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ForumsExercise & Body CompositionPilates for core strength during GLP-1 weight loss — anyone have experience?

Pilates for core strength during GLP-1 weight loss — anyone have experience?

mona_PHX Mon, Dec 29, 2025 at 12:14 AM 12 replies 1,174 viewsPage 1 of 3
mona_PHX
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Dec 29, 2025 at 12:14 AM#1

Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about lean-mass preservation, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

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.

The condition it depends on

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.

The practical version

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.

What I am not sure about

The question I want answered is whether resistance training and protein change the ratio or only the absolute amount. Tell me what I have not thought of.

— mona_PHX · corrections welcome and will be edited into this post with credit
12 7RetaRick_CA, JenPlateau, SallyK_inj and 9 others
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Dr.GastroMayo
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Dec 29, 2025 at 12:21 AM#2
mona_PHX 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…

That is correct as far as it goes, and here is where it stops going. 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.

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LipidDoc_ATL
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Dec 29, 2025 at 12:28 AM#3
mona_PHX 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…

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.

Last edited: Dec 29, 2025 at 5:28 AM
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paige_pharma
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Dec 29, 2025 at 12:35 AM#4

Short answer first, then the reasoning. 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 g/kg of reference body weight, and not making the deficit larger than the training can support. Cardio does not protect lean mass and in a deep deficit competes with recovery.

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alex_tucson
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Dec 29, 2025 at 1:10 AM#5
Dr.GastroMayo said:
There is also a quality change that the scan cannot see.

Same experience, arrived at from the opposite direction. The detail I would add is minor and it is already implied above.

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