DoctoriumGP
Body Composition Report
Jessica Gibson
26 April 2026
DoctoriumGP Body Composition Report — Scan 4 of 4
Following the 12 April consultation and adjusted protocol, Jessica’s body composition has shifted decisively in the right direction. Over the 28 days between Scan 2 (29 Mar) and Scan 4 (26 Apr), weight has dropped by −2.0 kg, body fat has fallen −2.1%, fat mass is down −2.6 kg, and — critically — muscle mass has increased by +0.6 kg. This is exactly the high-quality fat loss we were targeting: visceral and limb fat coming off while lean tissue is preserved and gained. The plateau identified in late March has broken; the suspected metabolic blocker appears to be responding to the revised approach.
At 38.1%, Jessica still carries more body fat than ~85% of UK women her age, but the trend is now moving in the right direction — down from 40.2% in late March. The desirable range remains 23–34%; current trajectory suggests she will breach the "Over Fat" threshold within 8–10 weeks if the protocol is maintained.
53.1 kg of muscle mass is exceptional — higher than ~93% of UK women aged 30–39 and up +0.6 kg in 28 days. Lean tissue has not just been preserved during fat loss — it has actively grown. This is the gold standard outcome.
Metabolic age remains at 51 (vs chronological 36) — this lags body composition by 8–12 weeks and is expected to begin shifting once the new fat-loss trajectory is sustained. It remains the next priority area to target.
At 32.8 (down from 33.5), Jessica still sits in Obese Class I, but BMI is a misleading metric here — her exceptional muscle mass inflates this figure significantly. Body fat percentage and segmental analysis give a more accurate clinical picture.
Visceral fat rating remains stable at 8 — within the healthy range (1–12) but sits mid-table for women her age. With overall fat mass now falling, this number is expected to begin trending down at the next scan. The trunk fat reduction (35.6% → 33.0%) suggests visceral fat is already starting to mobilise.
Scoring ~70 on the Tanita leg muscle scale, Jessica remains below average for her age. Despite strong overall muscle mass, lower body remains a relative weakness. Targeted lower body resistance work (squats, hip hinges, lunges) is the highest-leverage addition to lock in the metabolic momentum.
| Metric | Scan 1 1 Mar |
Scan 2 29 Mar |
Scan 3 12 Apr |
Scan 4 26 Apr |
Δ vs Baseline |
|---|---|---|---|---|---|
| Weight | 92.2 kg | 92.4 kg | 91.6 kg | 90.4 kg | −1.8 kg |
| Body Fat % | 39.70% | 40.20% | 39.80% | 38.10% | −1.6% |
| Fat Mass | 36.60 kg | 37.10 kg | 36.50 kg | 34.50 kg | −2.1 kg |
| Muscle Mass | 52.80 kg | 52.50 kg | 52.30 kg | 53.10 kg | +0.3 kg |
| FFM | 55.6 kg | 55.3 kg | 55.1 kg | 55.9 kg | +0.3 kg |
| BMI | 33.40 | 33.50 | 33.20 | 32.80 | −0.6 |
| BMR | 1,704 kcal | 1,697 kcal | 1,691 kcal | 1,705 kcal | +1 kcal |
| Visceral Fat | 8 | 8 | 8 | 8 | Unchanged |
| TBW % | 41.80% | 42.00% | 42.10% | 42.50% | +0.7% |
| Metabolic Age | 51 | 51 | 51 | 51 | Unchanged |
The plateau identified in late March has broken decisively. Across the 28 days between Scan 2 and Scan 4, Jessica has lost 2.0 kg of weight, 2.6 kg of fat mass and gained 0.6 kg of muscle. This is the high-quality body recomposition we were targeting — lean tissue is being preserved (and added) while visceral and limb fat are mobilising. The protocol adjustments agreed at the 12 April consultation are working.
The clinical priority now shifts from “investigate metabolic blocker” to “sustain and amplify what is working.” Continue current pharmacological and lifestyle protocol, layer in targeted lower-body resistance training to address the leg muscle score, and re-test at Scan 5 in late May to confirm trajectory.
Clinical Director, DoctoriumGP • 26 April 2026
The PCOS / insulin resistance picture remains the most likely underlying mechanism, but Scan 4 confirms that the combined approach — tirzepatide at 10 mg, insulin-sensitising support, addressing methylation, and lifestyle adjustments — is now producing the expected response. We do not need to escalate the GLP-1 dose at this time. Continue current protocol, await final blood and methylation results, and refine where indicated.
After the protocol pivot, the GLP-1 is now producing the expected effect: appetite regulation, fat-preferential loss, and lean mass preservation. Holding at 10 mg is appropriate — no escalation needed while the current trajectory continues.
Muscle mass increased +0.6 kg while fat dropped −2.6 kg. This is unusual on GLP-1 monotherapy — it suggests the protein, training and supplementation layer is doing meaningful work. Protect this signal: do not under-eat protein, do not skip resistance sessions.
Trunk fat % has dropped from 35.6% to 33.0% in 28 days — a meaningful shift in the most metabolically active depot. Visceral fat rating remains 8 (lags trunk %) but is expected to step down at the next scan. Continued reduction here directly improves cardiometabolic risk.
Metabolic age remains at 51 and leg muscle score remains below average — both lagging indicators. Targeted lower-body resistance work (2×/week) plus continued protein adequacy is the highest-leverage addition over the next 6–8 weeks.
Comprehensive blood work to identify underlying hormonal and metabolic issues that may be blocking weight loss.
MTHFR and methylation panel to identify whether impaired methylation pathways are a key driver behind the metabolic resistance. If Jessica has PCOS combined with poor methylation, this creates a compounding effect where the body cannot properly:
This test will show us what Jessica’s body isn’t doing properly at a cellular level — and give us a targeted supplementation and lifestyle protocol to correct it.
With Scan 4 confirming a clear positive trajectory (weight, fat mass and body fat % all falling, muscle mass rising), there is no indication to escalate the GLP-1 dose. Continue tirzepatide at 10 mg. Reassess at Scan 5 (late May). The combined approach — GLP-1 plus insulin-sensitising and methylation support — appears to be the right configuration.
Maintain protein at 1.6–2.0 g/kg to protect ongoing muscle gain. Add 2×/week lower-body resistance training to address the leg muscle score. Continue prioritising sleep and stress management — both are required for sustained insulin sensitivity and the metabolic-age improvement we are targeting next.
Clinical sign-off (26 Apr 2026): Dr Gemma Lewis MRCS MRCGP has reviewed Scan 4 alongside the prior three scans and confirmed the current protocol is producing the expected response. Tirzepatide held at 10 mg, supplementation continued, lower-body resistance work added. Next review: Scan 5 in late May 2026.
Comprehensive blood work completed and reviewed at the 12 April consultation. Findings informed the protocol adjustments now driving the current trajectory.
Blood panel reviewed with Dr Gemma Lewis. Protocol adjustments agreed (insulin-sensitising support, methylation support, refined nutrition and resistance work). Scan 3 captured.
Today: full clinical review with Dr Gemma Lewis. Scan 4 confirms the trajectory has reversed. Tirzepatide held at 10 mg; current protocol continued.
Add 2×/week lower-body resistance sessions (squats, hip hinges, lunges, step-ups) to address the leg muscle score and lock in metabolic momentum. Maintain protein at 1.6–2.0 g/kg.
Receive and review methylation panel results. Refine targeted supplementation (B-vitamins, choline, magnesium, inositol) and adjust based on MTHFR variant findings.
Repeat Tanita scan to confirm the trajectory has held over a further 4–5 weeks. Targeting weight <88 kg, body fat <36%, muscle mass ≥53.5 kg, and the first downward step in metabolic age.
| Segment | 6.25 kHz R/X | 50 kHz R/X | Phase Angle |
|---|---|---|---|
| Hand-to-Leg (H-L) | 772.2 / -45.4 | 662.6 / -77.9 | 6.74 |
| Right Leg (RL) | 321.7 / -21.7 | 275.2 / -31.7 | 6.60 |
| Left Leg (LL) | 351.8 / -22.6 | 303.6 / -35.5 | 5.57 |
| Right Hand (RH) | 422.9 / -27.5 | 367.2 / -41.9 | 6.54 |
| Left Hand (LH) | 405.9 / -28.1 | 349.0 / -40.6 | 6.67 |
| Leg-to-Leg (L-L) | 680.4 / -42.3 | 579.0 / -69.4 | 6.87 |