What kind of doctor do you see if you are concerned about body composition

In My Humble Opinion
1

A lil’ background on me.

Back in 2003, when I started college I noticed I gained some weight. I weighed myself, measured my waist and got my bodyfat tested with one of those electric body fat analyziers.

I would measure my waist first thing in the morning so that what I ate wouldn’t affect it one way or another. And I used my weight and my waist to track my weight loss.

Over the course of about 4 months I lost about 42 pounds. I noticed while I was losing weight that each 5 pounds was about 1" on my waist. I noticed this throughout the whole weight loss period, by the time I had lost 42 pounds (I stabalized at that weight) I had lost about 8.5" on my waist, which is in line with what I was experiencing. I had my bodyfat professionally measured at this weight, and they found that my lbm was the same as it was when I started so all the weight I lost was fat.

I eventually lost a little more weight (12-15 pounds, 2.5" on my waist) a year and a half later, but around that time I started reading up on the sociology of the obesity wars and decided I didn’t want to do that anymore (back then I was losing weight for appearances, not for health). So I gained the weight back since I had no incentive to try to keep it off.

Fast forward to now. I haven’t really been following my weight or waist size these last 6 years or so. But I have weighed myself and I was pretty much always a little above what I was in 2003.

But recently I was at a chiropractors and got weighed with a bodyfat analyzer. My weight is now 28 pounds higher than it was in 2003, and according to the bodyfat analyzer my lean body mass is 20 pounds higher.

I did the calculations, and from 2003 to the present I have gained 8 pounds of fat and 20 pounds of lbm, if the measurements in 2003 and the current ones are correct.

The problem with that is, my waist is no bigger than it was in 2003 (I remember what my waist was when I started trying to lose weight). And I’m not stronger. So where is the extra weight being stored, and what is it being stored as?

If I had gained 5-6" on my waist, and the bodyfat test showed I had gained 28 pounds of fat, I could live with that. And if the test is right and I gained 8 lbs of fat, maybe it is distributed in different parts than my waist. But if I gained subcutaneous or visceral fat, it should be around the waist but my waist is the same size as it was in 2003.

And since I’m not stronger, I don’t get where the higher LBM number is coming from.

Is it possible I’m just holding a lot of water right now? I’m kindof worried something weird is happening inside my body to make me gain weight w/o it being muscle or fat.

2

(bolding added)

The bolded I think indicate some of your problems. You’ve only had **one **professional bodyfat index analysis, and even that one isn’t guaranteed to be correct. A lot of the methods that were consistently used in the past have been shown to not be so accurate after all.

http://www.mayoclinic.com/health/body-fat-analyzers/AN01789

I would go to your GP (general practicioner/family doctor) and get them to advise you as to where to go - maybe a sports clinic, or a nuitritionist… it depends on who’s in your area and who your doctor likes. That person would then need to do an accurate bodyfat measurement, and then if you went on a weightloss program, they could check it again after time goes by and see how you’re doing.

3

Your legs get more muscly when you’re carting around more weight. I don’t know if that accounts for all of the difference you’re noticing, of course. But, just because you can’t bench press more than you used to be able to bench press, that doesn’t mean you haven’t gained muscle mass elsewhere.

This sounds like a pretty weird thing to worry about, though. If you were retaining water, you would be puffy. Not the “fat” kind of puffy, but the “having-trouble-getting-shoes-on” kind of puffy. Are you a hypochondriac about your health in general? This sounds like the kind of thing you should ask your primary doctor about, they could assure you whether or not you’re retaining water.

4

Moved from MPSIMS to IMHO, our forum for medical and other advice.

5

Yeah, in general I am a hypochondriac. I’ve been thinking of losing weight, but in my past experiences if I do it wrong (low carb, as an example) I gain back 2-3x more than I lost. So if I decided to try losing weight again, I don’t want to do it wrong and end up gaining 100 pounds.

6

You don’t sound like a hypochondriac to me. You seem curious and conscientious about your health. It’s not like you’re assuming something is wrong.

With that said Lasciel is right. You need to track your body composition using the exact same method over a period of time. I used to see a bariatrician (a medical doctor specializing in weight and metabolism and fat, etc.). My first couple visits they used a very expensive scale that measured composition by electrical impedance. Then they switched to a difference expensive scale for the office, just coincidentally.

When we looked at my progress they always ignored the original couple visits. Even though it was a high quality medical-grade equipment, it wasnt the same equipment so it wasnt a valid comparison.

The other reason you have to check multiple times is because the amount of water in your body changes so much. If you lose a significant amount of fat over time the % of your body weight made up of water will increase, but from one measurement to another it can still vary wildly.

You should start with your general physician and get him to recommend someone. If there’s someone in your region who specializes in weight and fat they would be perfect… it’s what they do all day.

7

I am in the habit of getting my body comp tested hydrostatically (water displacement) which as I understand is the most accurate kind.

I noticed the same thing WC noticed… at one point I was something like 30lbs over my college fighting weight, and I obviously looked 30 pounds fatter. But the test results were suggesting that 20 pounds of this extra weight was in fact lean, and I only needed to lose 10 pounds of fat to reach “optimal.”

I somehow gained 20 pounds of lean weight from eating poorly and being sedentary for a few years? Yeah, right.

So, I started losing weight. My weight went down, screaming and kicking. Just out of curiosity, I went back each month to be tested again. Sure enough, though my weight was decreasing and everyone could see I was losing fat, still the test stubbornly reported the same thing - “only 10 more pounds of fat to lose!”

Conclusion - at high percentages of fat, the test errs toward the lean side. Or, at low percentages of fat, the test errs toward the fat side.

8

What is “the sociology of the obesity wars?”

9

Sociology of the Obesity Wars.

I imagine an anime treatment of the subject.
There would be the inevitable encounter with tentacled monsters, but this time they are liposuction machines, driven to ingest the obscene amounts of American lipids.

Maybe Blue Oyster Cult could do the sound track.

…

OP, you might want to consult a physiologist. Many of them are trained in nutrition.

10

*You see me now a veteran of a thousand obese wars
I’ve been munching on the snacks so long
Where the breads of Bimbo roar
And I’m fat enough to look at
And far to dumb to see
All the cholesterol is on the inside
I’m not sure if there’s any muscle left on me…
*

11

If you started college in 2003 at the typical age of 18, I’d expect you to have developed significantly more muscle and bone mass, by now, in your late 20s, as a man- even without doing any exercise targeted at bulking or strengthening certain areas.

If your waist is trim your weight doesn’t matter.

12

For the intrested, a review of the advantages and limitations of each assessment method. No method is perfectly reliable. Most of those available outside research labs work by using models that make some basic assumptions about how things are compartmentalized that may be inaccurate as individuals age or lose weight and for different groups:

Some of the electric devices, bioelectrical impedance analysis devices are particularlyless reliable for the obese; they are not all created equal.

So yes one item is that the measurement devices are far from perfect.

Also while some particular store fat centrally (and are at greater health risk), some store less there. Maybe you store less there.

13

Electrical body fat composition measuring devices (even expensive ones) are not all that reliable. Beyond this worrying about body composition ratios is a huge waste of time if you simply want to be more fit.

Just eat less and exercise more and let your body composition sort itself out. Knowing your lean mass to fat ratios is largely irrelevant in trying to pursue an exercise and diet regimen unless you are some kind of finely tuned athlete.

14

The cultures attitudes on obesity seemed destructive and since I was concerned with weight loss for appearance sake back then, I lost interest in doing anything to maintain the loss. There were a variety of books I read at the time, the obesity myth by paul campos stands out but there were several others criticizing the cultural attitudes on the subject. If I did try to lose weight again, I’d have to reread that book beforehand to ensure I really wanted to commit myself to the effort.

15

On the Internet, nobody cares if you’re fat.

16

Its called sour grapes, and there is nothing wrong with it.

17

My photos are in the gallery…

18

I loved you in curb your enthusiasm.

19

It is FAR more likely that the assessments were inaccurate, than that there’s something weird and dangerous going on in your body.

I’m not sure what you think a doctor is going to tell you…

I can understand not losing weight (or maintaining a loss) for appearance reasons. But if you are concerned about your health, about your body composition, why not put that effort into getting stronger, and making permanent healthy changes to your eating.

Low carb, as you have seen, is an effective way to lose weight. But to maintain the loss you can’t go back to just eating whatever.

20

I can’t do low carb, I always gain far far more than I lost in the first place for some reason on low carb. Low fat diets don’t seem to have that effect on me, so I’d have to eat something like that.

I am working on improving my health. But what I still don’t get is why hasn’t my waist size changed? Maybe it is just water weight or I am storing fat and muscle somewhere else.