Semaglutide and lean mass: DEXA scan longitudinal data — 12 month update

DebRD_ATL 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 DebRD_ATL, 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.

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. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

LabKate said:

I think this board over-worries about lean mass.

Adding the part of the answer the thread has not reached. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

A narrower follow-up, since the general answer is now clear:

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.