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Question: what kind of doctor should I see to assess whether or not my body fat can be reduced through further diet and exercise?

Background: I've been an avid CrossFitter for over 2 years. I work out about 5 times a week. I eat healthy (mostly paleo plus dairy with occasional cheat meals). In February I started measuring and tracking my food intake via the Zone Diet simply so I can make sure to eat enough food and get enough fat/protein/carbs.

I was fat from elementary school through college due to bad diet and lack of exercise. Now I'm "skinny fat" and no matter how I adjust my diet or activity level, my level of "flab" does not change. I got down to 165 lbs at 6'1" and still had flab despite a somewhat gaunt appearance.

My primary doctor examined me and said I would never be able to lose it naturally – I'm stuck with it. While I believe she's right, I'd like to get a 2nd opinion from someone with expertise in body composition. Any direction?

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How much weight did you lose? Is the "flab" extra skin or is it actually body fat? Why not get some skin fold calipers on Amazon for $8 and measure your body fat yourself? If it's really an issue, you'd probably want to speak with an endocrinologist about hormone levels. – Daniel Nov 13 '14 at 14:37
@Daniel - It's nearly impossible to get an accurate skin fold measurement on yourself. About the only sites you could even come close to measuring accurately are the abdominal and front of thigh. All the others you either can't reach with both hands or you tense the muscle underneath (Such as outer pectoral site) which throws the reading. – JohnP Nov 13 '14 at 15:19
@JohnP You're right -- it would be difficult to hit all the spots by yourself. My girlfriend and I measured each other weekly for a few months. So, if you want a more accurate measurement, get some help. You could still keep measurements on the areas you can reach, at least to gauge for movement. – Daniel Nov 13 '14 at 15:24

I've just had this done as a part of a range of tests through a program run at my job. Essentially the company involved does what they call a "Health Screen". You'll find many by doing a search for that term. As you can see from this link here showing packages, body fat % is a standard even on the basic one which is pretty cheap. As well as the consultation, I got an email with the results and recommendations.

The test is pretty much standing on a machine that passes a current through you to determine body fat composition (fat around the organs is also checked).

I am not a doctor, and your question doesn't ask for the advice regarding it, but for me I have found great success with weight training. The muscle I put on has helped my body shape and seems to keep my weight down, and the flab too.

Hope that helps.

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You must keep in mind that bodyfat is essential to the human body. It's not necessarily a bad thing, and there is certainly a minimum requirement for good health. For example, it's absolutely necessary for nervous system function (myelin sheaths act as insulators for nerves, and are made up of fat).

Of course, in regards to your training and diet, there are a number of factors in play. It's possible with the training volume you're looking at, that you're actually not eating enough. If you haven't created a surplus of calories, your body is going to try to conserve energy vs building muscular adaptations. How has your performance improved after 2 years of crossfit? Have you hit a plateau? If you haven't gotten stronger, this may be an indicator that your training needs to change.

To answer your question, I don't think you're going to get solid answers from a medical doctor. Their job is to get you healthy, not improve your performance. You'd be much better served by a performance facility that employs strength coaches who have CSCS certification or similar, or a dietitian (not a nutritionist!). You can get truly accurate body comp from a DEXA scan (a test done for bone density) bod pod (air displacement) or someone who knows how to use medical-grade skin fold calipers (not the 20 dollar ones). Stay away from bio-electrical impedance (the one where it sends an electrical current through your hands).

Finally, focus on your performance. Train the movement, not the muscle. If you focus on that, the muscles and improved aesthetics will come.

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Get a DEXA reading. They cost a lot, but they are the gold standard. There are gyms, rehab clinics, colleges and universities that can provide them.

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