If you’re at all like me, you’re getting targeted endlessly by the meteoric rise in direct to consumer blood labs companies like Function and Everlywell. For good reason too, we use functional blood work at NHP with all our clients. But would it be surprising if I told you that’s not where I would start when it comes to fitness biometrics?

Think bigger picture. Whether you’re making a change and prioritizing fitness for the first time, or a veteran looking to manage your fitness more effectively, there’s nothing better than a reliable body composition scan.

The gold standard in the industry is DEXA, which stands for dual-energy X-ray absorptiometry. The process is fast, painless (no needles!), and gives you a heap of actionable data to work with.

What’s It Like

Getting a DEXA scan is about as challenging as taking a nap. You lie on a padded open table, no enclosed MRI tubes to cause claustrophobia, while an automated wand slowly passes over your body from head to toe. You don’t even have to take your clothes off!

What you get

Muscle Mass

DEXA measures three things that are critical to measuring health, longevity, and fitness.

The first is muscle mass. By now everyone knows muscle is the organ of fitness and longevity. The more of it you have the better you look, perform, and feel on a daily basis. More muscle means longer life and better independence as you age. On a day to day basis, strength performance is a good proxy for how much muscle you’re carrying, but that isn’t always the best metric.

A DEXA will tell you down to the tenth of a pound how much muscle you’re carrying. It even breaks it down into what’s called a segmental analysis allowing you to compare the amount of muscle in your right arm to your left, and right leg to left leg.

I find this incredibly useful when I design training programs for my athletes. Anything more than a single digit deficit side to side and you’re running an unnecessary risk for injury. In the clients I program for this triggers a shift to unilateral training on the limb in question.

Recently I had an athlete present with a 12% muscle mass difference side to side in her arms. As a tennis player, it’s obvious from the scan which arm is dominant. We’ve shifted to single arm movements and dumbbell preference over barbell to help even out the imbalance BEFORE it turns into an injury.

Body Fat

Long gone are the days of trying to get as shredded and lean as possible. If I had a nickel for every time an ambitious but misguided athlete told me they wanted to be sub-10% body fat…

By now we know there are much smarter and mature ways to approach body fat percentage. It still pays massive dividends to be leaner than the average American. Carrying excess body fat reduces fertility, disrupts hormone levels, causes inflammation, and is linked to chronic disease so many are suffering from. It also just plain doesn’t feel good to put on your clothes as twelve pounds of meat in an eight pound wrapper.

But there’s a risk to too little body fat as well. Get too lean and you won’t recover from exercise as well, your sleep will suffer, and yes, your hormones will suck there too. How do you find a happy middle ground? A DEXA will get you an exact percentage with an error rate at roughly 1-2% compared to bioimpedence with error rates of 4-10% or more.

In my experience health, performance, and looks are optimized for men in the mid teens (12-16%) and for women in the high teens or low twenties (16-22%). Keep in mind there is a LOT of individuality here, but the targets are real. If you’ve never been in this range, I suggest you try it before you knock it. You just might like it here.

One thing DEXA gives you that I find critical to a health assessment is a measure of VAT or Visceral Adipose Tissue. It’s the deep belly fat around your organs that’s the most dangerous to your health. Like a little softer look on yourself than the harder lean fitness norm? That can be perfectly healthy as long as your VAT is low to none. It’s better to know than to guess.

At the moment I’m working with a client who’s a big guy. He’s 6’5” and came to me at 250lbs wanting to trim up. He’s ambitious and set a goal of 15% body fat. When his home scale (bioimpedence) said he was at his goal, I insisted on a DEXA to confirm, particularly because he wasn’t as thrilled with the look he was seeing in the mirror as he hoped. Sure enough, DEXA told us he was actually closer to 20% body fat. That 5% error was another 10lbs of body fat. After a few more weeks in the trenches he’s closing in on his real goal and the abs are starting to show how he wanted.

From a different perspective, I’m working with a mid-forties mother of two who, despite intense training over the last 18mos, managed to put on twelve pounds. She came to me frustrated and overwhelmed. I insisted on a DEXA, which showed that fully half of the twelve pounds she put on was MUSCLE! This changed her mindset from being a failure to a massive success. Have you ever heard of a woman in her 40s putting on six pounds of muscle in a year and a half? She’s currently trimming those couple pounds of body fat, which is trivial in comparison to the muscle mass gain she’s experienced.

Bone Density

You don’t hear about this one much until you’re talking to people in their 60’s and beyond, but it’s maybe the most critical of the three metrics DEXA gives us. If you have great bone density, a trip and fall is a skinned knee and bruised ego. Take the same tumble with brittle bones and you’re headed to the ER with a break. Think of bone density as your whole body durability score.

I’m working with a busy working mom of three little ones, and let me tell you she’s a champ. Not only does she run her household, work full time, travel frequently, and care for her kids, she’s dedicated to her fitness. She’s in the gym 3-4x a week lifting weights, walks with friends, and pays a ton of attention to her food. Which is why we were both surprised when her bone density came back low, in the bottom quintile for her age range at 40 years old.

We’ve adjusted her dietary approach, fine tuned her micronutrient intake, and get her off a problematic medication and she’s back to building a solidly strong skeleton. Without that scan we wouldn’t have had the inflection point and a decade or two later she could be looking at osteopenia and taking delivery of the dire consequences of fragile bones.

How to get scanned

Due to the efficacy I just talked about, DEXA scans are popping up all over the country with brands like BodySpec, LiveLeanRX, and DEXA FIT providing excellent customer experiences. Prices are usually reasonable, around $75-150 per scan with big discounts on packages for multiple measurements purchased in advance. Ask your local shop if they’ll sell you a 4 pack at a discount, or wait for the seasonal sales and stock up around a holiday.

We run DEXA’s on our clients every six months so we can catch trajectory changes quickly with small adjustments instead of waiting until there’s a massive hole dig out of.

Don’t Fight It

Don’t wait. I can’t stress this last part enough.

It’s not fun to get a body composition scan done when you’re not proud of where you are, I get it. Nobody wants confirmation of a situation that brings them shame and even a touch of embarrassment. But I urge you to flip the script and use a DEXA as a starting point. Plant that flag in the ground and say from here I’m going to take care of myself.

You’ll be setting up future you to look back and be able to accurately and specifically measure the results of your efforts. Perfection is not the goal, but the opportunity to measurably improve IS the goal. What you can measure gets attention.

Lastly, if you’re on a GLP-1 like ozempic or retatrutide, you really can’t afford to NOT do regular DEXA scans. The way these drugs work, you WILL lose weight on them but WHAT that weight you’re losing is the big question. These drugs are powerful, and can be used well to improve health and body composition. Without a DEXA scan you’re more than likely to go down the wrong path.

If you’re thinking about making some fitness moves this fall, make a DEXA scan your starting point. I’ll even read and interpret yours for free through the lens of someone that sees a LOT of these scans. We can prioritize what comes next and get you off on the right foot based on the data you have in hand.

Whether your goals are continuing to maintain the temple of a body you’ve built, or maybe you’re just sick and tired of being sick and tired, a DEXA scan gives you real, accurate, actionable intel on your body and your starting point.

Want me to read your DEXA? Book a time HERE, for free!

Skip the blood labs, get a DEXA