Gain life, not just lose weight

A DXA scan measures the fat, lean mass and bone in each region of the body and estimates visceral fat. It is the reference for knowing whether what you lose is fat or muscle.

You lie down, dressed and without metal objects, for about ten minutes. The radiation dose is very low, lower than a chest X-ray. In LVNG Signature it is done before the first consultation and at six months; in the other programmes, as an add-on.

Glucose, insulin and HbA1c with the HOMA insulin resistance index; lipid profile with apoB and lipoprotein(a); liver with the FIB-4 fibrosis index; kidney with filtration rate and microalbuminuria; thyroid function, full blood count and uric acid.

In many men we add FSH, LH and testosterone; in more severe obesity, NT-proBNP and high-sensitivity CRP; and cortisol only if there are signs suggesting Cushing's syndrome.

A blood draw in the morning, after fasting for 8 to 12 hours. If you already have recent blood tests, we review them and only request what is missing.

It shows whether you have fatty liver and to what degree, as well as the gallbladder and other abdominal organs. It is indicated according to your blood tests and risk factors.

Six hours' fasting. You lie down, gel is applied to your abdomen and it takes about fifteen minutes. No radiation.

It explores your relationship with food, your mood and stress, and screens for binge eating disorder with a validated questionnaire. What happens in your head decides how long the change lasts.

A short questionnaire at the first visit. If it comes back abnormal, or if you choose psychology in your programme, sessions with a psychologist.

A protein target of 1.6 to 2.2 g per kilo a day while you lose weight, spread across meals, and an energy deficit you can sustain, adapted to your tastes and schedule.

We design it with you and adjust it at each review according to how your body composition changes.

Weekly menus with simple recipes and a shopping list that meet your protein target without weighing every gram.

You receive them every week and can swap dishes that don't suit you.

Progressive strength training to preserve and build muscle while you lose fat. It is the best protection against losing lean mass.

In-person or online sessions depending on your programme. If you already have a trainer, we coordinate with them.

A simple measure of muscle strength with a hand dynamometer. It is linked to overall health and is used to screen for sarcopenia according to European criteria.

Seated, you squeeze the dynamometer three times with each hand. It takes two minutes.

Blood pressure, heart rate and oxygen saturation with a standardised technique. Many improve as visceral fat falls and some require treatment to be adjusted.

At rest, seated, after five minutes. If your blood pressure is high, we'll ask you to take readings at home.

The STOP-Bang questionnaire estimates the risk of obstructive sleep apnoea, which is very common with excess weight and makes it harder to lose.

A few questions in the consultation. If the risk is high, we suggest a sleep study at home.

ApoB, lipoprotein(a) and validated scores such as SCORE2 to estimate your ten-year cardiovascular risk and decide how much it needs to come down.

It comes from your blood tests and vital signs. We go through it with you in the results consultation.

Weight, waist and hip circumference and waist-to-height ratio. Your waist says more about risk than your weight.

In light clothing, with the same tape and technique at every visit so the figures can be compared.

It estimates the fat and muscle mass of each segment of the body. It is used to follow the trend between one DXA and the next.

You step barefoot on the scale and hold the electrodes for a few seconds. Best done fasting and without having trained.

With fasting glucose and insulin we calculate insulin resistance (HOMA-IR) and detect prediabetes years before diabetes.

It is part of your fasting blood tests: no extra draw needed.

Simple tests such as rising from a chair and walking speed, which show how your muscle translates into independence.

A few minutes in the consultation, in comfortable clothes and shoes.

Sleep, daily activity, diet, alcohol and stress: what really sustains change in the long term.

A questionnaire before the first consultation to make the most of your time with your doctor.

If indicated, we assess medication: benefits, risks and contraindications, and how to combine it with nutrition and strength.

Only with a medical indication after the assessment. We message you a few days after each dose change and adjust at reviews.

LVNG Continuum: reviews further apart to consolidate what you have achieved and act early if your weight starts to rise.

It starts when you finish your programme, with an exit plan agreed from day one.