Proactive Health & Wellness with Dr Parker

Aging and the Metabolic continuum

Goal-Specific Assessments

We now offer online Metabolic Weight Loss programs and a virtual injection bar to support health goals.

The incremental weight-creep that comes with aging is real: a woman entering menopause gains an average of 20-30 pounds of body fat while muscle mass atrophies over ten years, a pathological process known as "redistribution". Although multifactorial, this process is a compensation for inappropriately low estrogen levels, a rise in androgen hormones, and the insulin resistance which ensues. Fat is translocated from subcutaneous and gluteo-femoral regions to the abdomen, leading to a phenomenon of menopausal metabolic syndrome. Without interventional endocrinology treatments combining medication, supplements, targeted nutrition and hormone therapy, reversing this progressive condition with diet and exercise alone is often elusive and frustrating.

As women progress in age, their sources of estrogen change. Where once estradiol was released from the ovaries, post-menopausal women produce the vast majority of their estrogens from body fat tissue. While this change impacts the entire female body due to the near omnipresence of estrogen receptors, weight change and body composition are some of the most evident burdens of proof that women can visualize and literally hold in their hands. Estrogen promotes functionality of brown adipose tissue (which is metabolically active fat), and its absence enables brown fat to be readily converted into white fat (white fat which is resistant to weight loss efforts). Estrogen exerts unique actions on the mitochondrial machinery of the cell and impacts cellular utilization of glucose. Both hormonal deficiencies and fluctuations can promote insulin resistance, obesity and type II diabetes. Menopause changes metabolism, hypothalamic food intake and appetite regulation, and increases insulin synthesis, all of which promote increases in body fat. To make this situation worse, women in mid-life have been prescribed weight-promoting medications and have not been informed of the long-term effects that these medications have on their waistlines.

In combination with lifestyle change, diet and supplementation, we do use and recommend glucagon-like peptide 1 (GLP-1) to catalyze body fat reduction as a foundational component of some weight loss programs. Some patients begin both hormone replacement therapy and a weight loss program after an in-depth appointment assessing both lab results and body composition analysis.

Most doctors and clinicians remain unaware of the beneficial impacts of estrogen upon metabolism, and are too often unaware of medication side effects associated with some of the most common prescription drugs used today. On lab work, these changes are quantifiable using advanced lipid portfolio assessments, MPO, LP-PLA2, fasting insulin, fasting glucose, high-sensitivity C-reactive protein and hemoglobin A1C, among other labs. These tests are uncommonly ordered by most providers, and even when they are, the effects of menopause upon these values are rarely contextualized into lab review appointments and personalized treatment plans.

Dr. Parker's version of anti-aging medicine includes hormonal decline within the context of aging and disease, and works to correct depletions and deficiencies. She also works with women who are struggling with weight concerns which have arisen after using birth control pills, as well as with younger women whose diligent efforts of diet and exercise have not fructified into visceral fat loss.

Stronger Not Smaller

Weight *gain* of muscle is promoted while undergoing weight loss to support:

Cardiometabolic Health
Enhanced Visceral Fat Loss
Improved Physical Function
Injury Prevention
Sustained Strength
Preserved Weight Loss over time

All programs offer metabolic support, nutrient injections, dietary plans + discounts on the Peptide Upgrade option for stubborn mid-section body fat.

Combining the Metabolic Weight Loss program with injectable nutrients, peptides and non-stimulant appetite controlling medication has helped many of our patients realize body composition goals that have not previously been possible for them.

Schedule An Appointment

Body composition testing

All patients are offered body composition testing with the InBody 570

Lean Muscle and whole body fat are quantified in your baseline analysis
Women need a healthy amount of body fat, and this can be distinguished from visceral fat via testing. We rely upon the InBody 570 machine, which goes beyond traditional body composition analysis and measures fat (including visceral fat), muscle and total body water. Total body water data can be divided into intracellular water and extracellular water, values important for understanding a user’s fluid distribution in medical, wellness and fitness contexts.

Non-Invasive, Pain-Free Testing
We do not rely upon dunk tanks, radiation-based scans or caliper tests. Instead, low-level, safe currents are sent through the body via hand and foot electrodes. The impedance levels which the currents encounter are measured in order to calculate body composition. InBody’s body impedance analysis technology provides accurate and consistent outputs that are highly correlated with gold standard methods.

Knowledge in less than one minute

In just 45 seconds, we can quickly measure fat mass, muscle mass, and body water levels. There is no discomfort associated with this device. Simply stand on the device and hold the hand electrodes.

What to Expect

The test will be administered by our medical assistant. You will be asked to remove shoes and socks, and you will be provided a single-use clean towelette prior to the procedure. You will be given a copy of your 570 InBody Test results at the end of your assessment, and this one-page document will give breakdowns of compositions of your body in terms of percentage of body fat, muscle mass distribution, muscle to fat ratio and body water balance. Dr. Parker will subsequently review these results in detail in your medical appointment, and you will be able to repeat the test periodically in order to closely track changes in body composition.

Body Composition Pre-Appointment Instructions:
Before you come to your appointment, please follow these guidelines to ensure accurate results.

Ensure you are well hydrated
Refrain from eating or drinking 3-4 hours prior (water is permitted)
Bring food and drink to consume after body composition test (if necessary)
Do not drink alcohol or consume caffeine 12 hours prior
Do not participate any excessive physical activity 24 hours prior
Take your medication(s) on the day of the test
Wear comfortable clothing (not tight clothes)
You'll be asked to take off your shoes and wipe off hands and feet. Feel free to also wash your hands in the washroom next to our office's front door
Note – the test is not recommended for:
- Individuals with electronic medical devices (i.e. pacemaker) or other metallic supports
- Women who are pregnant
- Women at the time of menstruation, since this can create a less accurate test

If you are ready for an appointment, give us a call so that we may assist you.

Call to schedule

Select references

Metabolic syndrome fat glucose fasting menopause hormones aging thin fast cholesterol diabetes hcg a

Metabolic Impacts of Estrogen on Body Composition in Women

Després JP. Intra‐abdominal obesity: an untreated risk factor for Type 2 diabetes and cardiovascular disease. J Endocrinol Invest. 2006;29(3 Suppl):77‐82.

Faulds M, Zhao C, Dahlman-Wright K Gustafsson J-Å. / J Endocrinol. 2012; 212 (1): 3-12.

Hee Man Kim et al. Dia. Care. 2007, 30: 701-706

Pedersen S. B et al. J. Clin. Epidemiol. Metab. 2004, 89 (4): 1869–1878

Razmara L., Sunday C. et al. J. Pharmacol. Experim. Therap. 2008, 325 (3): 782–790

Suba Z. Drug Des. Devel. Ther. 2015, 9: 2663-2675

Toth MJ, Sites CK, Eltabbakh GH, et al. / Diabetes Care. 2000; 23: 801-806.

Metabolic Impacts of GLP-1 medication on Body Composition

Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0. Epub 2021 Mar 2. PMID: 33667417.

Dungan, MD, K.,; DeSantis, MD, A. (2022). Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus. UpToDate. Retrieved November 4, 2022.

Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15. PMID: 27633186.

Rosenstock J, Allison D, Birkenfeld AL, Blicher TM, Deenadayalan S, Jacobsen JB, Serusclat P, Violante R, Watada H, Davies M; PIONEER 3 Investigators. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. JAMA. 2019 Apr 16;321(15):1466-1480. doi: 10.1001/jama.2019.2942. PMID: 30903796; PMCID: PMC6484814.

Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D; STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414-1425. doi: 10.1001/jama.2021.3224. PMID: 33755728; PMCID: PMC7988425.

Rubino DM, Greenway FL, Khalid U, O'Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT; STEP 8 Investigators. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022 Jan 11;327(2):138-150. doi: 10.1001/jama.2021.23619. PMID: 35015037; PMCID: PMC8753508.

Semaglutide injection, for subcutaneous use. US Food and Drug Administration (FDA) approved product information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/215256s000lbl.pdf#page=26 (Accessed on June 09, 2021).

Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.

Integrative & Functional Medicine