You're losing muscle right now. Your scale won't tell you.
After 30, you lose 3-8% of your muscle mass per decade. By 50, the shift is real: less muscle, more visceral fat, weaker bones, even if your weight hasn't changed. We run a DEXA scan to see exactly what's happening, a registered dietitian builds your protein plan from the data, and we rescan to show you what changed.
How this protocol works
This isn't just testing. It's a coached cycle designed to get you where you want to be.
What we measure
DEXA full body scan
The complete picture
Lean mass by region, total body fat percentage, visceral fat, bone mineral density, limb asymmetry. This is the gold standard. Smart scales use electrical impedance, which is imprecise. DEXA uses dual-energy X-ray and gets it right.
ALMI
Your muscle mass, normalized
Appendicular Lean Mass Index: your limb muscle mass divided by height squared. The clinical threshold for sarcopenia. We benchmark yours against age and sex norms.
FFMI
Overall lean composition
Fat-Free Mass Index: your total lean body mass normalized for height. Gives a broader picture than ALMI alone, including bone and organ mass.
VAT
Visceral fat, quantified
The fat packed around your organs. DEXA measures it precisely. Independently predicts metabolic disease, cardiovascular events, and cancer, even when your weight looks normal.
Bone mineral density
Not just for older adults
DEXA measures bone density at the spine and hip. Bone loss starts earlier than most people think. Catching a downward trend at 40 gives you options that catching it at 65 does not.
Grip strength
A surprisingly powerful predictor
Measured with a calibrated dynamometer. Independently predicts mortality, disability, and functional capacity. It drops before you notice anything else changing.
Protein intake assessment
Are you eating enough, and at the right times?
Per-meal logging at each encounter. Most people over 40 are under-eating protein, especially at breakfast and lunch. The dietitian uses this data to set specific targets.
What’s different after this protocol
You know your actual body composition. Not a guess from a smart scale or a BMI calculation, but DEXA-verified numbers: how much lean mass you carry, where your fat sits, how your bones are holding up.
If you were losing muscle, you caught it. Your dietitian built a protein plan specific to your body and your data. You followed it with coached check-ins. Then we rescanned and put the two images side by side.
The before-and-after tells you exactly what changed and where. Lean mass up or down. Visceral fat up or down. Bone density stable or not. No ambiguity.
What this protocol delivers
- DEXA-verified body composition: lean mass, fat mass, visceral fat, and bone density, broken out by region
- Your ASMI score with age and sex percentile ranking, so you know where you stand
- Sarcopenia screening results if you’re 50 or older, using the clinical standard (EWGSOP2)
- A protein prescription from your dietitian: daily target, per-meal distribution, leucine adequacy, specific food sources
- A caloric floor if you’re in a deficit, so you don’t lose muscle trying to lose fat
- A follow-up DEXA comparison showing what moved and by how much
- Data that feeds directly into Physical Capacity (training volume) and Metabolic Health (caloric adequacy)
Your weight can stay the same while your body falls apart
Here’s what nobody tells you at your annual physical. You can weigh the same at 50 as you did at 30 and have dramatically less muscle and more visceral fat. Your BMI looks fine. Your doctor says you’re healthy.
But your body composition has shifted in a direction that increases your risk for metabolic disease, fractures, and functional decline. The medical term is sarcopenia, and it’s one of the strongest predictors of disability, falls, hospitalization, and loss of independence in older adults.
After age 30, you lose 3-8% of your muscle mass per decade. After 60, it accelerates. A bathroom scale can’t see any of this. The only way to measure it accurately is a DEXA scan.
We scan you, build the plan, and rescan to prove it worked
A full DEXA scan at baseline, a protein prescription built from your actual body composition, and a second scan to show what moved.
See the full process
Baseline. Your dietitian runs a full DEXA scan with grip strength testing and sarcopenia screening (members 50+ get the complete EWGSOP2 algorithm). We calculate your ASMI and benchmark it against national age and sex norms. Food logging tells us where your protein intake really is.
The reveal. Your dietitian walks you through the DEXA results. Lean mass by region. Fat distribution. Visceral fat. Bone density. Then your protein prescription: a specific daily target based on your body composition and training volume, per-meal distribution to hit leucine thresholds, and a caloric floor if you’re under-eating. This isn’t a pamphlet. It’s built from your scan.
Midpoint check-ins. Your team reviews protein adherence and looks at trends from your smart scale and waist circumference data. If something moves significantly or a sarcopenia diagnosis triggers an intervention, we may order an interim DEXA. Otherwise, the data between scans tells the story.
Rescan. Full DEXA comparison against your baseline. Lean mass, visceral fat, bone mineral density. Protein prescription updated for the next cycle. The numbers either moved or they didn’t.
Muscle is the organizing principle, not weight.
Between scans, you’re still tracking
You don’t go between DEXA scans blind. Your team sets up three forms of ongoing tracking so trends stay visible.
See what we track between scans
- Smart scale (daily, trend-focused): single readings are noise, but the 7-day average tells you something real
- Waist circumference: a simple proxy for visceral fat changes that costs nothing
- Progress photos (standardized protocol): the visual record that numbers sometimes miss
Common questions
Is this protocol right for me?
A few patterns fit. You've been the same weight for years but your body looks and feels different, and you want to know what actually changed. You're over 50 and no one has ever screened you for sarcopenia. You're training hard but not sure whether you're eating enough protein, or whether you're distributing it across meals in a way that matters. You want real numbers, not a BMI chart or a bathroom scale readout.
How does this work?
DEXA at baseline and again after a full training cycle. Between scans, you track daily weight trends on a smart scale, waist circumference, and progress photos. Your dietitian and team check in as you go.
Is DEXA safe?
Yes. The radiation dose is very low, less than a cross-country flight. The scan takes about 10 minutes. No special preparation beyond fasting and hydration.
I already track my weight. Why do I need DEXA?
Because weight doesn't tell you what changed. You can lose 10 pounds of muscle and gain 10 pounds of fat and weigh exactly the same. DEXA separates lean mass, fat mass, visceral fat, and bone density by region. It's the difference between a number and a picture.
Do I need to be doing a training program?
No, but the data will be more useful if you are. Your DEXA results feed directly into the Physical Capacity protocol, where your team designs your training program. Many members run both protocols at the same time.
What comes after this protocol?
Body composition is the data layer underneath several other protocols. Your lean mass and caloric status directly inform the training program in Physical Capacity. Low bone density may trigger a deeper look at hormones in Hormonal Health. Visceral fat levels connect to insulin resistance in Metabolic Health. The DEXA scan doesn't sit in a drawer. It feeds forward.
What does this cost?
Included in Protocol membership: $695/mo, or $7,500/yr prepaid (save $840). The Foundation Assessment is the on-ramp: $1,500 standalone, included with annual membership.
From the Protocol blog
Your weight hasn't changed. Your body has.
Lean mass, fat distribution, visceral fat, bone density. One scan shows you what years of weighing yourself never could. Book a discovery call and we'll tell you if this protocol is the right place to start.
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