It’s really important to keep up with bone density and body composition testing.
While osteoporosis might seem like a condition that only affects older adults, it’s increasingly affecting younger individuals. This “silent” disease gradually decreases bone mass and density, which makes bones weaker and more susceptible to fractures.
More young people are experiencing this issue, possibly due to bad dietary choices, some health conditions, or drug usage.
Concierge doctors in Los Angeles, like Dr. Pooja Gidwani, warn about the risks for women using GLP-1 medications such as Ozempic, which might cause a quick drop in bone density.
She suggests women should have a “baseline” dual energy x-ray absorption (DEXA) scan to help understand their future health risks.
This testing measures not just body fat and muscle mass but also assesses bone strength and quality.
According to Gidwani, this kind of research and clinical practice has become a favorite in elite sports programs.
How does the DEXA scan work?
While regular X-rays provide images of bone structure, they don’t give information about bone density or fracture risk.
DEXA scans use X-ray technology to get a more comprehensive view of bone strength.
During the scan, two X-ray beams—one high energy and one low energy—are directed at the bones while the individual lies on a padded table. The absorption rates of bones and soft tissue differ, allowing the scanner to calculate bone mineral density and body composition with a high degree of accuracy.
“The scans are painless, non-invasive, and typically take less than 30 minutes,” Gidwani explains.
These procedures involve much less radiation than standard X-rays and are designed to detect significant bone loss before it becomes serious enough to cause fractures.
She also points out that these tests typically do not involve injections or contrast dyes and recommends scheduling the scans in the morning while possibly avoiding calcium supplements for a day prior.
What can a DEXA scan reveal?
DEXA scans are mainly used for diagnosing and tracking osteoporosis and osteopenia.
They can also identify conditions such as:
- Sarcopenia: Low muscle mass
- Sarcopenic obesity: Low muscle and high fat
- Osteocutaneous obesity: Low muscle, low bone density, high fat
- Abnormal fat distribution linked to metabolic conditions
- Suspected fractures or unexplained osteoporosis
Gidwani believes DEXA scans are more accurate than body fat scales and offer more detail than MRIs for whole-body composition.
“Their precision makes them perfect for monitoring changes over time, especially during weight loss, strength training, or hormonal changes around menopause,” she adds.
If I’m not feeling well, should I get a DEXA scan?
Bone density tends to peak around age 30, after which the natural bone remodeling process shifts slightly towards bone loss over the building of new bones.
Factors like genetics, diet, exercise, tobacco and alcohol use, and hormonal changes—especially drops in estrogen—can contribute to bone health deterioration.
“Estrogen levels can begin to fluctuate in the mid to late 30s,” Gidwani explains.
Risks for early bone density reduction can increase for women with a family history of osteoporosis, insufficient strength training, low calcium, protein, or vitamin D intake, as well as sedentary lifestyles.
Medications that suppress appetite, like GLP-1 drugs, can lead to rapid weight loss.
While GLP-1 can be helpful when used correctly, it’s important to ensure it’s paired with proper nutrition and resistance exercise to avoid unintended muscle and bone loss.
For women in their 30s and 40s using GLP-1s, a DEXA scan can be crucial for catching early signs of muscle and bone loss before symptoms become problematic.
Gidwani recounts a case where a 32-year-old patient showed low bone density on their scan.
In men, those with a family history of osteoporosis, a history of fractures, long-term steroid use, low testosterone, or extended use of GLP-1 should consider DEXA scans sooner than the usual guideline of age 70.
Where can I get DEXA scans?
You can find DEXA scans offered at hospitals, diagnostic imaging centers, women’s health clinics, endocrinology clinics, and more recently, wellness and fitness centers.
Companies like BodySpec and DEXAFIT provide mobile or easily accessible DEXA scans, often used for fitness tracking.
It’s worth checking whether the scan is meant for diagnostic purposes or health assessments.
Costs for DEXA scans can vary significantly, typically ranging from about $40 to over $300, depending on the facility and the type of scan performed.
Insurance generally covers scans for women over 65 on medications that increase fracture risk, men over 70, women post-menopause, and those with specific medical conditions.
As awareness of early bone loss and body composition increases, particularly with GLP-1 usage and hormonal shifts among younger women, hopefully screening guidelines will adapt accordingly.
What are the treatment options for low bone density?
If low bone density is detected, the initial step is to determine the underlying cause.
Gidwani notes that treatment plans typically involve:
- Strength training to boost bone and muscle health
- Increasing protein intake—aiming for 0.8-1.2 grams per pound—especially during weight loss
- Calcium and Vitamin D supplements
- Hormonal therapy for those around menopause
- Balance training to prevent falls
- Lifestyle changes, such as reducing alcohol and quitting smoking
In more serious cases, medications like bisphosphonates and denosumab can slow bone loss, while teriparatide helps in forming new bone.
“Prevention is the best strategy in your 30s and 40s,” emphasizes Gidwani.
