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Disclaimer: InBody devices should be used as an adjunct for clinical decision making and are not intended to diagnose or treat any diseases.

Dr. Anuruddh Kumar Misra is a board-certified physician specializing in internal medicine and sports medicine and is a medical director at Premise Health in San Francisco. He also serves as a consultant to MLB teams and has had previous experience working with the NFL.

As a medical student, Dr. Misra felt that there was too much focus on disease treatment instead of disease prevention. He wanted his practice to not only treat the sick but show them how to improve their health through lifestyle changes. That is why he decided to take on a subspecialty of Sports Medicine after his residency in Internal medicine. During his sports medicine fellowship, Dr. Misra gained expertise in exercise physiology, nutritional dietary practices, and exercise prescription.

Today at Premise Health San Francisco, he uses his well-rounded knowledge base to optimize the health of his patients. InBody has helped Dr. Misra elevate the patient visit by allowing him to give objective, instant feedback , and personalized recommendations. Patients leave his clinic feeling empowered and motivated to improve their health.    

Sparking an Honest Conversation About Health

“How do I optimize an individual’s baseline of health?”

That’s the question Dr. Misra runs through before each appointment with a patient. In his San Francisco practice, Dr. Misra wants to go beyond reactive medicine and practice preventative healthcare. With his expertise in fitness, nutrition, and internal medicine, Dr. Misra is uniquely qualified to provide his patients with a comprehensive course of action that will improve their lives. The first step in that process is to begin an honest conversation about health.  

The problem is that most patients don’t visit a doctor unless there is something wrong. Patients don’t treat their primary care provider as a source for preventive care.  

One issue in a traditional preventive health exam, which should be a great way to build a relationship with your doctor, is that a lack of immediate significant feedback exists.

During a typical exam, a doctor may order a variety of blood tests and other screenings, check your vitals, and calculate your BMI. The blood tests and screenings require repeated visits– time that many working adults and students don’t have. If you don’t a need for these tests, the only information you may get from your visit is your BMI.

For a patient who is overweight or obese, BMI is not going to reveal anything new. On the flip side, patients have both a normal weight and BMI may have hidden health risks such as excess visceral fat, increased risk of cardiovascular disease, and more due to BMI’s inability to distinguish between muscle and fat.

InBody Result Sheet displays an individual with a normal BMI of 22.5 but an elevated body fat percentage of 35%

Instead of relying on BMI to direct patient health, Dr. Misra wanted to incorporate body composition analysis to relay relevant health information and guidance his patients otherwise wouldn’t have access to: muscle mass measurements, body fat percentage, basal metabolic rate, and body water analysis. On the advice of a trusted colleague, he decided to try InBody. The overwhelming response from his patients became an “a-ha” moment and confirmed that

Dr. Misra and his staff decided to invite patients to try the InBody device as part of a wellness challenge. The response was incredibly encouraging. As the team was testing and interpreting results for the high volume of patients, it became obvious to him that he was making a difference in these patients’ health because InBody documented the actual health improvements patients were making.

After an InBody Test and consultation, a patient leaves Dr. Misra’s clinic with a detailed assessment of their health standing, specific areas to work on, and personalized recommendations on how to improve.  

In an area like downtown San Francisco, where people have come to expect cutting-edge technology and innovation, InBody is a tool that helps his clinic go the extra mile to guide and improve the health of his patients.

“It’s very fast. It’s non-invasive … and it gives you very specific data points where you can immediately give feedback to people about what they need to pay attention to. [InBody] is something I find ideal as I have a high-volume, busy practice.”

Using Body Composition Analysis to Combat Insulin Resistance

Today, Dr. Misra has patients who look forward to their InBody results. They feel comfortable admitting “Doc, I haven’t been that good over the last three or four months. I know this isn’t gonna look good. But I gotta know where I’m really at.”

Dr. Misra uses the InBody Result sheet to give very refined, targeted recommendations based on different data points. He finds that most of his patients can benefit from at least one of three interventions: modifying their baseline nutrition, improving their exercise prescription, and optimizing their metabolic profile with intermittent fasting. Each intervention requires a lot of dedication from the patient, but body composition analysis helps Dr. Misra motivate them to follow his protocol.

“Someone may not be too keen on fasting. They may not like lifting weights. They may not want to change their diet. But if I’m able to motivate them based on InBody results, and the plethora of other medical data points I have, now I’ll get them doing what they wanted to achieve and that is very powerful.”

The section of the result sheet that Dr. Misra find the most actionable is the visceral fat score, which has a direct correlation to “insulin resistance”, a precursor to prediabetes. The higher the score the higher the risk of developing insulin resistance.

A Visceral Fat Score over 10 cm² increases an individual’s risk for developing metabolic disorders.

When Dr. Misra sees a patient with an elevated score, his first course of action is to learn what their dietary practices are. What do they eat? How often do they eat?

In many patient cases, Dr. Misra likes to recommend monitored intermittent fasting because he believes that intermittent fasting is the single, most powerful therapeutic metabolic intervention a physician can do for a patient.

In between lab work, Dr.Misra will also test his patients on the InBody to track and monitor progress while they are on this program.  

“I don’t need to keep on checking labs on people if I can document progress in a different way. If I’m able to show a progressive decrease in the visceral fat score over the course of three to six months I am even able to reduce their lab draws. InBody becomes a great tool to give patient feedback and it helps the practitioner optimize their patient’s internal medicine issues”.

InBody has been a helpful tool to show patients that they aren’t necessarily stuck on a path that will end in medication. Patients can see the work they put in to improve their body composition translates to real health benefits.

“We’re taught in medical school and in post-doctoral education that diabetes is pretty much a one-way street. You’re a diabetic. It’s a life sentence and you’re gonna be on medication for life.  That just not the case.”

Through program design and careful monitoring, Dr. Misra has even been able to successfully liberate patients from their insulin medication. InBody plays a critical role in that process, acting as a patient’s GPS as they follow Dr. Misra’s roadmap for a healthier life.    

Building Trust and Improving Patient Care

Technology can help enhance patient care, but trust in a patient-doctor relationship remains one of the most important factors for an effective treatment plan. One study found that nearly two-thirds of patients with high levels of trust follow their doctor’s treatment plan.

The tools a doctor uses must be fundamentally reliable because trust itself is a non-negotiable entity. Dr. Misra trusts the InBody to monitor his own health, so he confidently recommends it to his patients. I say, “Look, I check this about once a month to keep track of my personal goals and fitness things that I have in mind, and I encourage you to do it too.”  

At the end of the day, it is up to the patient to take control and be accountable for their health. However, because of knowledge gaps, a patient may be too scared to bother the doctor with follow-up questions. Dr. Misra has found that starting a conversation around body composition – losing body fat and gaining muscle- is something that is relatable, helps build that conversation, and makes a patient a partner in being responsible for their lifestyle choices. When a patient is motivated to take responsibility and make changes, the rewards are endless.  

“It saves the patient from morbidity. It saves them money. It saves them time. It reduces their cost to their insurance plan. It reduces the cost to their employer. I mean it’s a universal win where the most important stakeholder – the patient – is the one who benefits the most.”

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