Take the STEP 8 body-composition substudy, not the main paper, and note how few participants were in it. Composition substudies are typically a small imaged subset of the full randomisation, so the lean-mass fraction carries a confidence interval far wider than the weight figures beside it. Then check the method: DEXA reports lean soft tissue, which includes water, and a large early fluid shift is counted as lean loss whether or not any protein left. The fraction most of these programmes land near is around a quarter of total loss, which is also roughly what caloric restriction alone produces — the interesting question is not the fraction but whether it differs from the deficit-matched control.
The short version: some lean loss is obligatory, the proportion is modifiable, and most of the early loss is water rather than tissue.
The conventional figure is that lean tissue accounts for roughly a quarter of total weight lost in unstructured weight loss, falling towards ten to fifteen per cent with adequate protein and progressive resistance training, and rising above a third with very rapid loss and no training stimulus.
More usefully, resistance training two to four times weekly with progressive load is the intervention with the strongest evidence for reducing the lean fraction of loss. Cardiovascular exercise does not substitute for it on this endpoint.
Track absolute lean mass, not lean percentage, or the arithmetic will mislead you.
8Worth adding that scan precision means half a kilogram is inside the noise. – bea_forsberg 6 days ago add a comment