What would an emergency physician tell his patients if he could have met them 20 years before their crisis?

Dr. Michael Doney, MD, MPH, MS, spent years as a board-certified emergency physician managing the acute consequences of chronic disease. Today he is Executive Medical Director of Biograph, a preventive health clinic that combines whole-body MRI, cardiovascular imaging, DEXA, VO2 max testing, movement analysis, blood work, and genetics with a team of physicians, registered dietitians, exercise physiologists, and sleep specialists.

In this episode he walks Dom D'Agostino through how that data turns into a plan: why a high relative VO2 max can mask low skeletal muscle mass, especially in women in their late 40s and 50s; why Biograph talks about body recomposition, fiber, protein, and carbohydrate quality instead of weight loss alone; and what an internal study of about 1,000 members suggested about fatty liver disease in women, who in that cohort showed MASLD at lower BMI and visceral fat levels than men, with higher insulin resistance and fewer liver enzyme abnormalities. He also takes on the main critique of whole-body MRI, explaining how a standardized reporting system, subspecialty radiologists, and clinical context brought Biograph's reported referral rate for follow-up testing to about 5.4%, compared with the roughly one-third figure often cited.

The conversation also covers AI in imaging and in personal health data, diffusion-weighted MRI, a new study with Vero Bioscience tracking proteomic organ age through lifestyle interventions, mental health screening, how Biograph supports members already on GLP-1 medications, and what it would take to make this kind of prevention broadly accessible.

Questions Answered in This Episode:

• Why can a high VO2 max be misleading when muscle mass is low?
• How does Biograph turn dozens of diagnostics into one personalized plan?
• Why might fatty liver disease be harder to detect in women?
• How can whole-body MRI programs reduce false positives and unnecessary follow-up testing?
• What is proteomic "organ age," and can lifestyle change it?
• How should people on GLP-1 medications protect lean mass?
• Can preventive medicine become accessible beyond concierge care?

Listeners and viewers will come away with a clearer picture of what a comprehensive preventive assessment measures, where its limits are, and how the results translate into nutrition, exercise, and sleep interventions.

Special thanks to the sponsors of this episode:

✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ Zocdoc: Find and instantly book a top-rated doctor here.
✅ fatty15: Get 15% off a 90-day starter kit with code METABOLICLINK here.

More Links

• Biograph: biograph.com
• Biograph x Vero organ age study: biograph.com/blog/organ-age-study
• The Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.com

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

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Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Join us for a FREE live Q&A with Dr. Boz on October 14 at 9:00 AM PT / 12:00 PM ET and ask her your questions directly. No membership required. Register here.

What happens when an internist teaches ketogenic nutrition to 200 students at the same time and tracks every one of their glucose and ketone readings on shared dashboards?

Dr. Annette Bosworth, MD, known to her audience as Dr. Boz, is an internal medicine physician and the author of ANYWAY YOU CAN and ketoCONTINUUM. After leaving corporate medicine she rebuilt her practice around ketone metabolic therapy, first with her own patients and now through a live 21-day class where small groups of ten work with coaches who have done the diet themselves.

In this episode she walks Dom D'Agostino through what that model has taught her: why every student does a 72-hour sardine fast and the changes she has observed in morning glucose and ketone readings the day after, how she started a medically supervised group already in ketosis on 0.6 mg of tirzepatide once weekly (approximately one-quarter of the labeled 2.5 mg starting dose) and her report that roughly nine in ten stayed at that dose, and why she asks every participant to keep their own physician involved

The conversation also covers the six-week ketogenic trial she ran with her mother during a leukemia recurrence, why she treats carbohydrate cravings the way she treated addiction in her clinic, and the free weekly support groups that classes from her first cohort still attend.

Questions Answered in This Episode:

• What has Dr. Boz observed during her 72-hour sardine challenges?
• What did Dr. Boz observe when using low-dose tirzepatide in patients already in ketosis?
• What does "relief, not joy" reveal about carbohydrate addiction?
• Why can blood pressure medications require reassessment when starting a ketogenic diet?
• Why does she emphasize physician involvement when participants take prescription medications?
• Why does she combine group coaching with glucose and ketone tracking?

Listeners and viewers will come away with a practical picture of ketone metabolic therapy as it is actually delivered: the protocol, the monitoring, the medication monitoring and reassessment, and the community structure that keeps people in it.

Special thanks to the sponsors of this episode:

✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ Cowboy Colostrum: Get up to 25% off your entire order with code METABOLIC here.
✅ iRestore: Get the iRestore Elite helmet and Illumina face mask bundle at an exclusive discount with code LINK here.

More Links

• Live Q&A with Dr. Boz, October 14, 9:00 AM PT / 12:00 PM ET (free, no membership): register here
• Dr. Boz's website: bozmd.com
• Dr. Boz on YouTube: @DoctorBoz
• Dr. Boz's books: ANYWAY YOU CAN and ketoCONTINUUM
• The Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.com

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.