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Patient A: Sarah, 45 Starting weight: 238 pounds Height: 56 Exercise approach: Resistance training 3x weekly from day one, 100g+ protein daily After 11 months: Weight: 165 pounds (73 pounds lost) Body fat: 28% (down from 42%) DEXA scan: 68 pounds fat lost, 5 pounds muscle lost Resting metabolic rate: Maintained within 50 calories of baseline Clothing size: 22 to 8 Strength: Maintained 85% of starting strength levels Sarah looked lean, fit, and 10 years younger