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Learn · Protecting muscle

Not all weight lost is fat

A meaningful share of weight lost on these medications is muscle. That is changeable, and this is the part most programmes leave out.

2 min read

When you lose weight, some of what you lose is muscle. This is true of every method of weight loss, and it is true of these medications.

The numbers are worth seeing plainly. In the STEP-1 trial, of 13.6 kg of mean weight reduction, 5.3 kg — about 38% — was lean mass. In SURMOUNT-1, total lean mass fell by 8.5 absolute percentage points.

Why it matters beyond how you look

Muscle is where most of your resting energy expenditure comes from, and it is what keeps you able to carry, climb and get up unaided in twenty years. Losing it makes weight easier to regain and makes the regained weight more likely to be fat.

It is also the part of body composition that responds to what you do. You cannot choose where fat comes off. You can substantially change how much muscle goes with it.

The two things that change it

Enough protein, and resistance training. Neither works well without the other: protein without a training stimulus is largely oxidised, and training without enough protein has nothing to build from.

The next two lessons cover each. They are short, and they are the highest-value thing in this library.

Where this comes from

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