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Body Fat Index Testing
Good for the patient - good to increase your reimbursement.
Sixty five percent of all Americans are fat, overweight and obese. Thirty five percent of all eight-grade students have high cholesterol. We all take in too many calories. America is considered the land of milk and honey and you can bet your bottom dollar that the average American citizen gets their share of the milk and honey.
You should try an experiment. Go to a function where the patrons have to go through a gate to get into the stadium, a theatre production or those waiting for an airplane to arrive. Count the number of obese individuals. You will be amazed at how many there are.
Discreetly, ask a few obese individuals what they had for breakfast. You will be amazed that almost none of them have breakfast. Ask how many do not drink diet pop. You will find none of them. Ask how many drink juice that is unsweetened. You’d be amazed that they don’t even think about the calories in regular pop and regular juice! Ask how many actually have a scale that they use every day to record their weight – the answer is none.
From the standpoint of the medical consequences, you know as well as I do, that obesity leads to artherosclerotic vascular disease, diabetes mellitus, coronary artery disease, renal failure and a whole host of diseases that cause early death. If you are going to talk with the patient about obesity you have to have a scientific study that will show what their fat body index is. To measure the fax body index, there are a number of inexpensive machines on the market.
My office uses omron body fat analyzer HBF.301. The test is simple to use. The patient stands with wet hands to ensure good contact with the measuring meter, and presto. It will produce a printout of their weight (from weighing them just before they undergo testing) and the percentage of their weight that is no more than fat. Once you have this information you can show it to the patient. If the index is not normal and shows that they are obese, you have the information to tell them the following:
Here is your weight. Here is the amount of pure fat that is eventually going to kill you. I then tell them this: “You can expect, down the line that you are exposing yourself to heart attack, stroke and kidney failure, plus diabetes if you do not change your ways and get down to a normal weight. I essentially frighten them with their obesity! The bottom line is this, “You have kids and you want to be around to enjoy them – but you won’t unless you follow the diet plan I give you and, I will want to monitor your progress monthly to make sure you are doing the job.”
In the meantime, we will do a special test for hemoglobin AIC, T3, free T3, T4, free T4, TSH & EKG here in the office. When you do the CBC with differential, 80% of these “obese ones” have a low hemoglobin – why? Too many carbohydrates, not enough protein!!!
Here is the plan for the patient:
If they have not lost weight the light should go on saying, “I am not doing my job”. I give them a 1000-calorie diet, with a calorie counter. (I know that they are going to cheat on a 1000-calorie diet, but this is a good start).
What is the value of all of this? If you get their weight down, and teach them how to properly eat, you have done a ton of good to prolong their lives. The plan generates the need for testing in your office. CBC with DIFF, HGB AIR, EKG, ultrasound for leg circulation, etc. You have helped the patient and you have increased your reimbursement with body fat index studies.
