DEXA Scan GLP-1 Weight Loss: A 5-Step Guide
August 05, 2024
If you’re on GLP-1 medication, it’s important to know how to effectively use DEXA scans. This can ensure you lose weight successfully and safely.
DEXA (Dual-Energy X-ray Absorptiometry) scan is a medical imaging technology that measures bone density and body composition. It is the gold standard for understanding body composition. Doctors are increasingly viewing weight as a poor measure of health. DEXA can more accurately assess health status and risks by focusing on muscle mass, fat mass, visceral fat, and bone density.
GLP-1 drugs can help with weight loss, but they may also cause a loss in muscle mass and bone density, both of which are critical for health and longevity and are hard to rebuild once lost. Losing too much muscle mass during your treatment period can cause serious problems, such as a reduction in strength. It can also slow down metabolism and put you at increased risk for sarcopenia.
The good news is that you can slow down this loss or even prevent it. Here’s a guide on how the DEXA scan can help.
1. Consult Your Healthcare Provider Before and After the Scan
The first thing you should do is talk with your doctor. Make your healthcare provider part of the journey, even before you go for the first scan.
Your doctor can help you better understand your current condition and work with you to create a care plan. After the scan, return to your doctor to discuss the results. When your doctor understands your body mass distribution, bone mass, and other factors that a DEXA scan shows, they can regularly change your care plan.
This ensures your safety remains a priority when it comes to weight loss.
2. Here’s the Frequency of Scans You Want to Aim For
It’s generally recommended to have a DEXA scan 2-3 times per year for body composition and at least once every two years for bone density. However, there are cases where more frequent scans are appropriate.
One such case is when you decide to use GLP-1 medication to help with weight loss. You want to regularly see how your body mass distribution changes as you lose weight. This is because you’re not just losing fat. Your lean and bone mass can also change as you undergo treatment with GLP-1 medication.
Your doctor will tell you about the best frequency for these scans based on your situation. That said, most doctors will recommend you go for a DEXA scan every quarter or at six-month intervals. Since GLP-1 medications can sometimes cause rapid weight loss, there are scenarios where your doctor will recommend even more frequent scans.
It’s important to remember that the DEXA scan is safe, and the radiation exposure is minimal. A DEXA body scan produces a level of radiation equivalent to flying by airplane from New York to California.
3. Here’s What to Expect from a Muscle Mass Perspective
When you step on a scale to see how much weight you’ve lost, it’s important to consider more than just the total number it displays. Your body composition changes as your weight goes down. This doesn’t just mean you’re losing fat but also muscle mass.
One study looked at how GLP-1 medication affected muscle mass loss in obese people. The researchers compared the results to a placebo.
After the trial period, the average amount of muscle mass that people lost in the placebo group was 0.11% or 1.48kg. However, in the GLP-1 group, the loss of muscle mass was much greater, at 3.61% or 6.92kg on average.
When you lose too much muscle mass during your treatment period, it can cause serious problems, such as a reduction in your strength. You may also see your metabolism slowing down. From a bone health and fracture risk perspective, there’s also the risk of sarcopenia, a musculoskeletal disease in which muscle mass, strength, and performance are significantly compromised with age.
In a narrative review, researchers also explain that medication focusing on lowering glucose, such as GLP-1 drugs, can impact protein catabolism and anabolism. They further explain that this effect may contribute to the higher prevalence of sarcopenia in type 2 diabetes patients.
4. Here’s How You Should Assess Bone Health
Keeping up with bone health is another important factor when using GLP-1 medication to help with weight loss. Like lean mass, you don’t want your bone mass to decline when you’re on a weight loss program.
There are mixed results when it comes to using GLP-1 drugs. For example, one study found that GLP-1 medication may help to preserve bone mass density in the forearms, spine, and hips when combined with exercise. The researchers compared these results to a group that only exercised without using a pharmaceutical intervention.
Yet another study found neutral effects, with GLP-1 not having any significant impact on bone mineral density when used as part of a weight loss program.
It’s still important to regularly compare new DEXA scan results with the baseline data you received. When your bone mineral density declines, it can cause problems, such as making you more susceptible to fractures and injuries.
5. Here’s How Your Doctor May Use the DEXA Scan to Adjust Your Care Plan
Your doctor can use and interpret the results from your DEXA scan in different ways. They will require a baseline scan, which is a scan before you start GLP-1 medication. This gives them a starting point.
The baseline helps your doctor create an initial treatment plan for you. As you follow the plan, you’ll have more DEXA scans. Your doctor will then use these to see how effective treatment is and to determine if changes are needed.
The DEXA scan helps your doctor with the following:
● Lifestyle considerations: Your doctor can suggest changing lifestyle factors based on details they obtain from the DEXA scan. This may include changing certain habits and giving up on things that may contribute to weight gain, muscle loss, and a decline in BMD.
● Diet: Your doctor can also suggest changing your diet when the DEXA scan results are not in line with their expectations. For example, if your healthcare provider finds that you’re losing too much lean mass, they will likely suggest increasing your protein intake. When bone mineral density declines, your doctor will recommend taking calcium and vitamin D supplements.
● Exercise: A DEXA scan can also provide feedback on your exercise program. This allows your doctor to make changes, such as introducing more muscle-building exercises to preserve your lean mass as you lose weight.
● Adjusting intervention plan: With regular DEXA scans, your doctor can determine if they need to make changes to the intervention program that you’re on. When you lose weight too fast, they may reduce the dose of the GLP-1 medication. If results are slow, your doctor could also consider increasing your dose or the frequency of taking the drug.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601689/
https://www.nejm.org/doi/suppl/10.1056/NEJMoa2032183/suppl_file/nejmoa2032183_appendix.pdf
https://www.uclahealth.org/news/article/rapid-weight-loss-can-lead-loss-muscle-mass
