Dr. Rees Checketts

Dr. Rees Checketts Internal medicine certified | Obesity medicine fellow | No shame evidence-based weight management

06/03/2026

I don’t think it’s possible to prevent 100% of muscle loss. Nor do I think that should be the goal. It’s OK to lose some muscle when the overall body mass has decreased. You need less mass when you’re moving less mass.

What’s not OK is to lose functional status the goal with weight loss is to improve your function. To have less difficulty sleeping, toileting, playing with your kids, performing your work, etc.

What’s more concerning to me is when someone is entirely sedentary, takes a GLP one, loses 80 to 100 pounds, and then can no longer pick up their toddler or grandchild. That’s devastating. But to have a little bit of muscle loss or a slight decrease in your one rep maximum at the gym isn’t a big deal in my opinion.

Many of the studies are also showing muscle QUALITY improves with weight loss. The MRI scans are showing less fat deposits within the muscle. That’s a very good thing but still reads as “muscle loss” on the DEXA.

Hope this helps.

06/03/2026

Yes — a calorie deficit causes weight loss. That part is true. Here’s the part that isn’t talked about: your body controls both sides of that equation. Cut calories hard enough, and it fights back. Metabolism drops. Hunger climbs. Fullness disappears. To drive you to eat more. Even if you successful resist that, your metabolism adjusts.

Your body temperature declines subtly (this is why people often feel cold all the time after weight loss or hot all the time before). Heart rate slows slightly. Kidney activity might reduce subtly. The spleen starts spleening a little slower. And so on.

Research from The Biggest Loser showed contestants were burning 500 fewer calories per day six years after the show — not because they failed, but because their biology was defending their old weight. Calories in calories out works in a textbook. In a human body, the body edits the math. If you adjust the input, it will adjust the output. That’s why this is a medical problem, not a character flaw.

Please when you restrict calories, make sure that you are at least meeting your basal metabolic rate. Your body still requires fuel to operate.

06/03/2026

Nighttime snack, packed with protein, fiber, and flavor. Careful with the oats, they’re loaded in more carbs and Jess fiber than you might think.

This dish won’t be featured on Food Network as it looks like a sludge. But man is it a nutritious and yummy sludge.

is one of my favorites. I have a link in my bio. I get mine at Costco. My kids love it.

drrees

06/02/2026

Showing up isn’t the same as progressing.

The mistake I see most: people confuse “tired” with “effective.” Soreness feels like proof, but it’s just novelty — it fades the moment your body adapts. The real signal is boring: are you lifting a little more than you were three weeks ago?

That’s the whole game. Progressive overload is the difference between training and just sweating.

Muscle is your metabolic insurance policy — it burns glucose, protects you as you age, and is one of the best predictors of keeping weight off.

Save this and check it against your last 3 workouts. 💪

Hey guys - I just was recognized as a top fan for the humorous and inspiring Shrink With Christi 🎉She’s an amazing woman...
06/02/2026

Hey guys - I just was recognized as a top fan for the humorous and inspiring Shrink With Christi 🎉

She’s an amazing woman with an exciting story to tell. I recommend her.

06/02/2026

Here’s an example of breakfast for my kids and they love it! Smoothies are active flavor, antioxidants, fiber, protein, and unsaturated fats. It’s actually extraordinarily filling because of the fiber and protein content.

Eating well doesn’t have to be expensive. It might even teach you some new skills. Start your kids young and you’ll set them off on a great path for when their adults.

06/01/2026

1. Dependence on them.
Honestly, I hear all the time how life changing these medications are. Many patients I meet WANT to be on them indefinitely. Their insulin requirements have gone down. They’re weaning off other medications. Disneyland is less painful, even enjoyable.

2. Gastroparesis (stomach paralysis).
It happens. It’s a big adjustment at first. If you try overeating on a GLP1, patients describe it as a punishing sensation. That’s not fun, but it’s a valuable teaching cue. This effect becomes less intense over time and almost never lasts after the medication is stopped.

3. Muscle loss.
A sedentary lifestyle and weight loss is NEVER a good combination. However, the 40% lean tissue loss that we have heard about was an artifact. It was the DEXA scanner combining other non-muscle tissues shrinking (like a sick fatty liver getting smaller and healthier). When people lift heavy things and eat protein, the lean tissue from muscle is much less. When we use an MRI instead of DEXA, we are much more precise.

06/01/2026

Your body has priorities. Hair isn’t at the top of the list, which is distressing 👎🏻☹️

When resources get scarce — whether from low calorie intake, protein restriction, micronutrient deficiency, or physiological stress — your body makes a decision. It redirects energy away from non-essential functions and toward survival.

Hair follicles are metabolically expensive. So they get deprioritized.

That’s telogen effluvium. It’s not random hair loss. It’s your body doing exactly what it was designed to do — protect what matters most.

The good news: once the underlying stressor is addressed, the follicles can recover.

This is why I always assess nutrition and metabolic stress in patients dealing with hair loss. The hair is just the signal. The root cause is deeper.

Follow for more on how your biology responds to stress, weight loss, and GLP-1 therapy.

Let us know your questions. We’re here to help.

05/30/2026

Said this in March. Now it’s trending.

A 2026 study of 32,000+ people found DEXA overestimates muscle mass — and misses real muscle loss that MRI detects. We may have been overcounting lean mass the whole time.

Increasingly, experts in my field are wondering if MRI should be the gold standard for body composition

This changes how we should interpret body composition results in GLP-1 patients.

📖 Basty et al. Commun Med 6, 227 (2026). DOI: 10.1038/s43856-026-01440-w

05/29/2026

Physical trauma to the brain—whether from a severe impact or an intricate neurosurgery (like a craniopharyngioma resection)—can damage the ultimate metabolic thermostat: the hypothalamus.

Standard diet and exercise advice simply doesn’t cut it here because the root cause is structural damage to the MC4R pathway. Check out the graphics to see how the science works and how medicine is evolving to fix the broken signal.

Knowledge is medicine. Share this to spread awareness for survivors navigating this invisible challenge. 🎗️

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