But for most people, “if the results are strong, maybe you don’t need another scan for five years,” Wagner said. “If they are lower, lifestyle interventions may help and you may need to recheck within a year.”
Radiation exposure is insignificant and smaller than chest X-rays. But psychological effects may be more complicated. For some, the numbers motivate: “When I was doing body composition tests at 36, I had more body fat than I expected,” Cheema said. “This prompted me to change my exercise and diet in ways that improve my health – BMI alone wouldn’t prompt.”
For others, especially those with a history of eating disorders or body image problems, it can be destructive and overwhelming. Numbers can be another indicator of obsession, not a healthy tool. “If you don’t have a clinician to explain the results, it can be overwhelming,” Gidwani said. “That’s why I scan all of my patients.”
Cheema agrees: “There are too much details without guidance that can meet an overwhelming person with information that overwhelms clinical action.”
“I don’t think Dexa provides much information compared to whole-body MRI, which can reveal stumbles that can cause anxiety and lead to unnecessary intervention,” Gidwani said. “Its data points are feasible: reduce body fat, reduce visceral fat, increase muscle.”
Experts emphasize feasibility is key. “The most important indicators are visceral adipose tissue and overall fat percentage, especially when tracking over time,” Cheema said. “But Dexa also destroys things through arms, legs, trunks, etc., which can turn to aesthetics rather than health.
Should you get one?
If you are 65 years old or older or at risk of osteoporosis, your doctor may have recommended that you have a bone health scan. For perimenopause women, early baseline scans may mark the risk of years in emergencies when bone density drops as much as 20%.
Dexa also detected muscle loss, obesity, and loss of muscle in high body fat side by side. “Someone may look normal to some extent, but DEXA can reveal a poor balance of muscle to fat,” Gidwani said.
Apart from these groups, the use cases are poor. Athletes, bodybuilders, and people with GLP-1 drugs may find the data to be useful. For general healthy adults, many clinicians are indifferent to their exercise, decent diet and exams with their doctors.
“I wouldn’t generally recommend it for a healthy person,” Cheema said. “Lifestyle changes and basic care may be more than just getting DEXA.” There are other optionsBioimpedance scaleBod Pods and AI-ai-ai-ables wearables, but none of them are as accurate as Dexa. For now, it is still the most precise, even expensive tool.
The final harvest
My DEXA turned out to be a little humble. Although exercise daily is almost an exercise and a decent diet, scanned more body fat than I expected, the beginning of spinal osteopenia. The bright side is the “excellent” visceral fat score, which I will brag indefinitely.
Capturing early bone loss sensations is operable. I can adjust my workouts to prioritize strength and mobility. However, body fat percentage has been in my brain without rent since then without providing much reward. I’m not going to pull out a few hundred dollars in a quick time for another scan, so I may never know if my tweak is working.
That is the paradox of Dexa. For those at medical risk, this is invaluable. This is another knob for athletes chasing marginal gains. But for the rest of us, this reminds you that data is only as useful as the data you are willing or able to process. Finally, Dexa does not promise longevity because the numbers it promises don’t add numbers, which doesn’t add years to your life.
Meet the experts
- Jennifer Wagner, MD, MS, Chief Health and Performance Officer, Canyon Ranch in Tucson, Arizona.
- Josh Cheema, MDMedical Director of Northwestern Medical Human Life Clinic in Chicago, Illinois.
- Pooja Gidwani, MD, MBAa certified physician on the board of internal medicine and obesity medicine in Los Angeles, California.
