Answering the narrow version, because the broad one does not have a single answer. 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.
I lifted three times a week throughout and still lost lean mass. Not as much as I expected to, but the idea that training prevents it entirely is not what my scan says.
If you are tracking this properly: same scanner, same time of day, same hydration, at least six months apart, and read grip strength or a lift number alongside it. Function is the outcome; the scan is the proxy.
The bit I cannot resolve on my own is whether resistance training and protein change the ratio or only the absolute amount.
Happy to be told the question itself is wrong.
TrialTracker_MD 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…
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.
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Shop Reference StandardsBrianDallas92 said:I lifted three times a week throughout and still lost lean mass.
This matches mine closely enough to be worth saying so. There is also a quality change that the scan cannot see. Weight loss shifts fiber-type distribution toward Type I and improves mitochondrial density and insulin-stimulated glucose uptake per fiber — so the muscle you keep is metabolically better even though there is less of it. That does not make the loss irrelevant, but it explains why function often holds up better than the number suggests.
Clinical perspective, offered as context rather than as advice.
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:
- Food diary review — is intake creeping up?
- Protein check — minimum 100g/day
- Activity audit — steps + resistance training
- Sleep quality — poor sleep kills GLP-1 efficacy
- 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.