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Does a DEXA repeated every four weeks give me an usable lean-mass trend?

Asked 26 Mar 2025Modified 12 months agoViewed 11k times
26

The trend is what I care about; individual weeks are obviously noise.

I want to know what the trade-off actually is rather than which option is fashionable.

I would rather have a defensible reason than a marginal improvement.

So which one, and on what grounds?

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askedseven_day_half16k1826 Mar 2025

5 Answers

Accepted answer first, then by votes
67

Accepted answer

The underlying point is that a plateau at four to six months is the expected shape of the curve, not a failure of it. Energy expenditure falls with mass, and the deficit closes itself unless intake falls further.

Protein target, worked: at 88 kg, a target of 1.6 g/kg is 88 × 1.6 = 141 g per day. Spread across three eating occasions that is roughly 47 g each, and the leucine threshold for a maximal muscle protein synthetic response is met at around 2.5 to 3 g of leucine, which corresponds to roughly 30 to 40 g of a high-quality protein. So three meals at 40 g plus one 25 g snack gets you to 145 g and clears the per-meal threshold each time. On 900 kcal that leaves about 340 kcal for everything else, which is the actual constraint.

What each body-composition method measures

MethodMeasuresSensitive toLeast significant change
DEXAThree-compartment by attenuationHydration, positioning~2–3 % regional lean
BIA (consumer)Impedance, modelledHydration, food, temperatureNot usable at this timescale
Air displacementTwo-compartment by densityLung volume, hair, clothing~1–2 % fat mass
Tape and scaleCircumference, massTechniqueSurprisingly usable as a trend

Stated carefully, hydration state moves a DEXA lean-mass figure directly, because the algorithm assigns water to the lean compartment. Scanning fasted, at the same time of day, before training and without a recent high-carbohydrate day is the difference between a comparable sequence and a noisy one. Bioelectrical impedance is far more sensitive to hydration again, which is why its trend is unusable at this timescale.

SURMOUNT-4 provides the cleanest maintenance-versus-withdrawal contrast available in the class, and it is the reference for any claim about what happens after stopping[1].

Train, eat the protein, measure something functional, and give the trend three months before you interpret it.

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UM
answered · acceptedunit_math13k1816 Jul 2025
For what it is worth, my own result was within half a per cent of this. – mateo_iglesias 8 months ago
Any reason this would differ for a longer peptide? – coldpack_88 7 months ago
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57

To be exact about it, the mechanism is worth having straight, because it predicts which interventions can work and which cannot.

The first four weeks of loss is substantially fluid and glycogen. Each gram of stored glycogen carries roughly three grams of water, and total glycogen is on the order of 400 to 500 g, so the obligatory water shift alone accounts for a couple of kilograms. This is why the first month looks dramatic and the second looks like a plateau when in fact the fat-loss rate has not changed.

The minimum effective resistance-training dose in a deficit is lower than most programmes assume. Two sessions a week covering the major movement patterns, with loads taken close to failure, is sufficient to retain most of what would otherwise be lost. Volume beyond that adds recovery cost that a large energy deficit is poorly placed to pay.

The plateau is arithmetic. Treat it as arithmetic and the response follows.

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MI
answeredmicron2236k13829 Mar 2025
30

Put another way, the commonly quoted figures for lean-mass loss are mostly measurement artefacts, and the artefact is well understood: fat-free mass as measured includes water and glycogen, both of which fall early and neither of which is contractile tissue.

The regain trajectory after stopping is roughly a mirror of the loss trajectory, and it is not primarily a willpower phenomenon. Appetite signalling returns, energy expenditure remains suppressed relative to the original mass, and the two combine. That is an argument for a maintenance plan existing before the stop, rather than an argument against stopping.

Fibre at very low total intake is a trap. Soluble fibre needs water and motility to work; insoluble fibre adds bulk to a slow transit. At 900 kcal a day with delayed gastric emptying, an osmotic agent is more predictable than a bulking one, and adequate fluid is doing more work than either.

The limitation of the arithmetic is that it assumes intake is being measured accurately, and self-reported intake is systematically underestimated by a substantial margin.

Two resistance sessions a week and a protein target you actually hit will do more than any refinement beyond them.

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TM
answeredtobias_maartens94k25820 Apr 2025
25

To be exact about it, what the data supports is narrower than what gets recommended, so it is worth separating the two.

Absolute strength holds up better than scale weight during a deficit for a straightforward reason: strength is substantially neural and skill-based, and the contractile tissue you retain is being trained harder relative to its size. Grip strength and repetition maxima are therefore lagging indicators of muscle loss rather than leading ones, which is an argument for measuring both.

The evidence for a higher protein intake preserving lean mass during an energy deficit is reasonably strong in resistance-trained populations and weaker in sedentary ones, with the meta-analytic estimates supporting intakes in the region of 1.6 g/kg over lower intakes when training is present[1].

Measure strength as well as mass. It is cheaper, it is less noisy, and it is closer to what you actually care about.

edited 30 Apr 2025 by Dr_Fatima_Belkacem — added the method parameters

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DB
answeredDr_Fatima_Belkacem52k1389 Apr 2025
22

Specifically, the distinction that resolves this is between proportional loss and functional loss. Losing lean mass in proportion to total mass is what happens in every weight loss intervention. Losing function is not, and function is measurable.

Cardio does not interfere with lean-mass retention at the volumes anyone here is doing; the interference effect in the literature appears at high concurrent volumes in trained athletes. What cardio does at a large deficit is add to the deficit, which is either the point or a problem depending on the objective.

A maintenance plan written before you need it is worth more than a better loss plan.

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CM
answeredcarys_meredith17k2813 Jun 2025

Your answer

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