglutide, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Adding the numbers, since they settle part of this. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

anders_CPH said:

I think this board over-worries about lean mass.

Adding the part of the answer the thread has not reached. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

That is the short version; the long version is somebody else's post.

Following on from sarah.morrison — and this may be the naive question:

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.