Wondering what your goal weight is?

It’s a question that I am frequently asked. And I get it.

When we look at body mass index charts, we see our height and then we follow the row or column over to see the weight range that corresponds to our height.

But I hate to break it to you - this number that this chart, or an app tells you, or even an online calculator gives misses the mark when it comes to understanding how this total weight number is affecting health. The total number that we see when we step on the scale does not offer a whole bunch of information as it pertains to health state or disease risk! What these charts and calculators are missing is the fact that the number we see when we step on a scale is made up of multiple weight components, such as muscle mass, water, bone mass, and fat mass.

The more helpful measures to understand and track are therefore body composition measures.

Specifically:

*Percent body fat: this is a result that tells a person what percentage of their total weight comes from fat. Percent body fat mass is highly variable, and may range from <5% to > 70% and is dependent upon both fat and muscle mass. Per the Obesity Medicine Association, the goal percent body fat for women is in general <30-33% and <23% for men.

*Visceral adipose tissue volume: This is an assessment of the fat that is underneath the abdominal muscle wall. This is the fat that surrounds the organ. While we need some fat to surround and protect the organs, once it exceeds a healthy threshold, it can infiltrate organs such as the liver. And this excess fat leads to inflammation, increasing the risk of cardiovascular disease, and diseases associated with insulin resistance, such as type 2 diabetes and fatty liver disease. In general, the goal for women is a visceral adipose tissue volume < 1-1.2L and in men, <2-3L.

*Skeletal muscle mass: Building and maintaining an adequate amount of skeletal muscle becomes very important for optimal and prolonged health. When individuals lose weight, without the proper attention and guidance into healthy ways of doing so, both fat and muscle mass are lost. This is not the goal and instead, the goal is to lose excess fat mass while preserving or building muscle mass. In order to do so, it is important to have a medical team that can accurately measure body composition and provide feedback on how the health habits are impacting skeletal muscle mass.

There are different ways to measure body composition which include skin calipers, air displacement assessment, bioimpedance analysis, and dual-energy x-ray absorptiometry (DXA). Not all doctor’s offices have the ability to offer this kind of high-level assessment of body composition at their site.

At Summon Health, it was important for me to offer my patients the ability to understand the important measures of body composition to help focus interventions related to improving metabolic health. This is why patients are offered body composition analysis via bioimpedance analysis. As an obesity medicine specialist - I measure and discuss body composition and focus on THIS rather than the total number on the scale.

This is the standard of care I offer to all my patients @summonhealth

A little information related to bioimpedance analysis (BIA):

It measures the resistance (aka impedance) by muscle and fat to the flow of an electrical current that passes through the body at sensors that a person holds on to and/or steps on. The more sensors a person’s hand and feet come into contact with, the more accurate the body composition assessment. Electrical current passes more easily through water and muscle and less easily through fat. The person does not feel this small current and the measurement itself takes approximately 10 seconds to complete. For the most reliable and accurate measurement, it is best to remove all metal from the body, eliminate body waste prior to the measurement, avoid activities that cause significant sweating at least eight hours before the measurement, and to avoid large amounts of caffeine or alcohol 12 hours before. If someone has an implantable cardiac defibrillator (ICD), they should not have this measurement done.

Reference: Tondt J, Freshwater M, Christensen S, Iliakova M, Weaver E, Benson-Davies S, Younglove C, Afreen S, Karjoo S, Khan N, Thiara D, Whittle C. Obesity Algorithm eBook, presented by the Obesity Medicine Association. www.obesityalgorithm.org. 2023. https://obesitymedicine.org/obesity-algorithm/ (Accessed = 8.20.2023)