What I learned from a DEXA Scan

And, it's not what you'd expect.

DEXA Scan, muscle, weight loss, Bone density, weight

I rarely, unless I happen to be flying in a small plane or having a check-up at the doctor’s, weigh myself. Not because I fear the scales but because I’d rather not be defined by (or obsess over) an abstract number. As long as I feel good and my clothes fit well, I figure I’m fine. But during a trip to Bondi’s Body & Bone clinic for a routine bone densitometry test ordered by my GP, I came across the DEXA (Dual Energy X-ray Absorbitometry) scan. A DEXA scan measures how much fat, muscle and bone you have, and I couldn’t help but be intrigued.
Managing director Jeff Gibson, who has been working in the field of sports medicine for more than 20 years, opened Body & Bone to bring the technology formerly only available at sports institutes and elite athlete clinics to the health-conscious public. They also offer all sorts of metabolic tests as well as nutrition coaching.

For the DEXA scan, you lie on a bed as two different energy levels X-rays pass through your body (a fraction of the radiation of a flight from Sydney to Melbourne, I’m assured). In just a few minutes, it can accurately measure everything from your visceral fat verses subcutaneous fat, where exactly on your body you store that fat, and how healthy that percentage of fat is in relation to the amount of lean muscle you carry.
Since I had added more strength training to my fitness routine this year and certainly felt stronger, I was interested to know how I measured up. In the process, I came away with some sound and refreshing advice from Gibson that busts many commonly held beliefs surrounding weight loss and encourages a healthy, body-positive point of view, that might have you throwing away those bathroom scales for good.

It’s all about lean muscle mass

“What we have is a society of people focused on weight loss,” says Gibson. “The problem with weight loss is that, without lean [muscle] mass, you yo-yo. You diet to achieve an outcome, you stop dieting, and you put the weight back on, because inherently it’s actually the lean muscle mass that allows you to lose that weight. So, if we think of it simply: What we want to do is build the size of the engine we have. The fuel we put into it, we have to burn. If you’ve only got a small engine and you’re putting in a lot of fuel, basically there’s excess, so what your body does is convert that to fat. As we work out and as we put on more lean mass, what happens is we can now burn more. So it’s about balancing between lean muscle and quality calorie intake to achieve your goals, and you can’t do that through weight loss alone.”

Eating enough is essential

“As we train more, we can eat more, but if you’re not eating enough then your engine slows down again and then you don’t lose that weight. Really, what happens is, if people aren’t training and they’re just doing [weight loss] purely through dieting and calorie restriction what will also happen is they’ll lose lean mass and they’ll actually be in a worse state than before they started dieting.”

In fact, being a little heavier (through increased lean muscle mass, which would technically make you weigh more on traditional scales), can work in your favour

“Because people, when they’re larger…walking around is weight-baring exercise, so therefore you’re actually developing a bit of muscle mass purely by shifting a bit of extra weight. If you lose that weight, you’re actually losing muscle along with it, and you will have a smaller motor at the end of it. So now when you eat what you were eating before, your weight just spikes. The whole goal is to put on lean mass, not weight loss. You can weigh the same, but with a higher percentage of muscle, and you’ll actually look smaller, because muscle takes up less space per kilo than fat does.”

It’s possible to rekindle your “motor” to burn more efficiently, even if you have a history of dieting

“You can at any age and at any point,” Gibson assures. “We all see the classic TV shows that are focusing on people getting healthy—The Biggest Loser, Bringing Sexy Back, and that sort of thing. Yes, anyone can do it, however it’s about changing your lifestyle, not just changing for six or eight weeks. A lot of people say, “Well I can’t maintain this diet for the rest of my life…” It’s not about maintaining a diet for the rest of your life, it’s about maintaining a healthier lifestyle so you can have those days when you go out and eat a pizza or whatever, however, it doesn’t become the normal day. You also then have to exercise to put on the muscle mass to ensure that you then burn that off.

Building lean muscle will not make you look like The Hulk

“A lot of the fear is—especially for women—if I go to the gym and lift weights, I’m going to bulk-up and look like a female body-builder, and that’s not how it works. Basically, the way that muscles work in males and females, women don’t bulk the same way that men do. So what women often do, is they become toned.”

You can be an athlete and unfit, and skinny yet fat

“We see a lot of ‘weekend athletes’ and people running half-marathons and triathlons, and it concerns me. People say, ‘Well I feel fit, I look good,’ but are they eating enough to sustain this? What we see at the end of most sporting seasons is, elite footballers and athletes get injuries. It’s not because it’s the end of the season and their body’s worn out…it’s actually because they hit a peak six to seven weeks into the season and then they don’t eat enough for their body to maintain it, and they also over-train, so their body condition decreases. The DEXA scan allows us to track that, to achieve an optimal outcome. You can appear skinny, but actually be carrying more fat than muscle. Your visceral fat is directly metabolized and that contributes immensely to heart disease and potential cardiac issues, so that’s what we want to minimize—especially in males. The whole spare tire, the beer belly type thing, that’s a high concentration of visceral fat and we want to reduce that. What we’re going to see [with a DEXA scan] it’s that androidal visceral region and the gynoid ratios as well. In females you’ll see more visceral fat in the gynoid region, which is around the hips, that’s where females traditionally carry their fat.”

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