The imaging substudy is an afterthought in the protocol and the centrepiece of the debate
The composition data comes from imaging substudies enrolling a few score participants at selected sites. It is the best evidence available and it is thin.
Exercise
Resistance training during weight loss and what it is and is not shown to preserve.
The imaging substudy is an afterthought in the protocol and the centrepiece of the debate
The trials measured mass. Nobody measured whether the participants got weaker.
Fat mass fell more than lean mass. That is the finding, and it is not the headline.
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
The advice is mostly reasonable. The certainty is not earned.
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
Lean mass is a compartment, not a tissue
The instrument determines the answer more than the drug does, and the trade quotes the answer without naming the instrument.
The one randomised trial that combined an incretin with supervised exercise
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
Load, not cardio: the distinction the general advice keeps losing
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
Bone density during rapid weight loss: what is known, which is less than you would hope
The evidence base is one secondary analysis, several small studies and a large amount of extrapolation from bariatric surgery.
Why "muscle-sparing" is a marketing term and not a measurement
Almost every practical recommendation in circulation was established in a population that does not resemble the people now following it.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
Why "muscle-sparing" is a marketing term and not a measurement
Grading six widely repeated claims against the studies actually behind them.
Load, not cardio: the distinction the general advice keeps losing
What was supervised, at what frequency, at what intensity, and for how long.
The one randomised trial that combined an incretin with supervised exercise
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
Load, not cardio: the distinction the general advice keeps losing
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
Load, not cardio: the distinction the general advice keeps losing
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
Why the bone question is harder than the muscle question
A plausible mechanism, a measurable change, and no outcome data. This is what an open question looks like.
Why "muscle-sparing" is a marketing term and not a measurement
Grading six widely repeated claims against the studies actually behind them.
How much of cagrilintide weight loss can any instrument actually attribute?
The compartment called lean mass contains water, glycogen, viscera and skin. Only some of it is the tissue anybody is worried about.
The one-quarter rule, and the paper that took it apart
Grading six widely repeated claims against the studies actually behind them.
The supplement trade found this drug class quickly, and the citations did not improve
A survey of what the meta-analyses support, with the populations named.