Step count challenge — June 2026 monthly competition

Dr.ObesityLA said:

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…

I read this differently from Dr.ObesityLA, 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.

wanda_boise said:

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

My endo's protocol for lean mass plateau: if weight loss stalls for 6+ weeks at current dose, we go through this checklist before titrating up:

1. Food diary review — is intake creeping up?
2. Protein check — minimum 100g/day
3. Activity audit — steps + resistance training
4. Sleep quality — poor sleep kills GLP-1 efficacy
5. Stress/cortisol management

Only after addressing all of these do we increase the dose. Often fixing one lifestyle factor restarts progress without needing more medication.

COA_Karl said:

I think this board over-worries about lean mass.

Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes. Losing 57 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.

One thing that is still open after SurmountFan_IN’s answer:

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

Reporting back.

Second scan under matched conditions came back with the lean number nearly a kilogram higher than the first, so a chunk of what I panicked about was hydration. Strength numbers were up throughout.