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ForumsExercise & Body CompositionPowerlifting on GLP-1 — my results so far

Powerlifting on GLP-1 — my results so far

PedsEndoPhilly Wed, Sep 10, 2025 at 4:40 PM 36 replies 1,892 viewsPage 1 of 8
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PedsEndoPhilly
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Sep 10, 2025 at 4:40 PM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

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.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

What I am trying to establish is 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. Practical detail welcome, however dull — the duller the better.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
48 18sarah_TO, wendy_avl, jason_paloalto and 45 others
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PharmacoVig_BOS
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Sep 10, 2025 at 5:18 PM#2
PedsEndoPhilly 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…

No disagreement with PedsEndoPhilly. One condition attached. 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.

Happy to go further on any of that.

47 17Dr.GutHealth, amsterdam_pete, LondonLisa and 44 others
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amsterdam_pete
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Sep 10, 2025 at 5:56 PM#3
PedsEndoPhilly 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 PedsEndoPhilly, 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.

46 16CanadaChris, ZaraB_AL, JakeSmashed95 and 43 others
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paige_pharma
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Sep 10, 2025 at 6:34 PM#4

This one has a reasonably settled answer, so here it is. 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.

45 15lisa_labSD, adam_van, Dr.SurgeonPGH and 42 others
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maya_sedona
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Sep 10, 2025 at 10:08 PM#5
PharmacoVig_BOS said:
There is also a quality change that the scan cannot see.

Second this. I had assumed I was the exception until I read this.

44 14Dr.RaviCardio, jennifer_SEA, tyler_CSCS and 41 others
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