New DXA Scan Shows Gain in Fat


Just came from my second DXA scan and I have gained Fat! I’ve been in nutritional ketosis since May, I fast (usually 16/8 with BPC in morning to get me thru), I don’t “cheat” and I keep my carbs below 20 net grams daily. What am I doing wrong?

Total Body Fat - 39.7%
Total Mass - 168.1
Fat Tissue - 66.7
Lean Tissue - 96
BMC - 5.3

Total Body Fat - 41.9%
Total Mass - 168.2
Fat Tissue - 70.4
Lean Tissue - 92.2
BMC - 5.6

I haven’t been hardcore tracking my meals but I know what I’ve eaten over the last few days and it’s typical.

BPC in morning with butter and MCT

Lunch is usually steak, a burger or some salmon. If I have a burger it might be 5 Guys little bacon cheeseburger and mushrooms on lettuce, if I build my own from somewhere it would normally be 1/3 lb
beef with avocado and bacon and cheese maybe grilled mushrooms on lettuce. If it’s steak or salmon it would be accompanied with a side salad usually Caesar with no croutons.

I usually eat between 2-4.

I don’t get home until late (I’m in production and it’s long hours) if I’m home around 7:30 it’s early!

When I get home I might have a chicken thigh with skin and pork rind “breading” in the air fryer or rib eye or liver.

I always use oil based dressing on my salad - although I may be picking up some extra carbs there if I’m eating out which happens a lot.

I think my problem might be I do have strawberries or raspberries for dessert with heavy cream. Not every night but several nights per week. I need something to chill out with when I’m vegging in front of the TV.

Help - I’m thinking I need a keto coach or nutritionist.

(Michael - When reality fails to meet expectations, the problem is not reality.) #2

Maybe you’re just eating more fat than you need to.

(Barbara Schibly) #3

I would try switching to plain black coffee in the am instead of BPC. And also, get rid of the dairy.

(Justin Jordan) #4

Dexa Scans aren’t (remotely) perfect. Have your measurements changed? If you legitimately gained several pounds of fat and (ESPECIALLY) lost several pounds of lean mass, you’d see it and feel it.

All bodyfat measurements are at best rough guides.

(Bacon by any other name would taste just as great.) #5

The first thing to check is the amount of carbohydrate you are eating. It’s dietary carbohydrate that gets stored as fat; dietary fat usually gets metabolised for energy. I know, it’s contrary to everything they’ve told you, but the difference is that carbohydrate activates insulin secretion, and insulin is the fat-storage hormone. Fat in your food has almost no effect on insulin whatsoever, so it is a safe source of calories, as long as we don’t eat too much carbohydrate along with it.

So check your food for what we call “hidden” carbs. If you live in the U.S., you will have to check the ingredients list of every food, as well as the nutrition label, because U.S. companies are allowed to choose serving sizes that allow them to pretend their products contain no sugar.

Also, depending on how insulin-resistant you are, even as little of 20 grams of carbohydrate a day might be too much. You might have to lower your carb intake even further. And be sure to count total carbs, rather than subtracting out the fibre. I suspect that if you try these things, you will find the source of your problem.


Thanks. I’ll start tracking again.

I did just have blood work done - what markers should I look for that would show if I’m still insulin resistant?

(Michael - When reality fails to meet expectations, the problem is not reality.) #7

I want to amend my previous comment. I assumed you are consuming sub-20 grams of carbs per day. But as @PaulL mentions, if you haven’t been tracking carbs that would be the prime suspect.

(Barbara Schibly) #8

A fasting insulin. Should be very low. I like it to be 3 or less. (“Within range” is meaningless since the range reflects the average value in the US population - which is a very insulin resistant population)

(Windmill Tilter) #9

Don’t worry about it! Dexa scans really aren’t that accurate. Read the article that @Justin_Jordan posted a few posts up. You could shift the results by that much simply by eating less salt than usual and having an appt at a different time of day. Unless something dreadful happened, there is no way you lost 4lbs of lean mass in 5 months and miraculously gained the exact same 4lbs of fat!

Your body composition likely hasn’t changed whatsoever.


DXA scans are reknown for inaccuracy. I’d be way more concerned with your actual measurements, have you been taking them? You should be finding measurement differences in some section of the body or another every month.

Since you’re fat-adapted, you may well be eating too much fat (it’s easy to do, considering how we had to teach ourselves to allow for fatty foods, etc). I reigned in my exogenous fat intake after a year on keto, and it helped boost my recomposition.

BPC is fabulous and works great for me - and it looks like you have it standalone without a breakfast feast, so that should be fine.

Sometimes there can be an issue with not eating enough, but looks like you’re eating well enough.

The only other thing I can think of is the rather intriguing science that trainer Thomas DeLauer has mentioned in a few of his video talks on belly fat (50+ people) and it is that for a temporary time there is an increase in type of highly conducive, healthy brown/visceral fat as a part of powering the burning of adipose white fat. This occurs after having already dealt with much or all of any dangerous unhealthy visceral fat.

A good resource for female keto and fat-burning is Anna Cabeca MD’s book The Hormone Fix - and there’s a great, deep, recent interview of her posted over in the midlife females thread. Your berries are wonderful for you and highly recommended by many keto experts - and they are alkalinizing. Acidic states (not enough alkalinizing veg/fruit) can wreak havoc on many female hormonal profiles.


If I’m reading my lab results correctly my current insulin was 7.6 vs 9.9 in February. Im sure my hormones are also keeping me from losing - I’m on the Wiley protocol and naturethroid - I see a naturopath here in Los Angeles but I’m not sure how versed she is in the ketogenic diet.

I did have a few good changes on my recent blood work so she was happy with the progress. A1C down to 5.2 and CRP at .5 down from 2.8.
There were some Things that she wasn’t sure about like a decrease in growth hormone to 87 from 186, she was going to try and research if it’s ok.

(Troy) #12

Agree with others
Go with your measurements

@KetoMom2ASkater just out of curiosity, what was your VAT/Viceral Fat differences from those two scans?
Probably listed in lbs. I believe


@Tmdlkwd it’s a .14 variance. It went from 2.61 to 2.75

(David Mathis) #14

I’ve been looking into buying this due to being in keto for almost 5 months and seeing slow results. I think my issue is muscle gain and water weight fluctuations, but this scale sure would help. It’s accurate to 1mm.

I’ve been using other methods in the meantime such as paying attention to the notches on my leather belt. I can see that I’ve reduced my waist size by three notches. If you have not lost any muscle around the waist then measuring waist might help gauge progress.

(Consensus is Politics) #15

Lots of good advice I see here. I would add look out for hidden “carbs”. Quotes on that because they are not really carbs. Im speaking of additives like Maltodextrine/Maltodextrose. They are never listed as carbs ir sugars but should be!

Maltodextrine has a glycemic index of 100+. White table sugar is 55. Its often used in powdered flavorings, like the kind put on BBQ Pork rinds. Its also the MAIN INGRIDIENT in “safe for diabetics -sugar free” Metamucil. When I was dx with T2DM I started using it to get the fiber my diet was missing. My blood sugar was skyrocketing a few times a day. I finally discovered that as the cause. Also after much research discovered there is no need for fiber in a diet, and may actual cause problems.

When I started Keto I went cold turkey on carbs. I still do not measure carbs. I just aim for ZERO carbs a day. Eat only one meal a day. This helped me to lose 60 pounds in four months, the first 40 pounds in the first 14 days. I went from 250 to 190 and have been holding there very steady no matter what I do. But thats fine with me, seeing as so many other health problems went away. And after 7 months my Endocrinologist said she doesnt want to see me anymore having my A1C go from 11.8% to 5.8% in 4 months to 5.5% three months after that :cowboy_hat_face:

(Barbara Schibly) #16

Are you eating a carnivore diet then?


@bschibly no I’m not carnivore but there are certainly day’s that I eat closely to that way.
I have definitely dropped my vegetable consumption in the last few months but do usually eat some lettuce everyday.

Why do you ask?

(Barbara Schibly) #18

I asked because you said you shoot for zero carbs. So I was wondering if you ate anything other than meat. (even that doesn’t really have zero carbs but it’s about as close as you can get)


@bschibly. Ah gotcha. That was actually a response from @Robert_Johnson that mentioned zero carbs
I do below 20 Net.

I started a new migraine medication about 6 months ago - Emgality- I think I need to look into the side effects of that as well. I also take a lot of Migraine Excedrin and a little bit of Treximet- maybe these are adding to my issues.


@David_Mathis Scale looks pretty cool but it’s not clear when they are releasing it or how much it’s going to cost. Do you know?

I have some leggings that also work with an app and take/track your measurements AND tell you what kind of jeans you should buy to fit you the best :grinning:. The only issue is that you have to be sure you put them on exactly the same each time so the sensors are in the same place. Seem fairly accurate in terms of sizing. Like A Glove - Measuring Shorts and Leggings