Want to add some context from the recent literature. A 2024 study in JAMA looked specifically at the effect of structured resistance training during GLP-1 RA therapy:

• Exercise group: 88% of weight loss was fat mass
• Control group (no exercise): 61% of weight loss was fat mass
• The exercise group also had better metabolic markers, better functional capacity, and reported higher quality of life

Dave's 81% is right in line with the exercise group data. The evidence is really clear at this point — resistance training during GLP-1 therapy should be considered standard of care, not optional.

The challenge is implementation. Most prescribers don't have the infrastructure to provide exercise guidance alongside the prescription. That's a systemic problem.

Just want to share my experience as a cautionary tale. Lost 40kg on semaglutide over 12 months with zero exercise and minimal protein attention. Got a DEXA at the end and 42% of my weight loss was lean mass. My RMR dropped by nearly 400 calories/day.

I look thinner but I'm weak. Can't carry groceries up the stairs without getting winded. My doctor is now concerned about bone density.

I'm not telling this story to scare people but to emphasize what Dave and the others are saying — the weight loss is only half the equation. HOW you lose matters as much as how MUCH you lose. Start lifting. Eat protein. Don't make my mistake.

Thank you for sharing that — it takes courage. And the good news is, as mentioned above, you can rebuild. Muscle memory is real. If you start a structured program now with proper nutrition, you'll likely see faster initial gains than someone who's never trained before.

Your RMR can recover too as you rebuild lean mass. It's not a permanent sentence. Just a course correction needed.