Are you still relying on the scale to measure your health? Have you ever wondered what your body is made of?

Today, we’re exploring a topic that’s revolutionizing the way we approach weight loss, fitness, and long-term health: body composition. What is it? Why does it matter? And where do we even begin?

Dr. Nina Crowley, a clinical expert in bariatric care and weight management, discusses what body composition reveals, beyond just the pounds on a scale. She explains how bioimpedance technology works, why BMI isn't the whole story, and how understanding your muscle mass and fat mass can completely change your approach to health.

Whether you’re newly post-op, years into your journey, or just getting curious about what’s under the surface, this conversation is for you.

IN THIS EPISODE:

• (01:01) Dr. Crowley shares her professional bariatric and weight loss background
• (03:12) Discussion of body composition, muscle mass, and fat mass and bioimpedance technology and analysis explained
• (09:15) Why it is critical to know your body composition and the limitations of using BMI as a health metric 
• (13:30) Why some providers hesitate to use body composition tools and how to overcome those barriers.
• (17:58) Dr. Crowley shares how to work toward your goals once you have the data

KEY TAKEAWAYS:

• Dr. Nina Crowley emphasizes that traditional weight measurements, such as stepping on a scale, only tell part of the story. Body composition analysis reveals what the body is made of—primarily fat mass versus fat-free mass (including muscle, bone, and water). This deeper understanding enables patients to make more informed decisions about their health and wellness, particularly during the aging process or following bariatric surgery.
• Crowley explains how bioimpedance analysis offers quick, reliable, and clinically validated results on fat and muscle mass by sending a low electrical current through the body. It provides a point-of-care tool for clinicians and patients to receive meaningful data in under a minute, enabling more effective, real-time conversations about health goals.
• Understanding internal health drives better lifestyle choices. This data empowers individuals to focus more on nutrition, movement, and aging-related health concerns, rather than obsessing over a single number on the scale.

RESOURCES:

• BariNation Website 
• Join the BariNation Membership community meetups to support you on your journey with obesity treatment. https://barination.com/pages/join-our-community
• Want to see bonus content? Head over to https://www.patreon.com/BariNationPodcast to get more and support the podcast for as low as $5 per month!    

OTHER RESOURCES: 

BariNation - Email

GUEST RESOURCES:

Dr. Nina Crowley LinkedIn

seca website

Beyond BMI: Understanding Body Composition & Obesity YouTube Video

https://secambca.com/ask-your-provider-to-offer-body-composition-analysis/

https://www.obesityaction.org/resources/all-about-body-composition/

BIOGRAPHY: 

Nina Crowley, PhD, RD, is a nationally recognized expert in obesity care and a longtime advocate for patient-centered communication and access to treatment. She began her career as a bariatric dietitian and led the Metabolic and Bariatric Surgery Program at the Medical University of South Carolina. Nina now serves as Director of Clinical Education and Partnerships at seca. She sits on the Board of Directors for the Obesity Action Coalition, advancing education, advocacy, and the use of body composition to support individualized care beyond the scale.

ABOUT:

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April Williams: You've just tuned into a podcast that welcomes you into a community, a resource center, and a safe place that powers your [00:00:15] journey towards personal wellness.

Natalie Tierney: Our goal is you leave us today feeling hopeful, inspired, and ready to live your best bariatric life.

Hi Nina. Hi. Thanks for having me. Thank you for joining me. Before we jump into the conversation, will you take a moment and introduce yourselves to our friends, listeners, and watchers who don't know you yet?

Um, I worked at the Medical University of South Carolina here in [00:01:15] Charleston, South Carolina, where I still live. For, um, 17 years, 10 as a dietician, six as a coordinator, and one because that's just, I aged as that. It was a stressful role at the end there. That makes sense. 16 years [00:01:30] as there. 16 years. And um, and now I work for a company called Zika, which makes body composition equipment.

I've really stayed connected to my patients in that way, and so I'm happy to be here talking to your audience.

The, the industrial side of, uh, of, of the bariatric world, and you bring all of those [00:02:30] together and you help us understand some really complex issues in ways that just make sense for us. So thank you for that.

Nina Crowley: Thank you. Yeah. I did not think I was gonna be able to use all that psychology and behavioral stuff in this role.

April Williams: Yep, absolutely. Well, let's just jump right in, right into this conversation. So we hear body com, body composition absolutely everywhere now. So let's kind of start, start with the basics. What is body com or body [00:03:15] composition?

Nina Crowley: Sure. So yeah, first of all, I'm super excited to hear you say that you and patients and people who you know are living with obesity have been hearing a lot about body composition because yes.

Obesity and all of that. We learned a little [00:03:45] bit about a lot of different methods to assess someone's body composition, which is the makeup of what's inside. So in essence, we're really looking at kind of breaking that into typically fat mass and everything else. Which we call fat free mass. [00:04:00] And then we sort of take that fat free mass and, and kind of come down from what, what that's made up of.

And then from that, everything else we wanna sort of look at maybe the tissue level of [00:04:30] what is adipose tissue and what is, um, you know, in particular visceral adipose tissue, the stuff around your organs in midsection. 'cause that's the, the part that's most unhealthy. So kind of measuring and understanding that.

But even further from that is the skeletal muscle. And so from that, you would look at imaging like an MRI. To be able to tell you what of your body tissue is made up of skeletal muscle. And that's [00:05:15] really the stuff that we're working on, wanting to preserve, wanting to grow, wanting to keep active 'cause it has impact on our metabolism and how we burn calories.

There's a lot of different ways that. Tried over the years to do that old school ways, like underwater weighing, um, research things that like take all day. Right? So the best way to estimate your fat [00:06:00] mass is by looking at, um, something called the four compartment model. And that's looking at, you know, four different ways to test.

And we see [00:06:30] how close those numbers line up and we're looking at, you know, 97, 90 8% agreement. And we feel very comfortable that that's good enough and like we were. Talking about earlier, it's, it's nice for that to be something you step on in your doctor's [00:06:45] office or in a clinical situation. You get there, you get the numbers in less than a minute, you can talk to your clinician about it that day and be able to make some changes right on the spot.

And so it takes all of that data and there's some, you know, high level predictive formulas that they use, um, to figure out, you know, at. At that speed of that impedance or the slowing down when you're going through fat tissue [00:07:30] and the speeding up when you're going through tissue that has more water like muscle, those come into, um, formulas and then they, you know, give you an output, which would show you, this is how much fat mass you have, this is how much muscle mass you have.

Mm-hmm. Being able to give someone those results right away. There's a lot of. Work that kind of goes into, if you send someone out to get a test and how are you gonna talk about it? Do you come back to the clinic? You know, my, my [00:08:15] goal was always how do we do, um, the most amount of, you know, work right there, right then when it matters, and then, um, be able to send you off with some practical things to do in

April Williams: between.

But now that I'm aging and I'm experiencing different medical diagnoses. Having the understanding of what's actually happening in my body to the things that I can't see has [00:09:00] allowed me to make very different decisions about what I do with my body and how I treat my body, the things that I put into my body, because that is actually the most important data, not necessarily the right my weight.

Nina Crowley: Well, and even, you know, we, we talk a lot about how it's not appropriate to just do weight and VMI anymore, and it's not appropriate to give them the counseling of, you just need to [00:09:45] eat less and move more. Right. But we also know. You know, a lot of times people would say, well, we just need to strength train.

April Williams: Yes. In that

Nina Crowley: way, like, oh wow, you know, maybe my muscle mass is lower than I would've thought and maybe my, mm-hmm.

And then, you know, connecting that to what are the reasons for, for making those changes. And I like it too, as an experiment, right? Like I would always, as a, as a dietician, talk to patients about, you know, [00:10:45] there's lots of advice out there of what to do and eat. There's plenty of people willing to give you that advice.

And then of course you do still have to get on that scale. So it was mm-hmm. Disjointed and now I feel like we can make those sort of experimental [00:11:15] recommendations. You go off and you work on it and, you know, maybe a month or two later you are able to see, um, some small shifts in the composition. Um, you know, lower fat, higher muscle, if that's, you know, where we're, where we're going.

April Williams: It is so powerful to look at your data. I'm the type of person that, [00:11:45] right, I, I, my, my voice in my head will talk me out of doing anything because it will always tell me, yeah, but that was somebody else, but that's general information and you don't really know if that's gonna work for you.

Yeah.

For years. Yes. Yes. But then all you [00:12:45] would do would be come in and get on the scale, disconnect between what we're saying and what we're doing. And so I think the, you know, kind of. Coming about with medications now, where there's more people who are in this [00:13:00] space. It's not just the, you know, I think people had a tendency to other, the surgical realm.

Well. [00:13:30]

If, if we want to understand what our body is doing, looking like and is composed of on the inside, where do we begin?

There's many ways to do this. You know, there's, every clinic is gonna be a little different. Some providers may have body comp in their office, some may not. There may be referrals available to, you know, centers that have other [00:14:15] types of imaging. So we've, with just. Like my goal is that we start talking about it and offering it at some level.

That's one that we don't have time to talk through today. That's something some people are doing. But I think more than that, we're seeing more of the bio impedance in a clinic. So if your doctor has that, your, not just your doctor, but your, your care team has, um, a bio impedance scale in [00:15:00] the office.

Bio impedance [00:15:30] or body comp testing in the office, what would I want it to say? So I've crafted a letter that I can give you, um, access to on our website. Um, yes, for your show notes so that we can offer that. I would say download that, fill in your story as much as possible, but, but show your [00:15:45] doctor or your care team that you know them.

But we know that that's just probably the start of a conversation. Um, that's one thing to do. There are some. Other, you [00:16:15] know, kind of centers that have, you know, a DEXA scan is something that can measure both your bone density and they have some that have software to look at your body composition. Mm-hmm.

That'd be a way to look at, um, some data there. And [00:16:45] then, um, we also do have some in gym settings or fitness center settings. So, you know, we have, um, crunch or YMCA that may have our device there. So some of those are a little bit more open to, you know, hey, I wanna come in and do this. Um, some other [00:17:00] gyms have some of our, you know, maybe competitors and so that would be something to look around like in your area.

Is there a place that that offers body composition analysis in any kind of way, shape, or form? I.

But we'll also kind of provide you with a little bit of a cheat sheet that you can download that [00:17:30] will, uh, kind of summarize. What you can ask, who you can call, kind of where you start this process. 'cause we know it can be a little bit overwhelming sometimes, so we'll make sure that we provide that in our show notes, uh, as well.

Yeah.

April Williams: Yep. Oh, phenomenal. Phenomenal. There's already 8,000 questions that I wanna ask [00:18:30] you, but we are out of time. Nina and I are gonna keep the conversation going though for a bonus episode of the, of this conversation. So if you are a member of BariNation, you're gonna find it there in the community. But Nina, thank you so much for joining us today.

Nina Crowley: Thank you so much for having me.

Natalie Tierney: Join us@barination.mn.co.

Jason Smith: And just remember at the end of the day, you've got this. We've got you. And we'll see you next time. Bye [00:19:30] everybody.