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Thursday, Jan. 26, 2017 12:13 am

Measuring beyond the scale

Dr. Craig Backs


When I first started my journey to fitness and better health almost five years ago, I knew I was overweight. I even had to admit that I was obese, based on my body mass index (BMI) being over 30 and my weight being 235 pounds at 5 feet 11 inches.

But knowing my weight did not seem to motivate me to change. At the recommendation of my coach, I got an accurate assessment of my body composition. I learned that 35 percent of me was fat, when my fat percentage should be less than 20 percent.

That number was more motivating than my weight or BMI because I could not deny or “fudge” it. With a high BMI, I could lie to myself and say “it’s muscle.” It sounds crazy now, but we all use defense mechanisms to protect our ego.

Body mass index uses height and weight to calculate a number that is more meaningful than weight alone. But BMI can be misleading, as can weight. Neither distinguish between fat and muscle. Therefore, very fit, heavily muscled individuals will have BMI’s that categorize them as overweight, despite a low content of body fat. And some thin individuals who have little muscle will be categorized as normal when they have excess fat. We call these individuals “TOFI”: Thin Outside, Fat Inside.

If that inside fat is concentrated inside the abdomen, around the intestines and other internal organs, it creates a state of insulin resistance, which can lead to Type 2 Diabetes. We call this “visceral” fat, as opposed to “subcutaneous” fat, which we can pinch under our skin.

When there is high visceral fat, even before the blood glucose (sugar) is high enough to call your condition diabetes, disease is progressing, especially in the arteries.

Thanks to the motivation of knowing my fat percentage, I lost 55 pounds, put on muscle and now my body fat is less than 20 percent.

Since that time, I have known that my patients weren’t being well served by just measuring their weight. But I could not justify the cost of the technology for the DXA machine on which I had been measured. Spending more than $50,000 was more than my practice could handle. But another technology, BioImpedance Analysis (BIA) offered an alternative that is less costly and portable.

After doing my research, about five months ago I purchased a BIA device that measures body composition by measuring impedance, or resistance, to a low-intensity electrical current. It then uses mathematical calculations of that resistance to measure body water, muscle mass and fat content. In addition, this device describes where the fat and muscle are distributed, including how much is “visceral” – around the internal organs or your gut.

The assessment takes less than a minute. Standing on the device barefoot with enough clothing to protect modesty but not add weight, it correlates well with other reliable methods, including DXA, MRI and immersion/buoyancy measurements.

I have been pleased that my patients are responding to knowing their fat percentage the same way I responded to knowing mine. They are losing their fat, gaining muscle and seeing the results of their efforts. And they are getting healthier. We are identifying the conditions associated with prediabetes at a much earlier stage than would be found by waiting for a slight rise in the blood glucose or HbA1c. I’m finding the visceral fat level is correlating well with other measures of insulin resistance.

I offer this measurement to my patients, to fitness facilities and to individuals who can’t get the information from their current doctor. For details, go to http://www.thecenterforprevention.com/body-composition-analysis/ and call 217-321-1987 to arrange a test.

Going beyond the scale will take you beyond your current results.  

Contact Dr. Craig Backs at drbacks@craigbacksmd.com.

Dr. Backs delivers a free public lecture, “Making future strokes and heart attacks a thing of the past,” 5:30-7:30 Feb. 1 at Memorial Center for Learning and Innovation. Register at MemorialMedical.com or call 217-788-3333.

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