Concerns About Body Composition: A Case of High Body Fat and Normal BMI
Greetings, I am a 23-year-old female leading a moderately active lifestyle. Roughly a year ago, I committed to a regular workout routine; my focus is primarily on weightlifting to enhance muscle mass, especially since a DXA scan revealed I have a lower muscle percentage relative to my height. Despite appearing slender with a defined hourglass figure, I carry more weight in my lower body—a body shape that has developed since puberty. Since July 2025, I have consistently lifted weights, attending the gym three to five times weekly. Although there have been some gains in strength, they have been modest. Initially, my DXA scan in July recorded my body fat percentage at 37, but a subsequent scan in December reflected an increase to 38.8, which has raised concerns as it also indicated a decrease in muscle mass. I’ve focused exclusively on weight training without incorporating cardio, yet I’ve noticed improvements in my lifting capabilities. This inconsistency is puzzling to me. I maintain a high-protein diet, aiming for around one gram of protein per pound of body weight, and I consume a standard number of calories daily. My weight has remained relatively stable, increasing only by about six pounds this year, as I hoped that a slight caloric surplus would aid in muscle development. My waist measures approximately 27 inches, while my lower body is about 39 inches, highlighting the noticeable differences in proportions between my upper and lower halves. I’m dissatisfied with the appearance of my buttocks, which seem overly plump and lack the firmness of muscle. I am contemplating whether I might have a muscle-related issue or if lipedema is at play, contributing to this strange juxtaposition between my fitness efforts and the challenges I face in building muscle. Although I have been referred to a kinesiologist, there is a significant wait, with an appointment anticipated in about a year. My query is whether lipedema could be responsible for the elevated body fat despite a seemingly normal BMI, or if there is an alternative explanation for this situation?
Answers (1)
2/5/2026, 8:30:51 PM
OpenHealth AI
Thank you for sharing your detailed concerns about your body composition and fitness journey. It's clear you're dedicated to improving your health and muscle mass. Let's break down your concerns surrounding body fat, muscle development, and the potential influence of lipedema.
Main Points
- Body Fat and Muscle Composition: Your increasing body fat percentage alongside a slight increase in weight can be concerning, especially given your weightlifting routine.
- Potential Influence of Lipedema: It’s important to consider lipedema; however, there are other explanations as well for your body composition.
- Actionable Next Steps: Focus on a balanced approach that includes both weight training and cardiovascular activity while monitoring your dietary intake.
Explanation
You mentioned that your body fat percentage has increased despite your commitment to a weightlifting regimen. This can happen for several reasons, including:
- Muscle vs. Fat Gain: It’s possible to gain fat while gaining some muscle, which may not always show significant physical changes despite strength improvements. Monitor your overall body composition – not just weight or appearance.
- Insulin Sensitivity and Hormones: Your body may respond differently to caloric surplus depending on insulin sensitivity and hormones, which can influence fat storage and muscle gain.
- Lipedema Considerations: Lipedema is characterized by an abnormal accumulation of fat, often in the legs and buttocks, which you noted. This condition can lead to a disparity between your body shape and overall health metrics like BMI.
Actionable Next Steps
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Incorporate Cardiovascular Activity: Integrate cardio into your routine (e.g., brisk walking, cycling, or swimming) at least 2-3 times per week. This can aid in improving overall fat loss and assist muscle definition.
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Re-evaluate Dietary Intake: Since you focus on a high-protein diet, ensure you're balancing this with healthy fats and carbohydrates. Consider tracking your macronutrient intake and overall caloric consumption to find the right balance for muscle gain versus fat management.
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Strength Training Adjustments: While you are lifting weights, consider mixing in different rep ranges (higher reps for endurance), increasing overall volume, or changing your workout routine to stimulate different muscle fibers.
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Educate on Lipedema: Research and educate yourself about lipedema and consult with a healthcare professional (if possible) to determine if this may be affecting your body composition.
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Symptom Journal: Keep a journal to track your body measurements, dietary intake, energy levels, and moods. This could help highlight patterns related to your workouts and dietary choices.
If you continue to struggle with changes in body composition or experience symptoms associated with lipedema, maintain communication with your healthcare provider or kinesiologist when you are able to meet with them.
Remember, every journey is unique, and it’s essential to tailor your approach to your body’s responses. Keep focusing on your strength improvements, and you will likely find your approach to body composition becomes clearer over time.
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