Interpretting DEXA Results - Stronger but somehow with less muscle?


(Bacon is a many-splendoured thing) #21

Ah. Thank you.


It’s two months later. I upped my protein intake to a minimum 200g/day (I weight around 242lbs) on lifting days, and supplement with at least 150g on non-lifting days.

I took another DEXA scan.

  • I got my lean mass back in my legs. Went up 3.4 lbs, but only 1.4 of it was lean.
  • total lean mass went up a total of 0.8 lbs, but fat went up 1.5 lbs.

My arms took a hit from two months ago. 4.4 lbs down! 2.4 of that was lean. Since I can lift more today that I could two months ago, that seemed very wrong to me. Also I took measurements at the beginning of the month, and biceps are larger, so on the surface, this didn’t make sense.

Why the difference? I think you guys were right, glycogen played a role… it wasn’t replenished. I did a heavy arm/back workout the day before for about an hour.

When I reported the my legs got ‘smaller’, I did a leg day the day before the scan.

So, would it be safe to say that one should wait 48 hours or so from the last workout to allow glycogen to get replenished in order to get a more accurate scan?

(Maria P) #23

A fasting expert (Megan Ramos) said on a podcast that one of her clients lost 10 lbs muscle in addition to losing significant fat according to DEXA scans despite being the client being much stronger. They believe it was some sort of “junk protein” lost thru autophagy while fasting.

(Bacon is a many-splendoured thing) #24

If you are significantly overweight, you need more muscle to haul all that fat around. So a certain amount of muscle loss is to be expected when shedding a large amount of fat, and it is healthy and normal, because the body tries not to maintain anything that is not necessary. As mentioned, the sign of benign muscle loss is that strength remains unaffected.

(Central Florida Bob ) #25

To add what @Maria_P and @PaulL said, a large amount of lean mass in the body, in this case the “junk protein” Megan Ramos mentions, is connective tissue that holds our internal organs in place (so that we don’t change shape like a water drop when we stand up). You want to be rid of extra.


Interesting. I am a big fan of using the DEXA scan, and have done so before I started Keto and 3 months later and every year after. I suspect you are trying to do too much. I would suspend OMAD and the 24-72 fasting entirely. I would change the 18/4 to 16/8 to every other day and test this protocol. The USD is .8grams of protein per body weight. This figure is well over 40 years old. It has been shown to be inadequate for most and even less for those who exercise. I would shoot for 1.5 to 2 grams per kilo of body weight, or 1 gram per pound of body weight spread out over the day. Its not easy to get this amount of protein unless you use protein drinks. With regards to weight lifting, again it sounds like you are doing too many different exercise (every 6 days). Focus on your main muscles.(Pareto Principle 80/20 rule) hex bar or trap bar engages about 90% of all skeletal muscle and is definitely your biggest bang for your time. A simple 5 day program would look like this:
5x5x5 5 reps, rest 5 mins and 5 sets. Add weight only when you can do all 5 sets. Heavy weights Monday, Tuesday and Wednesday. 80% on Thursday and Friday. Weekend no weights, maybe some walking.

Monday: Trap Bar
Tuesday: Chest Press
Wednesday: Deadlifts
Thursday: Chest Press 80% Light days
Friday: Trap Bar 80% Light days
OFF WEEKENDS TO RECOVER build muscle and strength.


I have now had two DEXA scans, and at first I was disconcerted to see that I had lost what I thought of as muscle. What the heck! I’d been working out and could actually see visible change and measure increased strength. But I now realize that “lean mass” is more than just muscle; it’s pretty much everything except fat and bone. There is supporting matrix and all kinds of anatomic goo. My reading since then suggests that losing 3 to 1 fat to lean is actually just fine. Plenty of people trying to lose weight with pure calorie restriction do worse than that. Exercise and protein help. I found an informative article entitled Preserving Healthy Muscle during Weight Loss that describes, among other things, how obese people have quite a bit of muscle mass with low strength and high lipid content. My TL;DR takeaway was:

1 ) compared with persons with normal weight, those with obesity have more muscle mass but poor muscle quality; 2 ) diet-induced weight loss reduces muscle mass without adversely affecting muscle strength;

And when you think about it, all of us who have lost a lot of weight know that much of what’s missing isn’t fat. For example, my waist has gone from 54 inches to 42 inches. That’s a foot of skin missing in action, with more from the thighs and upper arms that I figured would be jiggling around for the rest of my life but seem somehow to have found a way to contract (not completely, alas). Is it some kind of autophagy? Bottom line, no one should let small lean tissue loss in a DEXA result discourage them.

(Doug) #28

True - skin is signifcant, 1/6 of our weight (which amazes me). DEXA scans vary with hydration levels too - water in muscle, for example, shows as ‘lean mass,’ and can go up or down, all other things being equal.