How come that you think this?
>Among these patients, lean mass accounted for approximately 39% of total weight loss – substantially higher than ideal. In a substudy of 178 patients from the SUSTAIN 8 trial on semaglutide as a diabetes treatment, the average proportion of lean mass loss was nearly identical at 40%, despite lower doses and less total weight loss than in the STEP 1 trial. [...]
Or in other words, 60% of the weight loss was in fat. The article paints this as concerning, but doesn't provide justification why. Sure, it'd be better to have 0% lean body mass loss, but how does 40% stack compared to calorie deficit diets? The mechanism of action behind the drugs is to cause you to eat less, and if the side effects are consistent with eating less, I don't see why people should be extra concerned.
The justification is provided: this is nearly double the lean body mass loss usually seen in drastic weight loss. Yes, 0% is impossible, but this is worryingly high. It might be OK in younger individuals who have a ton of fat mass to lose, and they might gain any lean body mass back. But in older individuals that are already having a hard time exercising, it's unlikely that lean body mass will ever come back.
Makes me think these drugs should probably be a measure of last resort. Unless more studies defuse this.
For the rest of us there's discipline and sheer willpower, as well as smart energy management.
Train too hard? My appetite goes nuts. Train not enough? The weight loss is muscle. It kind of never stops.
(Speaking as someone fast approaching the big five oh, on the very upper end of the normal BMI and not enough muscle to sugar coat all the excess gut fat which somehow disappears when clothed thanks to an above average height yet is still very much a risk factor.)
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To emphasize: the real point is the meta-framework of experiments. Formulate a hypothesis, design a 30-day experiment, test it. I’ve probably done dozens of these over the years.
Here are some examples from the last few years:
30 days of cold showers
90 days of no online news (I thought stress might contribute)
90 days of the carnivore diet
30 days of eating only at In’n’out burger
Doing Starting Strength, a beginner’s powerlifting program
Doing Simple & Sinister, a kettlebell training program
30 days of a low-fiber diet
30 days of a low-protein diet
30 days of a potato diet
30 days of drinking only distilled water (including for coffee)
Eating only pemmican, a raw meat paste invented by Native Americans
But I had that "willpower" for decades and didn't lose much weight. Certainly "pushing harder" didn't change anything.
And then flicking one little switch made it super easy with no willpower involved. So I just don't see how the willpower is related to losing fat.
Do have to add - it's impressive that you went through all these documented efforts. In the name of science and all that.
2) I didn't lose the weight on keto. I did keto for 7 years and managed to gain 100lbs back while on keto. This fat loss is very recent, and while it's still a ketogenic diet, it really is some magic little switch that I've flicked - I just don't know (yet) which one :)
It's far easier for me to just do caloric restriction. Granted I wouldn't lose weight as quickly.