Hormonal
Higher baseline insulin sensitivity is associated with greater retention of lean mass during diet-induced weight loss, but this protective effect is nullified when aerobic or resistance exercise is included in the intervention.
If you are losing weight through diet alone, your metabolic health (insulin sensitivity) dictates how much muscle you keep; those with better sensitivity lose less muscle. However, if you add exercise (especially resistance training), your baseline insulin sensitivity no longer matters for muscle preservation. Exercise protects muscle mass regardless of your metabolic profile, making it the most reliable tool for preserving lean mass during weight loss.
Higher baseline SI is associated with greater retention of LM when weight loss is induced with diet alone, but not when exercise (aerobic or resistance) is included.
Why this rating
Randomized controlled trial design with rigorous measurement (IVGTT, DXA), though it is a secondary analysis.
Source
The Role of Insulin Sensitivity in Lean Mass Changes During Weight Loss With or Without Exercise
Ciera L. Bartholomew et al. · Obesity · 2025
DOI 10.1002/oby.70010
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