Composition
The night before the scan, I went looking for gym shorts. I could not find a pair that fit. Not because I had gained weight. Because I had lost it. The shorts I wore six months ago slid off my hips. I did not know this had happened. The body had changed and I had not registered it.
I went to Composition ID in McLean on March 4 for a DEXA scan and resting metabolic rate test. The DEXA takes seven minutes. I lay on a table while an arm passed over me slowly, measuring density, mass, distribution. It does not ask how the body feels. It does not care about narrative. When it finishes, it produces a picture of the skeleton overlaid with data.
The blood panel from February gave me chemistry. This was structure. A technician walked me through every page.
The headline: 224 pounds. 147 pounds of lean mass. 73 pounds of fat. Body fat percentage: 33.1. The lean mass is higher than expected. The fat mass is not.
Resting metabolic rate: 2,271 calories per day. Faster than average for my height and weight. My body, at rest, burns more than the models predict. That is the kind of number that feels like good news. It is good news. It is also incomplete news, in the same way that the biological age estimate from the blood panel was incomplete news. A favorable headline with a complicated report underneath.
The complication is distribution.
The body does not store fat evenly, and where it stores fat matters more than how much it stores. My android region (the abdomen, the visceral compartment) is at 42 percent fat. My A/G ratio, the relationship between abdominal and hip fat, is 1.30. In clinical terms, that ratio should be below 1.0. Mine is not close.
This is the pattern the blood panel suggested. The metabolic markers that pointed to insulin resistance, the glucose regulation numbers that were strained beneath a flattering surface: the DEXA confirms them structurally. The fat is not evenly distributed. It is concentrated in the place that correlates most directly with metabolic disease, cardiovascular risk, and the kind of slow systemic damage that does not announce itself until it has compounded.
I knew this. I have known this for years the way a person knows something they have not measured: with enough certainty to worry and not enough to act precisely. The DEXA replaced that with geometry.
Then there is the finding I did not expect.
The scan measures lean mass symmetry: right side against left, region by region. Arms were balanced. Trunk was balanced. Legs were not. The imbalance is not dramatic, but it is there, and it is on the side of the surgical fusion.
I have written about the fused ankle since the first post. The congenital deformity, the surgery, the baseline pain that does not go away. It is the reason I switched to flat pedals. It is the structural constraint that every equipment decision routes around. I have described it as a limitation. I have described it as load. I have not, until now, seen it rendered as asymmetry in lean tissue.
The body adapted around the constraint. It built itself unevenly. Not because of injury or neglect. Because the architecture demanded it. The left leg carried load differently, and over years, the composition diverged.
This is what a system looks like when it is finally measured at the level the problem actually lives.
Bone density was normal. Osteoporosis runs in my family, and that answer changes the calculus on everything. T-score within range. One less variable.
I sat in the parking lot afterward and looked at the report. Not the summary page, but the full regional breakdown. Arms, legs, trunk, android, gynoid. Fat mass, lean mass, bone mineral content. Each section accounted for separately, then reassembled into a whole.
Composition. Not a single number. A map.
The blood panel said the chemistry is strained. The DEXA says the structure matches. The RMR says the engine is capable. Three instruments, three layers. Together they form a picture more specific than any one alone.
I have a baseline now. Not a story about how I feel. Not a favorable number I can hold up as reassurance. A dimensional, regional, structural account of what the system actually is.
It is not the body I want. It is the body I am starting from.
Ken Wake is the author of Thinking Design (forthcoming) and a Professor and Entrepreneur in Residence at Georgetown University. His work explores systems, technology, design, and meaning. Tour de Ken is his weekly log.
