Women over 30 should know about this tool to prevent a stealthy disease

It’s time to get hip to this bone density and body composition test.

Osteoporosis may seem like an old person’s problem — the “silent” condition gradually reduces bone mass and density, making your inner scaffolding weaker, thinner and more prone to fractures.

The disease is actually becoming increasingly common among younger people due to poor eating habits, certain underlying health issues and medication use.

Dr. Pooja Gidwani, a concierge physician in L.A., is particularly worried about women taking GLP-1 drugs like Ozempic, which can cause a decrease in bone density along with rapid weight loss.

She recommends women undergo a “baseline” dual-energy X-ray absorptiometry (DEXA) scan in their early to mid-30s to help predict future health risks.

The test measures the strength and quality of bones while also quantifying body fat, lean mass and visceral fat.

“It’s a favorite in research, clinical medicine and elite athletic programs for this reason,” Gidwani told The Post.

Here’s everything you need to know about this enlightening technology.

How does a DEXA scan work?

An X-ray provides detailed images of bone shape and structure, but it cannot accurately measure bone density or forecast fracture risk.

A DEXA scan harnesses the power of X-rays to reveal a clearer picture of bone strength.

The machine directs two X-ray beams, one high-energy and one low-energy, at your bones as you lie still on a padded table.

The beams are absorbed by bone and soft tissue at different rates.

The scanner detects this difference and calculates bone mineral density and body composition with an error rate typically within 1% to 2%.

“The scan is painless, noninvasive and usually takes less than 30 minutes start to finish,” Gidwani said.

“It uses far less radiation than a standard X-ray and is designed to catch bone loss well before it becomes visible or leads to fractures.”

Gidwani noted that the exam doesn’t involve injections or contrast dyes. She advised getting scanned in the morning.

These tests are generally not recommended for pregnant women, and calcium supplement users may need to stop taking the tablets 24 hours beforehand.

What can a DEXA scan reveal?

DEXA scans are primarily used to diagnose and monitor osteoporosis and osteopenia, a milder, earlier stage of bone loss.

It can also detect nuanced conditions such as:

• Sarcopenia: low skeletal muscle mass
• Sarcopenic obesity: low muscle and high fat
• Osteosarcopenic obesity: low muscle, low bone density and high fat
• Abnormal visceral fat distribution linked to metabolic disease 
• Unexplained fractures or suspected secondary osteoporosis (due to medications, hormonal disorders, etc.)

“It’s more reliable than body fat scales and more detailed than MRI for whole-body composition,” Gidwani said of DEXA.

“Its precision makes it ideal for tracking changes over time, especially during weight loss, strength training or hormone transitions like perimenopause and menopause.”

Should I get a DEXA scan if I’m otherwise healthy?

Bone mass tends to peak around age 30. The bone remodeling process continues, but the breakdown of old bone starts to slightly outpace the formation of new bone.

Genetics and personal habits such as diet, exercise, cigarette use and alcohol consumption influence bone health. Hormonal shifts — particularly a decrease in estrogen — can accelerate bone breakdown.

“Estrogen levels can begin to fluctuate in the mid-to-late 30s,” Gidwani explained, “due to a range of factors, including early or natural perimenopausal transition, chronic stress, postpartum recovery, disrupted ovulatory cycles, low body fat, overtraining or preexisting gynecological or endocrine conditions like PCOS or hypothalamic amenorrhea.”

Women are also at risk of early bone density decline if they have a family history of early osteoporosis, a lack of strength training, insufficient calcium, protein or vitamin D intake, disordered eating, sedentary behavior or rapid weight loss.

GLP-1 drugs, which suppress appetite, can cause speedy slimdowns.

“While GLP-1s can be incredibly helpful when done right, they can also lead to unintended losses in lean muscle and bone density if not paired with proper nutrition and resistance training,” said Gidwani, who treats women on GLP-1s and focuses on hormone health and longevity.

“In women in their 30s and 40s using GLP-1s,” she added, “DEXA is especially valuable for detecting early loss of muscle or bone, often long before symptoms or complications arise.”

Gidwani said she’s seen female patients as young as 32 show low bone density on scans.

For men, Gidwani suggests that those with a family history of osteopenia/osteoporosis, a history of fractures, long-term steroid use, low muscle mass, very low testosterone or long-term GLP-1 use consider a DEXA scan earlier than the standard guideline of age 70.

Where can I get a DEXA scan?

Hospitals, diagnostic imaging centers, women’s health or endocrinology clinics and increasingly, wellness and fitness centers offer DEXA scans.

“Companies like BodySpec and DexaFit specialize in mobile or consumer-accessible DEXA scanning, often used for fitness tracking,” Gidwani said.

“Just be sure to confirm whether the scan is being done for diagnostic purposes (bone density) or wellness (body composition).”

DEXA costs vary widely, from $40 to $300 or more out of pocket, depending on the facility, the extent of the scan and the specific reason for it.

Scans are typically covered by insurance for women over the age of 65, men older than 70, postmenopausal women with risk factors, people with certain medical conditions or those taking medications that increase fracture risk.

“Hopefully, as awareness around early bone loss and changes in body composition increases (especially in the context of GLP-1 use and hormonal shifts in younger women),” Gidwani said, “screening guidelines will begin to reflect this need for earlier, proactive intervention.”

What are the treatment options for low bone density?

If a scan reveals low bone density, the first step is to identify the cause.

Gidwani said a treatment plan typically includes:

• Strength training to improve bone and muscle
• Increased protein intake — aim for at least 0.8 to 1.2 grams of protein per pound of body weight, especially if you’re on GLP-1s or losing weight.
• Calcium and vitamin D supplementation
• Hormone therapy, particularly for perimenopausal and postpartum patients
• Fall prevention and balance training
• Lifestyle changes such as reducing alcohol intake, quitting smoking and addressing nutritional deficiencies

In moderate to severe cases, medications like bisphosphonates and denosumab slow bone breakdown while teriparatide stimulates the formation of new bone.

“In your 30s or 40s, the most impactful strategy is prevention,” Gidwani said, “identifying early losses, tailoring lifestyle interventions and checking progress over time with repeat DEXA scans.”