A New Method of Classifying Adiposity Using Height, Volume and Surface Area

Introducing the Barix^sm

Continued...

page 1,2,3,4,5

The Barix Trajectory and the Barix Rate of Change : Interpreting Changes in an Individual's Barix over Time

Positive Barix Trajectory Example

An individual's Barix will change over time. This can be due to the normal effects of aging, or changes in the individual's lifestyle, such as a new diet or exercise regimen. Such changes to an individual's Barix will most likely be measured. Dramatic changes to an individual's Barix in either direction may be cause for concern if that individual is not participating in a severely calorie restricted diet or undergoing a surgical procedure that affects the physical contours of the body.

Monitoring changes to an individual's Barix can assist the physician or surgeon in evaluating post-operative recovery. Monitoring changes to an individual's Barix can also assist the fitness or nutrition professional in assessing the progress of an individual's change in lifestyle (diet, exercise, undue stress, cessation from smoking, etc).

Each individual has their own Barix Trajectory. The Barix Trajectory is simply the direction or trend that an individual's Barix takes over time. If the individual's Barix is increasing slightly over time (positive), that individual is enjoying the results of a new exercise or diet regimen. If the individual's Barix decreases slightly over time (negative), it could indicate the normal aging process or a trend toward gaining weight.

The following is an example of interpreting the Positive Barix Trajectory of subjects that have undergone cosmetic surgical procedures. In this case, the subject has undergone an abdominoplasty.

The same techniques can be used to monitor the recovery process for subjects that have undergone bariatric surgical procedures.

Figure 18a and 18b depict the scan image profile of a pre-operative bariatric patient and the 3 month post-operative scan image profile.

Figure 18a
Scan Image Profiles of an Abdominoplasty Surgery Subject

Pre-op Scan	3 Mo Post-op	6 Mo Post-op

Figure 18b
Scan Image Profiles of an Abdominoplasty Surgery Subject

9 Mo Post-op Scan Image	12 Mo Post-op Scan Image

Table 15 displays the waist and hip measurements in centimeters, torso height, torso volume, torso surface area and Barix for the pre-operative and the 3 month post-operative scan images.

Table 15
Pre-operative and Periodic Post-Operative Barix Information

Note that the torso height has been rounded to the nearest digit.

Close inspection of Table 15 yields some interesting insights into the effects of the swelling associated with the abdominoplasty procedure.

The subject's pre-operative waist measurement was 78.5 cm and her hip measurement was 97.5 cm. The subject's initial Barix was 8.937. Three months after the procedure, the subject's waist measurement was 71.7 cm. This was expected as the abdominoplasty procedure effectively removes tissue around the waist region. The subject's hip measurement rose from 97.5 cm to 100.5 cm, indicating the effects of post-operative swelling. The subject's Barix rose from 8.937 to 9.068. This is a positive Barix Trajectory, reflecting the removal of tissue.

The rate of change of the subject's Barix is an additional measure of recovery. The Barix Rate of Change is defined as the change of the Barix between sequential periods of time divided by the time period, usually in months. In the example above, the subject's Barix rate of change from her pre-operative state to her 3 month post-operative condition is (9.068-8.937)/3 (months), or 0.044. This is a positive rate of change, indicating that the subject has lost mass due to removal of tissue.

The subject's 6 month post-operative waist measurement rose from 71.7 to 73.3 cm and her hip measurement rose from 100.5 cm to 102 cm. The subject's Barix decreased from 9.068 to 8.972. This is a negative Barix Trajectory, indicating that swelling did not diminish between the 6 month post-operative and 3 month post-operative period. Indeed, swelling had increased as reflected by the increased hip and waist measurements.

The Barix Rate of Change from her 6 month post-operative condition and 3 month post-operative condition was (8.972 – 9.068)/3 (months), or -0.032. This is a negative rate of change, indicating that the subject's body experienced more swelling between the 3 and 6 month post-operative period.

The subject's 12 month post-operative waist measurement decreased from 71.4 cm to 69.6 and her hip measurements decreased from 98.6 cm to 97.6 cm. The subject's Barix increased from 9.185 to 9.298. This is a positive Barix Trajectory. The subject's Barix Rate of Change between the 12 month and month post-operative period was (9.298 – 9.185)/ 3 (months), or 0.038. This is an increasing Barix Rate of Change, though less than the Barix Rate of Change during the 6 month to 9 month post-operative period. This indicates that the rate of swelling reduction is decreasing.

The subject's 15 month and 18 month Barix values indicate that she is nearing her Optimal Barix Range and is receiving the full benefits of the abdominoplasty procedure. The Optimal Barix Range is a narrow band in which periodic Barix calculations remain within.

Figure 19 depicts this information in a chart.

Figure 19 depicts that immediately after the surgical procedure, the subject's Barix improved. This is because the amount of tissue removed was greater than the resultant swelling. However, swelling increased during the 3 month to 6 month post-operative period. At some point within the 6 month to 9 month period, swelling peaked and began to abate. Swelling continued to abate during the 9 month to 12 month period, but at a diminished rate. Finally, the subject reached her Optimal Barix Range, indicating manifestation of the full benefit of the abdominoplasty procedure.

Should the subject's Barix depart from her Optimal Barix Range, a condition could be developing that may require medical attention.

Each subject's Barix Rate of Change can be compared to other subjects that have undergone a similar surgical procedure.

The Barix, Barix Trajectory and Barix Rate of Change can be calculated for each periodic scan. Eventually, sequential Barix rate of changes will decrease to a narrow band around a steady state point. The Barix Trajectory may also in turn change its magnitude. At this stage, the post-operative subject that underwent contouring surgical procedure will have manifested the full effects of the surgical outcome. The Optimal Barix Range for this individual will have been reached.

This same approach can be used to monitor reduction of mass from bariatric surgical procedures.

Periodic post-operative scans, calculation of the Barix, Barix Trajectory and the Barix Rate of Change can assist the bariatric surgeon in understanding the point in time that maximum post-operative weight loss has been reached and the subject's torso reaches a “steady state”.

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