I’ll give you a brief reprieve from my GLP-1 fixation this week. Instead, I’ll pivot to another reliable topic of interest: me.
This edition of Peptide Purgatory features a personal health update after an action-packed senior week. I’ll cover the results of two scans I had earlier this week, give an update on my recovery from hernia repair surgery, and describe how I’m ramping my exercise program back up after eight weeks of enforced sloth. To set up a baseline for muscle mass and body composition, I’ve also scheduled a DEXA scan for early February. I’ll explain what that scan does, why it matters, and what I expect to learn from it. Finally, Bullshit Corner makes an appearance, inspired by the aggressively aspirational marketing machine attached to the very same company performing that scan.
A Paradox, or a Pair of Docs?
If you’ve followed my Mounjaro Updates—which somehow metastasized into Peptide Purgatory—you may recall a former physician whose pseudonym I no longer invoke, though his legacy of medical gaslighting and professional indifference lives on. This was the concierge doctor who once told me, without irony, “I can’t keep track of all your chronic conditions!”
Well. That was rather the point of the concierge fee, wasn’t it? So I canned his ass and moved on.
To be fair, he was right about one thing: I do, in fact, have a shitload of chronic conditions. Most are under control at the moment. At age seventy-nine, I’m in reasonably good health and far better shape than many men my age, but I’ve crossed into what Medicare politely calls the “elderly” category—bonus time, if you like. So yes, from time to time I bore you with updates on my expanding catalog of bodily quirks. It’s hereditary. My paternal grandmother was a career hypochondriac who suffered from every ailment known to medicine and then died inconveniently young at ninety-seven.
IPMNs: A “Vogue Diagnosis”
That same overwhelmed physician once ridiculed my gastroenterologist’s diagnosis of IPMNs in my pancreas as “the latest vogue diagnosis.” IPMN is an acronym I won’t expand here, but the short version is this: precancerous growths in the pancreatic ducts. You do not want things growing in your pancreas. If they turn malignant, you are, medically speaking, cooked.
These were first identified in 2023. A fine-needle aspiration at the time found them benign, but IPMNs are the sort of lesions that earn you a lifetime subscription to follow-up imaging, because some of them change character over time. Fortunately, my current physician—Dr. Macallan—takes the diagnosis seriously. He ordered an MRI to reassess the situation.
After spending most of Tuesday doing my best pins-and-needles impression, I finally received the imaging results. Here’s the spoiler: the IPMNs have not grown, there is no significant dilation of the main pancreatic duct, and there is no notable inflammation of the stomach or colon. Even better, there is no thickening of the stomach wall or fatty infiltration of the liver, suggesting that my chronic erosive gastritis has improved and my low-carb approach has worked well. Kidney cysts and my benign adrenal tumor were unchanged.
The hernia repair itself lies outside the MRI’s field of view, so the mesh couldn’t be directly assessed, but there were no signs of seromas or abnormal fluid accumulation.
In short, I can stand down from general quarters—for now—on the abdominal front.
Low-Dose Chest CT
Citing established guidelines, Dr. Macallan also ordered a low-dose chest CT because I once smoked. Never mind that I quit the same year Taylor Swift was born; the Former Smoker ID Card is apparently non-refundable. There was also an old pulmonary nodule on file that merited continued surveillance.
The results provided reason for continued watchful waiting. Despite excellent VO2 max and spirometry results in late 2025, the scan showed early emphysematous changes (thank you, Marlboros) and a few new small nodules. The original nodule had grown only slightly. Given my history—three confirmed bouts of pneumonia, one requiring hospitalization back in 2002—these nodules are more likely infection remnants than anything more sinister.
Dr. Macallan wants a follow-up scan in one year. That seems reasonable. I’m not treating this as a ticking time bomb until it behaves like one.
Post-Hernia Surgery: The Ramp-Up
At our pre-surgery consult, Dr. O—my hernia surgeon—sentenced me to eight grim weeks of post-surgical muscle neglect, with a strict lifting limit of ten pounds. At the two-week follow-up, he showed mercy and raised the ceiling to twenty pounds, while hinting that I could return to real weight training sometime near the end of January. Until then, I was confined to my deeply resented five- and ten-pound neoprene dumbbells.
The end of January, mercifully, arrived.
And I’m back! Back to deadlifting—light, at around 135 pounds—and bench pressing again, equally conservative at about 100. I’ll ramp gradually toward my pre-surgery numbers, back when I thoughtfully gave myself the hernia in the first place. It felt spectacular to be back under a barbell after two months away. I plan to continue slowly, prudently, and with no wish whatsoever to test the tensile strength of surgical mesh. That means no belts, no Valsalva breathing, and no working to exhaustion.
My strategy is to increase loads during weeks eight through twelve, working five or six days per week as my body allows. I’ll alternate days between my home gym and the YMCA gym. At home I’ll do deadlifts, bench presses, dumbbell work, and kettlebell goblet squats. At the Y, I’ll do cardio and weight machines like lat pull-downs, rows, and overhead presses. I’ll keep it simple, eschewing accessory exercises. And I’ll avoid stressing the core, giving the hernia repair an extra four weeks to heal.
To set a baseline for this rebuild, I’ve scheduled a DEXA scan for February 11 with a company called DexaFit. They would very much like to sell me far more than a DEXA scan, which I’ll tackle in Bullshit Corner. For those who only associate DEXA with bone density testing, the scan also provides detailed data on lean mass, muscle mass, fat distribution, and regional composition. What I want is a granular, location-specific snapshot—something precise enough to measure whether my training is preserving muscle rather than merely flattering my optimism.
That, at least, is the plan. Read on to learn how DexaFit has a grander plan for me—and my wallet.
Let’s start with math, because bullshit is always easier to spot when you force it to wear numbers.
A one-off DEXA scan at DexaFit costs $179, a price that appears to exist primarily so it can be “discounted.” Enter the prominently displayed coupon code DEXA50, which magically brings the price down to $129—the amount that any rational adult will actually pay.
The DexaFit membership promises a “lifetime” scan price of $109. Compared to the real-world price you’re paying, that’s a savings of:
$129 − $109 = $20 per scan
The membership costs $200 per year plus a $150 initiation fee. That’s $350 up front for your first 12 months.
To break even:
$350 ÷ $20 = 17.5 scans
Round up, because fractional skeletons are frowned upon. That’s 18 DEXA scans in one year—roughly one every three weeks.
No, that probably won’t kill you from radiation exposure. That’s not the point. The point is that if you need 18 DEXA scans a year to justify a pricing plan, you’re no longer “tracking body composition.” You’re serving as a longitudinal research subject. You also likely flunked sixth-grade arithmetic.
What’s that? You say we should spread the scans out over two years? OK, so here’s how that would work:
Year one: $350
Year two: $200 + 5% = $210
Total: $560
Break-even math:
$560 ÷ $20 = 28 scans
That’s more than one scan per month for two consecutive years. If that sounds reasonable to you, congratulations—you’ve crossed the line from “data-driven” into “DEXA obsessed.”
Now for the buzzwords.
“Locks in lifetime diagnostic pricing.”
Translation: we can raise the non-member price whenever we want so this sentence remains technically true.
“Membership dues increase by no more than 5% annually.”
Wowzer. My Medicare premiums are thrilled to hear this. Very generous.
“Only 50 Founding Memberships available.”
Artificial scarcity: the last refuge of the boutique wellness industry. I bet they’re selling like hotcakes.
“Share your membership with family and friends for $25 per person.”
Because nothing says “healthy lifestyle” like turning Thanksgiving dinner into a cost-sharing seminar. Can we get a family pet discount for Rover and Fluffy, too?
And hovering over all of this is the Attia Effect. Once Peter Attia mentions a tool, it must immediately be wrapped in a subscription, a founding tier, and a vague suggestion that failing to participate borders on negligence. You must be influenced by the influential influencers on YouTube and Patreon, or don’t bother living.
Let’s be clear: the DEXA scan itself is useful. For someone coming off surgery, ramping exercise back up, managing sarcopenia risk, or running GLP-1s, a baseline scan makes sense.
That’s why I’m doing one. For $129, using a coupon code so prominent that it might as well be blinking.
What does not make sense is turning a legitimate diagnostic tool into a boutique lifestyle subscription for people with too much disposable income and too little skepticism. Consequently, I expect to get the full upsell whammy during my February 11 visit. The diagnostic session morphing into a time-share condo sales pitch will be my cue to exit, report in hand.
The scan might be a loss leader, or just break-even. They need memberships to cut their nut in their chosen high rent district locations. It’s either sell memberships or price scans above the market, where they will be destroyed by competition. But none of that is my problem, is it?
Bullshit Corner verdict:
DEXA scan — legitimate.
DEXA membership — premium, artisanal, scarcity-infused bullshit.
Scan wisely. Subscribe to nothing.
See You Next Week
Thanks for bearing with me in this “all about me” issue. I hope some of you find some of my medical travails interesting, for whatever reason. Schadenfreude is permissible and, in fact, encouraged here. Nevertheless, I promise to get back to non-egocentric issues next week.
I’ll let you know what I’m working on. In past issues, we’ve looked at how Big Pharma has created a market for GLP-1 receptor agonists and ramped it up exponentially. We’ve dissected the secondary market, disdaining the opportunistic compounding pharmacy/telehealth players. Last week, we explored the food and food supplement industry hopping on the GLP-1 bandwagon. So, it is completely expected that the plaintiff bar would sit up and take notice of the potential for large jury awards relating to GLP-1s. We’ll deal with that sordid mess next week, right here in Peptide Purgatory.
In the meantime, stay warm and good health to all!
Peptide Purgatory, published more or less weekly, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!
For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.
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