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.
Lean mass
Body-composition change during rapid weight loss, and what the protein and resistance-training literature supports.
Reading the exenatide composition data without the press release
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
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.
What we would need to randomise to answer this properly
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 recommendation survives scrutiny. The reasoning offered for it frequently does not.
The skeleton responds to load, and load is falling
Weight loss reduces bone mineral density at load-bearing sites. Whether that translates into fractures in this population is unmeasured.
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.
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.
What the older diet-and-exercise trials found in the hip
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
Grading six widely repeated claims against the studies actually behind them.
Percentage of loss, absolute kilograms, and the sleight of hand between them
Both the reassuring reading and the alarming reading are supportable from the same tables. This piece sets out which is which.
The one randomised trial that combined an incretin with supervised exercise
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
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.
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.
What the older diet-and-exercise trials found in the hip
The evidence base is one secondary analysis, several small studies and a large amount of extrapolation from bariatric surgery.
Two sessions a week, and the evidence behind the prescription
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
Eating enough protein on a suppressed appetite is an arithmetic problem before it is a nutritional one
The resistance-training and energy-deficit literature supports a higher protein intake. None of it was conducted in people taking an incretin.
Fat mass fell more than lean mass. That is the finding, and it is not the headline.
What was pre-specified, what was exploratory, and what was calculated afterwards by people who did not run the trial.