That distinction is becoming one of the most consequential health questions for the millions now on GLP-1 treatments.

DEXA body composition scanning has become the gold standard for answering it. In a few minutes, you get a precise breakdown of fat mass, visceral fat, lean mass, and bone density — the data that tells you whether your GLP-1 treatment is doing what it’s supposed to do. A clinical-grade snapshot of your body composition over time.

The key word is over time. DEXA’s real power is longitudinal: scanning every 3-6 months to track whether you’re preserving muscle while losing fat. That’s the data that changes treatment decisions.

But longitudinal data is only meaningful for your GLP-1 treatment if it produces rigorous, clinical-grade tracking.

As low-cost DEXA services expand across the longevity and medical weight loss market, Fitnescity Health established the Clinical Integrity Standard — a quality framework to educate consumers and elevate the industry.

Unlike DEXA bone density testing — which carries diagnostic, billing, and malpractice accountability — DEXA body composition operates without equivalent consequential quality requirements.

The Clinical Integrity Standard’s goal is to identify and vet DEXA operators committed to conditions that make longitudinal DEXA data more trustworthy. It establishes three pillars:

1. Fixed-site, stationary test centers. Fitnescity Health’s network includes world-class hospital systems, renowned radiology networks, and carefully-vetted wellness facilities. This fixed-site model is purpose-built to facilitate adherence to the same-machine recommendation from the International Society for Clinical Densitometry (ISCD) — ensuring that changes in an individual’s data reflect true physiological shifts, not environmental drift.

2. Longitudinal quality assurance. Operators should maintain calibration protocols, technologist training, and reporting consistency per ISCD guidance.

3. Credentialed oversight. Results should be reviewed and contextualized by a credentialed professional capable of interpreting findings and guiding next steps.

Because when DEXA informs a GLP-1 treatment decision, the data deserves to be reliable. The lowest-cost option may not always deliver the reproducible longitudinal data these decisions require.

The GLP-1 revolution is one of the most significant shifts in metabolic medicine in a generation. DEXA is the tool that makes it measurable, turning a weight loss journey into a precision health intervention with data that actually guides treatment.

Fitnescity Health’s network of 1,000+ fixed-site locations nationwide integrates with platforms building the future of GLP-1 care, longevity medicine, and metabolic health. If you’re building that platform, let’s talk.

Learn more at fitnescity.com/cis or reach out directly.

Disclaimer: The Clinical Integrity Standard (CIS) is a private, voluntary quality framework developed by Fitnescity Health. It is not a government, regulatory, or FDA-sponsored certification. Fitnescity Health is a sponsor of the ISCD. The CIS is not affiliated with, endorsed by, or developed in partnership with the ISCD. The ISCD has not reviewed, approved, certified, or endorsed the CIS. The CIS and Fitnescity Health’s DEXA scans are for informational purposes only and do not constitute medical advice, diagnosis, or treatment. Individuals should consult their prescribing physician regarding GLP-1 therapies, sarcopenia, or any other medical conditions.

One in two women over 50 will break a bone due to weakened bones.

Most don’t see it coming. Because bone loss doesn’t feel like anything.
It happens quietly, over years, without symptoms.

And yet, most women are told to get their first bone density scan at 65.

By then, it’s not prevention. It’s damage control.

Why we wait until 65

We don’t wait until 65 to check cholesterol or blood pressure.

But for bone health, one of the strongest predictors of fracture, mobility, and independence later in life, we wait. Not because measurement tools are not there. But because the system hasn’t caught up.

Earlier screening can detect bone loss before it becomes osteoporosis, when intervention is far more effective.

It starts earlier than we think

Bone density doesn’t suddenly decline at 65, and it doesn’t start only at menopause. Peak bone mass is reached in early adulthood. From there, it can slowly decline.

It is possible to have low bone density in your 30s and not know it.

No symptoms. No routine screening. No signal until much later.

Menopause accelerates the process, but it does not start it.

The problem is timing

We measure too late. Across DEXA scans from 1,000+ test centers nationwide, we consistently see meaningful differences in bone density, muscle, and visceral fat in women well before 65.

A DEXA scan doesn’t just measure bone density. It also shows lean mass and visceral fat. These are not cosmetic details. They are directly tied to strength, metabolic health, and long-term outcomes.

If we believe in prevention, we have to measure earlier. Because what we don’t measure, we miss. And what we miss, we can’t change.

This Mother’s Day

This Mother’s Day, we’re focusing on bone health earlier.
Not as a late-stage condition, but as something we can understand, track, and act on sooner.

Because 65 is not the beginning. It’s often when we finally measure what has already been lost.

This Mother’s Day, Fitnescity Health is offering $50 off any Fitnescity Health gift card or package.

Available starting April 14.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

A routine physical exam is designed to answer a simple question: Are you healthy?

In most cases, that answer is based on a familiar set of measurements. Blood is drawn, a panel is reviewed, and if cholesterol, glucose, and other markers fall within range, the conclusion is straightforward.

Everything looks normal.

These tests are important. They have become the foundation of preventive care, and they play a critical role in identifying disease and managing risk.

But they are not designed to measure the body's structure.

They do not capture how much muscle you have, where fat is distributed, or whether bone density is beginning to change. These are not cosmetic variables. They are associated with insulin resistance, mobility decline, increased cardiometabolic risk, and, over time, higher risk of morbidity and mortality.

What a standard physical does and does not measure

Most annual exams focus on biochemical markers. They assess what is circulating in the bloodstream and whether it falls within established ranges. This approach works well for detecting abnormalities once they become measurable.

It is less effective for identifying earlier changes that occur before those thresholds are reached.

Across the Fitnescity Health dataset, individuals with normal lab results frequently show meaningful differences in lean mass and visceral fat. These differences are associated with metabolic risk and physical function, yet they are not captured in routine testing.

What is missing from the current model

The gap is not that existing tests are incorrect. It is that they are incomplete. A standard physical evaluates biochemical markers but does not assess body composition, leaving clinically relevant changes in muscle, fat distribution, and bone density unmeasured. As a result, individuals with different risk profiles are often evaluated in the same way.

This has practical implications. Health decisions are frequently based on whether values fall within a defined range. When those values are normal, no action is taken. But when structural changes are not measured, they are not incorporated into the assessment, even when they are already present.

An individual may be losing muscle, accumulating visceral fat, or experiencing early changes in bone density while remaining within normal lab ranges. From a clinical perspective, nothing is flagged. From a physiological perspective, the trajectory may already be different.

Rethinking what belongs in the annual physical

If the goal of an annual physical is to understand health early and accurately, the scope of measurement needs to evolve. Bloodwork provides essential information about metabolic and biochemical status, but it does not provide a comprehensive view of the body.

Body composition offers that missing layer. It allows for direct measurement of lean mass, fat distribution, and bone density, all of which are associated with long-term health outcomes and functional aging.

DEXA provides a practical way to capture this information. It does not replace traditional testing. It complements it by making visible what is otherwise inferred or overlooked.

From optional to expected

Several preventive health and longevity platforms are beginning to incorporate structural testing directly into the patient journey, rather than relying solely on traditional annual exams. Through the Fitnescity Health API, we are seeing partners embed DEXA and other diagnostics early, making body composition part of how risk is assessed and decisions are made from the outset.

These platforms offer a preview of how health will be evaluated going forward. Instead of periodic snapshots based on a limited set of markers, they are building more complete views of the body.

As this model expands, structural measurement is likely to move from optional to expected, becoming a core component of standard care.

The takeaway

A normal lab panel remains an important part of understanding health. But it does not capture the full picture.

Health is not defined solely by what circulates in the bloodstream. It is also defined by the body’s composition and how it changes over time.

A physical exam that includes both perspectives is not a different approach to care. It is a more complete one.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

For decades, Body Mass Index, or BMI, has been one of the most widely used numbers in medicine. It is used to classify millions of people as underweight, normal weight, overweight, or obese.

Today, BMI plays an even larger role. In many cases, it determines eligibility for GLP-1 medications used for weight loss.

In reality, BMI was never designed to measure health. And in many situations, it can be surprisingly misleading.

At Fitnescity Health, these limitations are evident across DEXA scans performed across our network of 1,000+ locations.

BMI Was Never Designed as a Health Metric

BMI was developed in the 1830s by Belgian statistician Adolphe Quetelet.

Its purpose was not medical diagnosis. It was a statistical tool used to study patterns across populations.

It was never intended to assess the health of individual people.

Over time, however, BMI became a convenient way to categorize weight in clinical settings. Today it is embedded in medical guidelines, research studies, and insurance policies.

BMI Can Misclassify Health Risk

One of BMI’s biggest limitations is that it cannot distinguish between muscle and fat. This is often illustrated with athletes, who can be classified as overweight or even obese despite having low body fat and high levels of fitness.

But the more important issue is less visible. Across tens of thousands of DEXA scans on our platform, we consistently observe individuals with similar BMIs who have markedly different body fat, muscle mass, and metabolic risk levels.

Two people can have the exact same BMI and be classified the same way, yet have very different metabolic risk levels. One may have higher muscle mass and lower body fat. Another may have lower muscle mass and higher body fat.

The second individual carries a higher metabolic risk, including insulin resistance and long-term disease. BMI treats them as identical.

BMI also does not account for where fat is stored.

Visceral fat, the fat stored around organs, is strongly associated with higher risks of cardiovascular disease, metabolic disease, and insulin resistance. In practice, we often see individuals with “normal” BMI ranges who nonetheless have elevated visceral fat levels. BMI does not detect this.

BMI Now Determines Access to GLP-1 Therapies

The limitations of BMI are becoming more visible as GLP-1 medications transform the treatment of obesity. Clinical guidelines and insurance policies typically use BMI thresholds to determine eligibility for these drugs.

In many cases, patients qualify if they have:

• a BMI of 30 or higher, or

• a BMI of 27 with certain related conditions.

This means a single number derived from height and weight can determine access to one of the most effective weight-loss therapies ever developed. Yet BMI cannot measure body composition, detect visceral fat, or assess metabolic health.

From what we are observing, the mismatch between BMI and underlying physiology becomes particularly clear in this context. Consider two individuals:

• One has a BMI of 26, but carries high visceral fat and low muscle mass.

• Another has a BMI of 30, with higher muscle mass and a more favorable fat distribution.

Under current guidelines, the second individual may qualify for GLP-1 therapy, while the first may not. Their underlying physiology, however, may suggest the opposite.

As GLP-1 adoption accelerates, these edge cases are becoming more common rather than rare.

Looking Beyond BMI

BMI helped medicine categorize weight across populations. But understanding individual health requires looking deeper than height and weight.

At Fitnescity Health, we see a growing shift toward measuring what BMI cannot capture:

• body composition

• visceral fat

• bone density

• cardiorespiratory fitness

These metrics provide a more complete picture of how the body is changing over time.

As new therapies like GLP-1 medications reshape metabolic care, the need for more precise measures of health is becoming increasingly clear.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

When most people think about their health, they focus on familiar numbers: cholesterol, blood pressure, and blood sugar.

These markers matter. But many of them detect disease only once it has already begun to develop.

Healthspan, the number of years we remain healthy, strong, and independent, is influenced by a different set of factors.

These metrics measure how the body is built and how it performs: muscle mass, bone density, metabolic function, cardiovascular fitness, and structural heart risk.

Unlike many traditional lab markers, these numbers often begin to change decades before symptoms appear.

Here are eight measurements that research consistently links to long-term health and longevity.

1. Lean Muscle Mass

Muscle is one of the body’s most important organs for long-term health.

Beyond strength and appearance, muscle plays a central role in metabolism, glucose regulation, mobility, and injury prevention.

Higher levels of lean muscle mass are associated with lower risk of metabolic disease, better physical resilience with aging, and greater independence later in life.

Yet muscle loss often begins earlier than most people realize, gradually accelerating over time if it is not actively maintained.

2. Visceral Fat

Fat stored around the organs carries far greater risk than fat under the skin.

Visceral fat accumulates deep inside the abdomen around vital organs such as the liver and pancreas.

Unlike subcutaneous fat, it is metabolically active and strongly associated with insulin resistance, cardiovascular disease, and chronic inflammation.

Two people with the same weight or body mass index can have dramatically different levels of visceral fat — and very different long-term health risks.

3. Bone Density

Bone strength quietly declines for many people long before fractures occur.

Bone density reflects the structural strength of the skeleton.

Lower bone density increases the risk of fractures, mobility limitations, and long-term disability later in life.

Because bone loss typically happens silently over many years, early measurement is one of the few ways to identify risk before problems appear.

4. Resting Heart Rate

A lower resting heart rate generally reflects a more efficient cardiovascular system.

Resting heart rate measures how many times the heart beats per minute at rest.

Higher resting heart rates are associated with increased risk of cardiovascular disease and all-cause mortality, while lower rates often reflect stronger cardiovascular conditioning.

It is one of the simplest indicators of overall cardiovascular efficiency.

5. Resting Metabolic Rate (RMR)

Your metabolic rate reflects how much energy your body needs just to function.

Resting metabolic rate represents the number of calories the body burns at rest to sustain basic physiological processes.

It is closely linked to lean muscle mass and metabolic health.

As muscle declines, metabolic rate often declines as well, which can influence weight regulation and metabolic resilience over time.

6. Grip Strength

Grip strength is one of the simplest yet most powerful indicators of physical resilience.

Large population studies have shown that lower grip strength is associated with a higher risk of cardiovascular disease, functional decline, and mortality.

Because it reflects neuromuscular health, grip strength often serves as an early signal of broader physical deterioration.

7. VO2 Max

Among all cardiovascular fitness measurements, VO2 Max consistently ranks among the strongest predictors of longevity.

VO2 Max measures the maximum amount of oxygen the body can use per minute per kilogram during exercise.

Higher levels of cardiorespiratory fitness are strongly associated with lower risks of cardiovascular disease, metabolic disorders, and premature mortality.

Unlike many risk factors, VO2 Max is also highly trainable. Even modest improvements in aerobic fitness can significantly improve long-term health outcomes.

8. Coronary Artery Calcium (CAC)

The calcium score measures actual plaque buildup inside the arteries of the heart.

A coronary artery calcium scan detects calcified plaque inside the coronary arteries.

Among imaging tests available today, CAC scoring is one of the strongest predictors of future heart disease.

Rather than estimating risk from indirect markers, the test measures the presence of plaque itself, often revealing cardiovascular risk years before symptoms appear.

Why These Numbers Matter

Most health assessments focus on markers that change once disease processes are already underway.

But the body often begins to change long before that point.

Muscle slowly declines, visceral fat accumulates, physical fitness decreases, and bone density weakens.

These structural and functional measurements provide a clearer window into how the body is aging — and often reveal risk decades earlier than conventional screening.

Healthspan is not determined by a single number. It emerges from a combination of factors that influence how strong, metabolically healthy, and resilient the body remains over time.

The earlier these numbers are measured and tracked, the greater the opportunity to influence their trajectory.

Fitnescity Health is the world’s largest platform for health and wellness tests such as DEXA body composition scans, VO2 Max testing, cardiac calcium scoring, metabolic assessments, and more.

Through a national network of over 1,000 medical and performance centers, Fitnescity Health makes it easier to measure the numbers that matter most.

Because prevention works best when we measure what changes first.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

New research presented yesterday at the AAOS Annual Meeting has shifted part of the GLP-1 conversation from weight loss to skeletal health.

GLP-1 medications are highly effective for reducing body weight and improving metabolic markers. That is well established.

What is now being examined more closely is the effect of significant, rapid weight reduction on bone mineral density (BMD) and lean mass.

The findings remain population-specific and evolving. But the direction of inquiry is clear:

Weight loss of this magnitude is not structurally neutral.

What the New Data Suggests

Across multiple orthopedic and metabolic sessions, three themes emerged:

1. Rapid mechanical unloading affects bone remodeling

Bone adapts to load. When total body mass decreases substantially, skeletal loading declines. In certain populations, that shift may alter remodeling balance toward bone resorption.

2. Muscle and bone decline can be linked

Lean mass loss is well documented in GLP-1–associated weight reduction. Because muscle provides mechanical stimulus to bone, reductions in muscle may influence bone-density trajectories.

3. Risk appears stratified

Postmenopausal women and older adults show greater vulnerability to measurable BMD changes during rapid weight loss. Younger individuals may demonstrate more resilience, though long-term longitudinal data are limited.

Importantly, this is not an argument against GLP-1 therapy. It is an argument for measurement alongside pharmacology.

What We Are Seeing Across 1,000+ Test Centers

At Fitnescity Health, we analyze DEXA-based body composition and bone-density data across a national network of more than 1,000 clinical test centers.

Our data are observational. However, consistent patterns are emerging:

• Individuals with greater than 15 percent body-weight reduction frequently show measurable lean mass decline.

• In postmenopausal women undergoing significant pharmacologic weight loss, site-specific BMD reductions are not uncommon.

• Individuals who incorporate structured resistance training and adequate protein intake demonstrate substantially better lean mass preservation and more stable bone metrics.

These real-world patterns align with what orthopedic researchers are beginning to quantify formally.

The encouraging reality is that structural change is measurable early and therefore modifiable.

The Monitoring Gap

GLP-1 prescriptions are increasing among adults in their 30s, 40s, and 50s.

Yet bone-density testing is typically deferred until age 65 or after a fracture.

Most treatment protocols track:

• Weight

• HbA1c

• Lipids

Few systematically track:

• Lean mass

• Regional bone density

• Structural change over time

Bone loss is often silent for years.

As pharmacologic weight loss becomes standard metabolic care, monitoring of muscle mass and bone density must evolve in parallel.

Clinical Implications

The emerging research suggests several practical considerations:

1. Baseline DEXA assessment before pharmacologic weight reduction.

2. Periodic monitoring of body composition and bone density during treatment.

3. Resistance training integrated as a core component of GLP-1 protocols.

4. Clear differentiation between weight reduction and muscle/bone health outcomes.

GLP-1 medications represent a powerful therapeutic shift. But as new clinical data make clear, success should not be defined by the scale alone.

Structural health—muscle and bone—deserves equal attention, and measurement must keep pace with medication.

- Laila Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Health conversations evolve, and health influencers come and go.

New voices emerge, others fade, and different frameworks rise and fall.

What doesn’t change is the biology:

• Muscle mass still declines with age.

• Bone density still decreases long before fractures occur.

• Cardiorespiratory fitness still predicts long-term health outcomes better than many routine clinical markers.

These facts don’t depend on who is explaining them at any given moment.

Yet historically, progress in preventive health has often relied on a small number of “translators.” These are people who are willing to connect complex science to everyday decisions, and they generally do it very well. They capture large audiences and often build a cult following.

When it comes to pushing the boundaries of preventive health, that model has limits: when translation depends too heavily on personalities, awareness can fluctuate as these influencers go out of vogue.
At the same time, the underlying need to measure health remains constant.

The healthcare system still rarely measures muscle, bone, or VO2 max early.
Guidelines still focus on late-stage risk. Most people are still told they’re “healthy” based on labs that miss structural decline.

This is why preventive health needs more than education.

It requires durable access to data that’s embedded in the system, regardless of whether an influencer is present.

Fitnescity Health was built on the idea that, regardless of who is talking about prevention, people should be able to measure it accurately, clinically, and over time.

• DEXA for muscle, bone, and fat distribution.

• CT cardiac scoring for heart health

• VO2 max for cardiorespiratory fitness.

All delivered through standardized protocols and medical-grade testing designed for repeat measurement.

Influencers may come and go. But the need to understand how the body is changing does not. Prevention works when data outlasts discourse.

—
Laila

Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

By the time heart risk is routinely taken seriously, decades of structural change have already taken place.

Most people believe heart health is something you monitor later in life. You get your cholesterol checked and watch your blood pressure. If those numbers come back “normal,” you’re told you’re fine.

But the body doesn’t wait.

Heart risk doesn’t start in your 60s

The problem isn’t that we can’t see these changes. It’s that we don’t look for them.

Long before traditional screening kicks in, measurable structural changes are already underway:

• Lean muscle mass declines steadily starting in your 30s, reducing metabolic efficiency and long-term cardiovascular resilience.

• Bone density decreases, especially in women, affecting not just fracture risk but vascular and overall health.

• Visceral fat accumulates quietly around the organs, driving inflammation and cardiometabolic risk, often while weight and labs still look acceptable.

The gap between what we can measure and what we do

Here’s the disconnect:

• Routine labs typically begin in midlife and are often labeled “normal.”

• Advanced heart imaging is usually considered much later, often after risk has already compounded.

• Bone density screening is commonly recommended in the mid‑60s or later.

In other words, we wait to act until the system is confident there’s a problem, not when prevention would be most effective.

Normal results don’t always mean low risk

Blood tests are useful, but they don’t tell the whole story.

Two people can have identical cholesterol panels and vastly different underlying risk profiles depending on their muscle mass, visceral fat levels, and bone health. Without considering the structure, we miss context, and reassurance can be misleading.

This is why so many people are surprised when issues appear “suddenly” later in life. The signals were there. They just weren’t being measured.

A different way to think about heart health

Heart health isn’t just about avoiding a future event. It’s about understanding how your body is changing early enough to respond.

That means shifting from:

• reactive screening → proactive measurement

• isolated lab values → whole‑body context

• late intervention → earlier awareness

Why this matters now

With rising use of weight‑loss drugs, longer lifespans, and growing interest in preventive care, the gap between what’s possible and what’s routine is becoming harder to ignore.

We don’t lack the tools; we lack the habit of using them early at a population level.

Heart Month is a reminder that prevention only works when we measure what matters before we’re told everything looks normal.

-Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

GLP-1s are often framed as breakthrough weight-loss drugs, but that framing is already outdated.

What’s happening in 2026 isn’t just broader adoption or better pricing. It’s a structural shift. GLP-1s are moving from short-term treatments to long-term, system-level interventions that shape how care is delivered, paid for, and evaluated.

If you’re using a GLP-1, considering one, or simply thinking more seriously about your long-term health, this shift affects you directly. Not because of the medication itself, but because of what it changes and what most people still aren’t measuring.

When Something Stops Being “Just a Drug”

When something becomes embedded across employer benefits, payer budgets, clinical pathways, and digital health programs, it stops being “just a product.” It becomes infrastructure.

This is not infrastructure in the abstract sense, but in a practical one:
something assumed to exist, paid for continuously, and relied upon by many parts of the system at once.

This shift has consequences, and one of them is now impossible to ignore.

GLP-1s Were Never Meant to Be Episodic

Early narratives treated GLP-1s as a finite intervention: Take the drug. Lose weight. Stop.

That is not how they’re being used in practice. By 2026:

• Millions of people are on GLP-1s long-term

• Doses are adjusted over time

• People cycle on and off

• Employers model multi-year costs

• Payers think in cohorts, not individuals

This looks far less like an acute prescription and far more like ongoing management. And ongoing management always requires an objective, repeatable measurement of physical change.

The Blind Spot Beneath the Surface

GLP-1s don’t just change body weight. They change what the body is made of.

• Muscle mass.

• Bone density.

• Fat distribution.

• Cardiovascular fitness.

These changes affect metabolic health, strength, mobility, early mortality, and the person’s quality of life over the last few decades.

Yet most GLP-1 programs still rely on proxies:

• The scale

• Basic labs

• Self-reported symptoms

• Engagement metrics

These are easy to collect, but they are not enough.

Claims data shows problems after they emerge. Labs capture chemistry, not structure. Wearables capture movement, not tissue.

For individuals, this gap shows up quietly: Weight may go down, while strength erodes. Progress can look successful, while important changes happen out of sight.

This is not a clinical debate. It’s an infrastructure gap.

When a Therapy Becomes Long-Term, Measurement Must Follow

Every long-term health intervention that scales eventually forces the same question:

How do we know it’s working beyond the headline outcome?

Statins didn’t scale without cholesterol monitoring.
Cardiac care didn’t evolve without imaging and risk stratification.

GLP-1s are now at that same inflection point.

Once a therapy becomes long-term and population-level, measurement is no longer optional. It becomes the connective tissue between individuals, providers, payers, and outcomes.

Without it:

• Success is misdefined

• Risks surface too late

• Costs rise without clarity

The Physical Measurement Layer Most People Never See

What’s missing today isn’t more digital engagement.

It’s reliable, real-world access to medical-grade physical measurement, done consistently and over time.

That means:

• Establishing meaningful baselines for muscle mass, bone density, and cardiovascular fitness

• Tracking change longitudinally

• Using standardized assessments

• Escalating when results fall outside expected ranges

This isn’t about testing for testing’s sake.

It’s about making physical change visible, so decisions aren’t made in the dark.

Why Longitudinal Data Changes Everything

As GLP-1 use becomes long-term, the most valuable insight isn’t a single data point.

It’s the pattern: Longitudinal physical data helps answer questions people rarely ask early enough:

• Am I preserving muscle as I lose weight?

• Are changes happening evenly or in ways that create future risk?

• How is my body adapting over time, not just responding short-term?

These answers don’t come from how you feel on a given day.

They come from measuring what’s actually changing.

What This Means for You

If you’re navigating GLP-1s, or any long-term health intervention, the most important question isn’t: “Is this working today?”

It’s: “What is this doing to my body over time?”

Measurement and visibility are what allow people to stay ahead of problems, rather than react to them later.

At Fitnescity Health, this belief guides everything we build: making physical change measurable, understandable, and actionable before small shifts become bigger ones.

-Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Most chronic diseases don’t begin with a diagnosis.
They don’t start with a bad lab result or a sudden symptom.

They start quietly.

Long before someone is told they have osteoporosis, heart disease, diabetes, or frailty, the body has already been changing slowly, predictably, and often invisibly.

Yet most of our healthcare system is still designed to react at the end of that process.

Decline Is Not the Same as Disease

We often talk about health as a binary state: healthy or sick.
But the truth is far less abrupt.

Health usually erodes in stages:

• Muscle mass gradually declines

• Cardiorespiratory fitness weakens

• Fat redistributes in more metabolically harmful ways

• Plaque begins to build inside arteries

None of this happens overnight. And most of it happens while people feel “fine.”

By the time symptoms appear, the underlying decline has often been underway for years, and sometimes decades.

The Problem Isn’t Aging. It’s What We Don’t Measure.

Aging gets blamed for a lot. But aging itself isn’t the real issue.

The issue is that we don’t systematically measure the forms of decline that matter most for long-term health and independence.

Most annual physicals still rely heavily on:

• Bloodwork

• Weight or BMI

• Blood pressure

These are important. But they tell only part of the story—and often a late part of the story.

They rarely show:

• How much muscle someone is losing

• Whether their cardiovascular fitness is deteriorating

• Whether structural changes are happening beneath the surface

As a result, many people are reassured that they’re “normal” while their physiology quietly moves in the wrong direction.

Why “Feeling Fine” Can Be Misleading

One of the most dangerous myths in health is that the absence of symptoms equals the absence of risk.

Muscle loss doesn’t hurt.
Declining fitness doesn’t trigger alarms.
Early arterial plaque doesn’t announce itself.

These changes are silent by nature. That’s precisely why they matter.

When health is evaluated only through symptoms or late-stage markers, prevention becomes reactive rather than proactive.

Prevention Only Works If We Detect Decline Early

True preventive care isn’t about more tests for the sake of testing.
It’s about measuring what actually changes before disease takes hold.

That means paying attention to:

• Body composition, not just weight

• Physical capacity, not just vitals

• Structural changes, not just lab values

When these forms of decline are identified early, people can intervene meaningfully—through movement, nutrition, training, and lifestyle—while change is still reversible.

Once decline progresses to disease, the options narrow dramatically.

A Shift That’s Already Underway

We’re beginning to see a quiet shift in how people think about health.

More individuals want to understand how their bodies are changing over time, not just whether they’ve crossed a clinical threshold yet.

This isn’t about obsessing over numbers.
It’s about awareness, agency, and timing.

Because no one wakes up sick.

They decline quietly first.

And the earlier we learn to see that decline, the more control we have over the years that follow.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Most people assume muscle loss begins in their 50s or 60s.

In reality, muscle erosion begins much earlier, often in our early 30s, and accelerates decade by decade.

This slow and steady decline is one of the most overlooked drivers of long-term health. In reality, it’s one of the strongest predictors of future frailty, insulin resistance, mobility loss, metabolic slowdown, and early mortality.

Yet most adults never measure it, and traditional checkups rarely mention it.

Over the past five years at Fitnescity Health, analyzing DEXA scan data across thousands of adults, one pattern has become clear.

Muscle mass declines earlier, faster, and more silently than most people realize.

And during the GLP-1 era, the stakes are even higher.

The Age Curve: What Actually Happens to Muscle Over Time

Research shows that:

• Muscle mass begins declining around age 30

• The rate accelerates after 40

• Adults can lose 3–8% of muscle per decade

• After 60, the loss can reach 10% per decade or more

On DEXA scans, this shows up long before a person notices any physical changes. A body that looks the same externally may be losing lean mass internally.

The danger lies in how foundational muscle is, not just for strength but for metabolic and cardiovascular resilience. Muscle functions as an endocrine organ, a glucose sink, and one of the strongest predictors of healthy aging.

What Our DEXA Data Shows Across Ages

Across Fitnescity Health’s national network, a repeated pattern emerges.

1. Many people in their 30s are already below optimal lean mass

Not dangerously low, just lower than ideal for long-term health.

2. Visceral fat often increases even when body weight stays stable

This is the “invisible shift” no scale can detect.

3. Muscle loss accelerates in the early 40s

This is where we see the clearest inflection point.

4. Most people underestimate the extent of the change

Until they see the numbers on a DEXA scan.

What makes this decline so silent is that it doesn’t feel like a problem until it is.

Why Muscle Loss Matters Far More Than Most People Think

Lean mass is one of the strongest predictors of:

• Metabolic health (insulin sensitivity and glucose control)

• Healthy weight management

• Bone density (muscle pulls on bone and stimulates bone formation)

• Mobility and fall risk later in life

• Basal metabolic rate (RMR)

• Early mortality

From a physiological standpoint, maintaining muscle mass is one of the most powerful disease-prevention strategies available.

The GLP-1 Twist: Faster Weight Loss Often Means Faster Muscle Loss

In our recent work with clinicians and GLP-1 patients across the country, another trend has emerged.

GLP-1 medications accelerate weight loss, and a significant portion of that loss often comes from lean mass.

This is not a critique of the medications. For many people, they are life-changing.

But in DEXA data, we often see:

• Rapid total weight loss

• A meaningful proportion coming from lean mass

• Lower resting metabolic rate (RMR)

• A higher likelihood of regaining weight later

This is why monitoring muscle becomes essential during GLP-1 therapy.

A DEXA scan before, during, and after treatment gives a clearer picture of what is changing, not just on the scale but inside the body.

Why This Problem Is So Hidden

Three reasons:

1. Weight is a misleading signal

A person can lose 20 pounds while gaining visceral fat and losing muscle.

2. Daily life doesn’t reflect small changes

You don’t feel a 2–3% shift in lean mass.

3. Primary care doesn’t measure body composition

Annual physicals rely on weight, BMI, and visual assessments.

The body is changing, but traditional tools cannot detect it.

The Good News: Muscle Is One of the Most Modifiable Tissues in the Body

Lean mass responds quickly to:

• Resistance training

• Adequate protein intake

• Strength-focused exercise

• Improved metabolic health

• Interventions tailored to your baseline DEXA profile

On the Fitnescity Health platform, we see people often improve lean mass and reduce visceral fat within 8–12 weeks when they have the right data.

You cannot fix what you do not measure. But once you measure it, it becomes actionable.

A More Proactive Way Forward

Muscle loss is not inevitable. It is measurable, trackable, and highly modifiable, but only if we identify it early.

At Fitnescity Health, we believe muscle should be treated like any other key health marker: measured regularly, interpreted clearly, and addressed proactively.

Whether you are in your 30s, entering your 40s, or using GLP-1 medications, the earlier you understand your body composition, the better you can protect your long-term health.

Early decline does not have to lead to long-term loss.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Everyone has an opinion about GLP-1s.

From doctors and investors to pharmaceutical companies, journalists, and influencers, everyone agrees these medications are reshaping weight loss, healthcare, and even culture.

But after five years of building Fitnescity Health and partnering with nearly 1,000 hospitals and diagnostic centers across the U.S., I’ve come to realize something more subtle:

GLP-1s didn’t just change how people lose weight.
They changed how people engage with their health.

And what we’ve seen behind the scenes—in tens of thousands of DEXA scans, VO2 Max tests, and metabolic assessments—tells a very different story than what you read in headlines.

The Unexpected Trend: GLP-1s Created a Surge in Health Curiosity

Before GLP-1s, most people booked a DEXA scan or VO2 Max test for one of two reasons: performance or longevity. They wanted to track body composition, measure fitness, or get ahead of age-related decline.

Then GLP-1s arrived, and suddenly, we saw a new pattern.

People who had never tracked a single health metric now wanted to know everything:

• Am I losing fat or muscle?

• Is my metabolism slowing down?

• Is rapid weight loss affecting my cardiovascular fitness?

• Am I actually getting healthier or just lighter?

What surprised me most wasn’t the volume of new test takers.
It was the motivation.

Once people start losing weight rapidly, they want to understand what’s really happening inside their bodies.
For many, GLP-1s became the first gateway into preventive health.

But What They Expect… Isn’t What the Data Shows

Most people start GLP-1s with the same assumption:

If the scale is going down, my health must be improving.

But the data tells a more complicated story.

Across thousands of DEXA scans, especially repeat tests from GLP-1 users, we see three recurring patterns:

1. Lean mass loss is common — and often underestimated.
   Rapid weight loss makes it challenging to preserve muscle, especially without structured strength training.

2. VO2 Max doesn’t automatically improve.
   Weight may drop, but cardiovascular fitness doesn’t improve unless people actively train.

3. Metabolic rate often declines.
   RMR tests show decreases that make long-term maintenance harder if habits aren’t built along the way.

None of this means GLP-1s don’t work.
They work incredibly well.

But they reveal something we often forget:
Weight loss and health improvement are not the same thing.

What We’re Seeing Across 1,000+ Test Centers

Because Fitnescity Health spans hundreds of institutions—hospitals, diagnostic centers, sports labs, and academic facilities—we see patterns that individual clinics can’t.

Here’s what stands out:

• Providers are increasingly referring GLP-1 patients for monitoring.

• Weight-loss clinics are adding DEXA as a standard part of treatment.

• GLP-1 users are likely to book repeat DEXA scans.

• Many progress from DEXA → RMR → VO2 Max once they see how much information they’ve been missing.

This has become a new behavioral funnel:
GLP-1 → curiosity → data → action.

GLP-1s didn’t just change body weight.
They changed the way people interact with their health data—often for the first time.

The Silent Cost: What Rapid Weight Loss Exposes

Here is the part that few people talk about.

Shortcuts reveal hidden weaknesses.

When weight drops quickly, the body shows the imbalances it’s been holding for years:

• Weak muscle foundation

• Low cardiovascular capacity

• Sluggish metabolism

• Poor strength-to-weight ratio

• High visceral fat despite lower total weight

Losing muscle isn’t just an aesthetic issue. It’s one of the strongest predictors of future frailty, insulin resistance, mobility loss, metabolic slowdown, and early mortality.

Muscle mass is tightly linked to longevity, bone density, balance, immune resilience, and even cognitive health.

When rapid weight loss accelerates muscle and bone loss, healthspan—the number of years lived in good health—can quietly shrink even as the number on the scale improves.

For many, this becomes the wake-up call that pushes them to start resistance training, address nutrition, and rebuild metabolic health — not just lose weight.

The Better Path: GLP-1 + Testing + Strength

In many cases, GLP-1 medications are life-changing.

But what we’ve seen nationwide is clear:

The people who maintain their results and actually improve their health are the ones who pair medication with data and strength.

That means:

• DEXA to protect lean mass

• VO2 Max to build cardiovascular fitness

• RMR to understand and maintain metabolic rate

• Strength training as the non-negotiable foundation

This is precisely the kind of proactive, metric-driven approach we’ve been building at Fitnescity Health.

A Final Thought

If GLP-1s revealed anything, it’s this: People have always struggled with weight—emotionally, physically, and biologically.

What ultimately influences long-term outcomes is understanding how the body is changing beyond the scale. Without visibility into muscle and bone mass, rapid weight loss can unintentionally accelerate aging rather than improve health.

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Most people monitor familiar health metrics such as weight, cholesterol, and blood pressure. Yet these measures offer only a partial view of long-term health.

The data that most reliably predicts outcomes such as cardiovascular disease, metabolic dysfunction, and overall longevity is often hidden, overlooked, or never measured.

Over the past five years building Fitnescity Health and partnering with nearly a thousand hospitals, imaging centers, and academic institutions, I’ve had a front-row seat to how dramatically the right data can change a person’s understanding of their health. Certain metrics surface early signals that routine exams miss. Others reveal risks years before symptoms appear.

This article highlights eight numbers that, taken together, provide one of the clearest and most actionable snapshots of long-term health. They are grounded in decades of research, widely used in clinical practice, and — importantly — accessible to anyone willing to measure them.

1. VO2 Max: Your Body’s Engine Power

If I had to pick a single number that predicts longevity better than almost anything else, it’s VO2 Max.

VO2 Max measures how much oxygen your body can use during exercise. Higher levels are strongly associated with lower rates of cardiovascular disease, metabolic disease, and even all-cause mortality.

The best part?
It’s highly modifiable.

Unlike many health metrics, you can improve VO2 Max within weeks through structured training.

2. Coronary Calcium Score: A Look Inside Your Arteries

The Calcium Score is one of the most powerful predictors of future heart disease ever discovered.

It quantifies calcified plaque in your coronary arteries—the buildup that leads to heart attacks. The test is quick, painless, and incredibly actionable: a score of zero is reassuring, while a higher score guides conversations with your clinician on how to reduce risk.

This is the one number on this list you can’t change — but knowing it can change your future.

3. DEXA Body Composition: Beyond Weight, Toward What Matters

Your weight doesn’t tell you whether you’re healthy. Body composition does.

A DEXA scan breaks down your body into:

• Lean mass (muscle)

• Fat mass

• Visceral fat — the dangerous fat around your organs

High visceral fat is strongly tied to metabolic disease and early cardiovascular risk. Maintaining muscle mass is one of the best predictors of healthy aging — especially after 40.

4. Resting Metabolic Rate (RMR): Your Metabolism’s Baseline

RMR tells you how many calories your body burns at rest. It’s the foundation of energy balance and deeply linked to metabolic health.

A low or unexpectedly slow RMR may signal hormonal changes, loss of muscle mass, or early metabolic dysfunction.
A healthy, higher RMR is often a sign of good metabolic flexibility and lean mass.

5. Hemoglobin A1C: Your Long-Term Glucose Picture

A1C reflects your average blood sugar over the past three months.

Even mildly elevated levels — long before diabetes — are associated with increased cardiovascular risk, cognitive decline, and metabolic dysfunction.

This number often changes silently, which makes it essential to track.

6. ApoB: The Most Powerful Lipid Number Most People Don’t Know

If you’ve only been checking LDL cholesterol, you’re missing the full picture.

ApoB measures the actual number of atherogenic particles that drive plaque formation. It’s a far stronger predictor of cardiovascular risk than LDL alone — and it’s becoming the new standard among cardiologists and longevity physicians.

7. hsCRP: The Inflammation Signal

Chronic inflammation increases the risk of heart disease, cancer, and metabolic disorders.

hsCRP (high-sensitivity C-reactive protein) is a simple marker that reflects low-grade systemic inflammation. It’s sensitive, predictive, and modifiable through lifestyle, stress management, and clinical interventions.

8. Blood Pressure: The Silent Risk Multiplier

High blood pressure is one of the most common — and most overlooked — risk factors for heart disease and stroke.

It often rises gradually, with no symptoms, and amplifies the danger of other risk factors like high ApoB or elevated A1C.

Blood pressure is not just a number; it’s a lens into the health of your vascular system.

Why These 8 Numbers?

Three reasons:

1. They predict the health outcomes that matter most.

Cardiovascular disease, metabolic disease, and chronic inflammation underpin most long-term health risks.

2. They’re modifiable — you can act on them.

Except for the Calcium Score, each number can be improved with lifestyle, training, or medical guidance.

3. Together, they give a full-body picture.

Performance, structure, metabolism, inflammation, vascular health.
Eight numbers — no redundancy, no noise.

The Future of Preventive Health Is Data You Can Use

At Fitnescity Health, this philosophy guides everything we do. Whether it’s VO2 Max, DEXA body composition, metabolic tests, or the Cardiac Calcium Score, our goal is simple:

Help people know their numbers and take control of their health before problems arise.

Prevention isn’t guesswork.
It’s measurement, understanding, and action.

These eight numbers are a powerful place to start.

—
Laila Zemrani
Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test. results.

The missing half of your annual labs

Blood tests show chemistry (glucose, lipids, hormones), but they can’t show structure: where fat is stored, how much muscle you carry, and whether your bones are quietly weakening.

Those three structural factors (visceral fat, skeletal muscle, and bone density) are independently tied to diabetes, heart disease, cancer, disability, and fractures. DEXA is the fastest, lowest-dose way to measure all three—objectively, in ~10 minutes. IAEA

1) Fat quality matters more than weight — and DEXA sees it

Visceral fat (VAT) around your organs drives metabolic disease and cardiovascular risk far more than BMI or total weight. DEXA directly estimates VAT and central fat patterns validated against CT/MRI and shows stronger correlations with cardiometabolic risk factors than scale metrics. PubMed+1

• Cardiometabolic risk: In adults, DEXA-estimated VAT tracks more tightly with insulin resistance, blood pressure, HDL, and triglycerides than BMI or waist alone. PMC

• Central fat pattern: A higher android-to-gynoid fat ratio (from DEXA) is linked to worse lipid profiles and higher blood pressure, signaling elevated cardiovascular risk even when BMI is “normal.” PMC

• Cancer burden: In a 2024 population study, high visceral fat explained more total cancer than high BMI (population-attributable risk: ~9–12% for VAT vs ~5–8% for BMI), highlighting why “where fat sits” beats “how much you weigh.” PubMed
  
  

  Bottom line: If you only track weight, you’ll miss the risk hiding in abdominal fat. DEXA shows it precisely and reproducibly. PMC

2) Muscle is a longevity vital sign — and DEXA quantifies it

Low skeletal muscle (sarcopenia) and the combo of low muscle + high fat (sarcopenic obesity) are consistently associated with higher all-cause mortality. DEXA is the clinical standard to quantify appendicular lean mass and diagnose sarcopenia. PMC

• Mortality signal: A 2024 JAMA Network Open study of older adults found sarcopenia and sarcopenic obesity predicted worse survival, reinforcing the need to screen and intervene early. JAMA Network

• Meta-analytic evidence: Systematic reviews link lower lean mass to higher mortality independent of BMI, underscoring that body composition > body weight. PMC+1
  

Clinical payoff: Muscle mass is trainable. With a DEXA baseline, resistance training, protein optimization, and targeted programs can be measured in weeks, not guessed. PMC

3) Bone density predicts fractures — years before they happen

Bone loss begins silently; one bad fall can change a life. Each standard-deviation drop in bone mineral density (BMD) raises fracture risk substantially; DEXA BMD is the accepted predictor used in tools like FRAX and in treatment decisions. New England Journal of Medicine

• Therapy decisions rely on BMD: Major osteoporosis trials and editorials emphasize that low BMD is a fracture risk factor and a core input to decide on anti-resorptive or anabolic therapy, not vitamin D alone. New England Journal of Medicine+1
  

Actionability: A single DEXA can identify osteopenia years before a fracture and track the effects of exercise, calcium, vitamin D optimization, and medications. New England Journal of Medicine

Safety, speed, and standardization

DEXA uses very low radiation — typically less than a chest X-ray — and takes ~10 minutes with high test-retest reliability for fat, lean mass, and BMD. IAEA

What this changes in your annual physical

Without DEXA: you can be “normal BMI” with dangerous visceral fat, “normal weight” but low muscle, or losing bone density unnoticed.
With DEXA: you and your doctor get three objective risk levers to pull: reduce visceral fat, build/maintain muscle, and protect bone. PMC+2JAMA Network+2

How doctors use DEXA data (in practice)

• Cardiometabolic prevention: If VAT or android:gynoid ratio is high, intensify lifestyle therapy, consider CGM-guided nutrition, prioritize resistance training, and track VAT change on follow-up DEXA (3–6 months). PMC+1

• Sarcopenia screening: Low appendicular lean mass → prescribe progressive resistance training + protein (1.2–1.6 g/kg/day as appropriate), re-scan to confirm muscle gain. PMC

• Bone health: Low BMD or rapid loss → assess secondary causes, optimize calcium/vitamin D, load-bearing exercise; if indicated, initiate pharmacotherapy and monitor BMD. New England Journal of Medicine+1
  
  

For consumers: what to do with your numbers

1. Know your VAT and android:gynoid ratio. Aim to bring VAT down with nutrition quality, sleep, and resistance + zone 2 training; confirm change on your follow-up DEXA. PMC+1

2. Protect your muscle. Track lean mass and aim for progressive strength gains; muscle is your metabolic and mobility insurance. PMC

3. Guard your bones. If you’re 40+ (earlier with risk factors), get a baseline; if post-menopausal or on risk-raising meds, discuss cadence with your clinician. New England Journal of Medicine
   
   

Why Fitnescity Health

We make hospital-grade DEXA accessible nationwide with clear reports and guidance your physician can use.

Fitnescity Health is the world’s largest platform for health and wellness tests like the DEXA Scan, the VO2 Max, the Calcium Score Test, and more. Fitnescity Health partners with the nation’s leading hospitals, diagnostic centers, and academic institutions to make testing more accessible and provide personalized insights.

If you already do annual bloodwork, add a DEXA once a year.
Know your structure. Change your trajectory.

Sources

• DEXA-VAT vs cardiometabolic risk; DEXA VAT validation vs CT. PMC+1

• Android:gynoid fat ratio and risk markers. PMC

• Visceral fat and total cancer burden (higher than BMI). PubMed

• Lean mass and mortality; sarcopenic obesity. JAMA Network+2PMC+2

• BMD and fracture risk; role of BMD in decisions. New England Journal of Medicine+2New England Journal of Medicine+2

• Dose & safety (DEXA < chest X-ray).IAEA

Over the past year, one preventive test has been rising in popularity — discussed by longevity doctors, business executives, and health influencers alike: the Coronary Artery Calcium (CAC) Score, also known as the Calcium Score Test.

Unlike the DEXA Scan or VO2 Max test — which reveal how your body is performing — this one looks into the future more directly. As someone with a family history of high cholesterol and heart disease, I wanted to ask a fundamental question: What is my cardiovascular risk?

Five Minutes

The Calcium Score Test uses a quick, non-invasive CT scan to measure the buildup of calcified plaque in the coronary arteries — the vessels that feed your heart with oxygen-rich blood. It takes only a few minutes, but the insight it provides can be life-changing.

I was in and out in about five minutes. I’ll admit — I was distracted and a little OCD about the experience because I was doing it as a customer of my own company, Fitnescity Health. I couldn’t help obsessing over every detail. Still, the test itself is very chill and over before you know it. You can even get the results immediately.

When I received mine and saw that my score was 0 — meaning no evidence of calcified plaque and low risk for my age and gender — I felt both relieved and grateful. A zero score doesn’t mean I’m immune to heart disease, but it’s reassuring. It also gives me a clear baseline to track over time.

If your score is higher than zero — especially if you’re on the younger side — it’s an early warning sign that plaque is forming in your arteries.

The test can reveal silent risk years before symptoms appear, allowing you and your doctor to make changes — through lifestyle, medication, or both — to prevent future heart attacks or other cardiovascular events.

Why It Matters

What makes this test so powerful is its simplicity. It turns something invisible — plaque buildup — into life-saving information.

Cardiologists often call it one of the strongest predictors of future heart disease, even more so than cholesterol levels.

If you’ve ever wondered how healthy your heart really is, this test deserves a place on your list. It takes five minutes. It could change your future.

👉 Learn more or book your Calcium Score Test here.

—
Laila Zemrani
Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test. results.

Why VO2 Max May Be More Important than Weight, Blood Pressure, or Cholesterol

If you had to pick just one number to predict your long-term health, which would you choose?

Most people would say cholesterol, blood pressure, or body weight. But the world’s leading longevity scientists point to another: VO2 max.

VO2 max — short for “maximal oxygen uptake” — measures how efficiently your body uses oxygen during intense exercise. Think of it as your aerobic engine. The higher the number, the better your body can deliver oxygen to your muscles, sustain activity, and recover.

CBS’s 60 Minutes Spotlights VO2 Max as One of the Most Powerful Indicators of Long-term Health and Longevity

Why VO2 Max Matters

The New York Times recently highlighted VO2 max as one of the strongest predictors of both fitness and longevity. Research shows:

• People with higher VO2 max scores live longer, healthier lives.

• A low VO2 max can signal higher risk for cardiovascular disease, diabetes, and even dementia.

• Improving your score — even modestly — can significantly lower health risks.

Unlike weight or cholesterol, VO2 max isn’t just about disease prevention. It’s also about capacity: your ability to live fully, to play with your kids, to stay active as you age.

It’s not just a fitness number — it’s one of the strongest predictors of lifespan ever studied.

How to Measure It

VO2 max can be estimated by wearables, but the most accurate method is through a VO2 max test: exercising (usually on a treadmill or bike) while your oxygen and carbon dioxide are measured with a mask.

At Fitnescity Health, VO2 max testing is one of the most requested health assessments we offer — because it provides actionable data you can’t get elsewhere.

Most people are surprised to discover their number — and even more surprised by how much it can improve.

How to Improve It

The best part: VO2 max isn’t fixed. You can improve it with training, especially through:

• Interval training: Short bursts of high intensity, followed by recovery.

• Steady-state endurance: Consistent aerobic activity like running, cycling, or swimming.

• Strength and mobility work: Indirect, but supports cardiovascular capacity.

Even small, consistent changes can shift your score — and your long-term trajectory.

My Take

VO2 max may sound technical, but it reflects something simple: your ability to live life with energy and resilience.

Just as cholesterol once became a household word, I believe VO2 max deserves the same spotlight — It’s one of the most powerful tools we have to measure and improve not just lifespan, but healthspan.

As more people learn about VO2 max, we’re proud that Fitnescity Health has grown into the world’s largest platform for VO2 Max testing — helping people understand their number and improve it.

👉Learn more or book your VO2 Max Test here

— Laila Zemrani Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics, data, and the new era of personal health. Join tens of thousands of readers who are redefining what it means to stay well.

Note: Nothing in this article constitutes medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified medical professional if you have any questions about your health, well-being, or Fitnescity Health test results.

Those five years have taught me a lot. So, on our fifth birthday, I’m launching Own Your Health — a new publication about the rise of self-directed health and what it means for all of us.

Each article will distill data, research, and real-world stories into practical insights you can use to make more informed choices about your health.

Here’s a sample of what we’ll cover:

• The Metric That Predicts Longevity (and How to Improve It)

• I Am Not Aiming to be Bryan Johnson — What Can I still Do?

• Why the DEXA Scan Should Be in Everyone’s Physical

The New Reality

If you’ve recently found yourself asking more questions during a doctor’s visit, you’re not alone.

Everywhere you look, people are quietly starting to take control of their own health.
We order tests online, track our hearts on our wrists, ask algorithms about our symptoms, and often trust those answers more than a rushed appointment.

Five years ago, this idea was considered radical. Today, it’s the direction medicine is heading.

A recent Wall Street Journal article described how patients are increasingly diagnosing themselves using health tests, wearables, and even AI chatbots.

Blood tests can now be ordered online through national labs like Quest Diagnostics, body scans through platforms like Fitnescity Health, ECGs tracked on our wrists, and symptom questions asked of an algorithm.

To me, this isn’t a fringe movement. It’s the future of healthcare — one where individuals have greater ownership of their wellbeing.

Knowledge Is Power

You now have the tools to advocate for your own health. For too long, healthcare has been reactive: wait until you’re sick, see a doctor, and accept your fate.

Self-directed tools flip that model. They let you:

• Prevent instead of cure by catching risks earlier through continuous monitoring and self-initiated testing.

• Engage more deeply by asking questions, learning, and advocating for yourself.

• Personalize your care instead of relying on one-size-fits-all recommendations.

I built Fitnescity Health because I believe wholeheartedly in making preventive tools and consumer testing more accessible. Because informed, curious people make better decisions for themselves and their families.

Your doctor might not love this new reality — but that’s the way it is.

But Caution Matters

Not every device or test is created equal. There are real concerns about:

• Accuracy and validation: Some tools are rock-solid; others are not.

• Fragmented care: Without integration, people risk ending up with a stack of results and no clear next step.

• Privacy and trust: Data stewardship is critical when what’s at stake is your health.

Empowerment only works when it’s paired with responsibility and reliable information. That’s where society needs balance: empowering people while setting guardrails to ensure safety, trust, and effectiveness.

The Path Forward

I don’t see this as patients replacing physicians. I see a partnership of three:

• Individuals empowered by data.

• Technologists enabling insight.

• Clinicians guiding judgment.

If we get that balance right, healthcare becomes what it was always meant to be — preventive, personal, and participatory.

I’m more convinced than ever that the future of medicine isn’t about more treatment — it’s about earlier understanding.

By coincidence, Fitnescity Health was born in October, Health Literacy Month, a reminder that understanding our own bodies is where good health truly begins.

This newsletter is my way of exploring that future with you through real-life stories and actionable insights.

— Laila Zemrani
Co-Founder & CEO, Fitnescity Health

About Own Your Health

A founder’s letter about consumer-led diagnostics and how you can navigate this new era of personal health. Join tens of thousands of readers redefining what it means to stay well.

Note: The information in this article is for educational and informational purposes only. It is not intended as medical advice, diagnosis, or treatment. Always seek the guidance of your physician or another qualified healthcare provider with any questions you may have about your health, wellbeing, or Fitnescity Health test results.

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