Consultation outcome

Using dual energy x-ray absorptiometry (DEXA) scans for non-medical purposes as a justified practice: consultation response

Updated 7 October 2026

Introduction

This document presents the analysis of responses to the government consultation on using dual energy x-ray absorptiometry (DEXA) scans for non-medical purposes as a justified practice.

On behalf of the UK government and the devolved governments, the Department of Health and Social Care (DHSC) ran a 9-week consultation between 30 March and 1 June 2026. A Welsh language version of the consultation was also made available and ran between 1 May and 3 July 2026.

This consultation received 397 responses from a range of stakeholders, including members of the public, healthcare professionals, ionising radiation experts, sports and fitness professionals and businesses. No responses were received through the Welsh language consultation.

Of the 397 responses received, 22 contained one or more unanswered questions. Following review, these responses were considered sufficiently complete to be included in the analysis. As a result, totals may vary between questions where respondents did not provide an answer. Percentages presented throughout this report may not add up to exactly 100% due to rounding.

We would like to thank all respondents for taking time to provide their views.

Background

DEXA is an established medical imaging technique for assessing bone mineral density. It supports the diagnosis and monitoring of osteoporosis and osteopenia, and evaluating an individual’s risk of bone fracture.

The medical use of DEXA is a justified practice under the Justification of Practices Involving Ionising Radiation Regulations 2004 (JoPIIRR). Medical exposures involving ionising radiation are regulated under the Ionising Radiation (Medical Exposure) Regulations 2017 and the Northern Ireland Ionising Radiation (Medical Exposure) Regulations 2018.

While DEXA is widely recognised as a safe and effective medical procedure, its use for sports performance and general wellness purposes requires separate consideration. Under the current regulatory framework, the use of DEXA for non-medical sports and wellness purposes is not justified under JoPIIRR and is therefore prohibited.

Recognising the growing demand to use DEXA for purposes such as general body composition assessment and to support optimisation of sports performance, the government launched a public consultation to seek views on whether the use of DEXA scans for non-medical body composition assessment should be made a justified practice under JoPIIRR.

In particular, the consultation sought views on whether:

• the use of DEXA for non-medical purposes should be justified for both elite athletes and other individuals monitoring their body composition under general fitness and sporting programmes
• its use should exclude children, young people and individuals known to be pregnant
• there should be limits on the number of scans undertaken by an individual within a set time frame

In parallel, the government also undertook targeted engagement with medical and ionising radiation experts to inform the evidence-gathering process. Views from these engagements are included in the analysis below.

Following the conclusion of the public consultation, the government is now publishing its analysis of the responses received, setting out important findings from consultation respondents and wider stakeholder engagement.

Demographics of respondents

This section summarises responses to the demographic questions included at the beginning of the consultation. A total of 397 responses were received.

Respondent type and expertise

To support interpretation of the findings, respondents were asked whether they were responding in a personal or organisational capacity, and to provide information on any relevant expertise.

Of all the 397 respondents:

• 61% said they were an individual sharing their personal views and experiences
• 30% said they were an individual sharing professional views
• 9% said they were responding on behalf of an organisation

Respondents were also asked whether they, or the organisation they represented, had expertise in the medical uses of ionising radiation.

Around one-third of respondents (34%) said they had expertise in the use of ionising radiation, while 66% said they did not. Similarly, 34% of respondents said they were a medical or healthcare professional, with the remaining 66% reporting no medical or healthcare background.

Of those who said they had expertise in ionising radiation:

• 64% said they were a medical or healthcare professional
• 16% said they were not a medical or healthcare professional
• 19% were responding on behalf of an organisation and were not asked this question

Age

Respondents represented a range of age groups, although most (61%) were between 35 and 54. The largest proportion was aged 45 to 54 (32%), followed by 35 to 44 (29%).

The age breakdown of respondents was:

• under 16: 0.3%
• 16 to 24: 0.3%
• 25 to 34: 18%
• 35 to 44: 29%
• 45 to 54: 32%
• 55 to 64: 15%
• 65 to 74: 4%
• 75 to 84: 0.3%
• 85 or above: none

Location within UK

The 362 individual respondents were asked where they lived within the UK.

The location of respondents was:

• 91% in England
• 3% in Scotland
• 2% in Wales
• 1% in Northern Ireland
• 2% lived outside the UK
• 1% preferred not to say

The 331 respondents living in England were asked which region they lived in. Responses were received from every region of England.

The regional distribution of respondents living in England was:

• 37% in London
• 16% in south-east England
• 12% in north-west England
• 9% in east of England
• 9% in south-west England
• 5% in East Midlands
• 5% in Yorkshire and the Humber
• 4% in West Midlands
• 2% in north-east England
• 1% preferred not to say

Non-medical DEXA current and intended use

This section summarises respondents’ current and intended uses of non-medical DEXA scans, including what they are used for.

Interpretation of these findings should be treated with some caution. Respondents highlighted ambiguity around applications relating to body composition assessment, wellness services and sports performance monitoring, with differing views on whether such activities should be considered medical or non-medical in nature. This uncertainty may have influenced how some respondents answered questions relating to current and future service provision.

Medical vs non-medical DEXA

Bone density assessment was one of the most frequently cited benefits of DEXA. Respondents described identifying osteopenia, osteoporosis risk and low bone density through private scans, enabling preventative interventions and medical follow-up.

Consultation responses highlighted uncertainty about the distinction between medical and non-medical DEXA exposures. Respondents questioned whether several uses of DEXA should be regarded as for medical or non-medical purposes. These included:

• monitoring of body composition during GLP-1 treatment
• assessment of bone health in perimenopausal women
• supporting injury rehabilitation in athletes and monitoring individuals at risk of low energy availability or relative energy deficiency in sport (RED-S)

It was noted that these applications may have clinical or health-related purposes despite occurring outside traditional healthcare settings.

Given the ambiguity around other such use cases, the government will look to set out the scope of medical and non-medical uses respectively. 

Current and future service provision

This section summarises respondents’ current provision of non-medical DEXA services, their interest in providing services in the future, and the purposes for which non-medical DEXA services are currently being offered.

Current provision of non-medical DEXA services

Respondents representing organisations and businesses were asked whether their organisation currently offers DEXA scans for non-medical sports and wellness purposes. Of the 35 respondents, just over half (54%) reported that their organisation currently provides such services, while 43% indicated that they do not. A further 3% preferred not to say.

Organisations and businesses that did not currently provide non-medical DEXA services were asked whether they would be interested in doing so in the future. Responses from the 16 respondents were mixed:

• 38% expressed an interest in offering non-medical DEXA services in the future
• 44% said they were not interested
• 19% preferred not to say

Individual respondents were also asked whether they currently provide non-medical DEXA services. Of the 362 respondents:

• 58% said they do not provide such services
• 21% said they do
• 1% preferred not to say
• 20% said the question did not apply to them

Among the 96 respondents who identified themselves as providers of non-medical DEXA services, 59% reported having expertise in ionising radiation.

Respondents who said they do not currently provide non-medical DEXA services were additionally asked whether they would be interested in offering such services in the future. Of the 215 respondents:

• 77% said they would not be interested
• 20% said they would be interested
• 2% preferred not to say

Considered together, these findings suggest that non-medical DEXA services are already being provided by a proportion of respondents, particularly among organisational respondents. While there is some interest in the future provision of non-medical DEXA services, views were mixed.

Purposes for providing non-medical DEXA services

Respondents who currently provide non-medical DEXA services were asked what they provide the scans for. They were able to select multiple reasons. Of the 97 responses to this question:

• 85% selected sports performance assessments
• 77% selected physical health monitoring, including non-medical weight loss
• 43% selected research
• 42% selected general fitness purposes

These responses show the range of applications for which non-medical DEXA is currently being used outside of traditional clinical settings, including sports performance, fitness monitoring and body composition assessment.

Current and future service use

The consultation also explored individuals’ experiences of receiving non-medical DEXA scans and their interest in accessing such services in the future.

Previous use of non-medical DEXA scans

Of the 397 respondents:

• 64% said they had previously undergone a DEXA scan for non-medical sports and wellness purposes
• 33% said they had not
• 3% preferred not to say or said the question did not apply

The proportion of respondents that reported having previously undergone a DEXA scan for non-medical sport and wellness purposes were notably different among different subgroups. For example:

• 32% (40 of 125) for respondents who identified as a medical or healthcare professional
• 34% (46 of 135) for respondents who identified as having expertise in medical uses of ionising radiation
• 40% (14 of 35) for those responding on behalf of an organisation

In contrast, 87% (187 of 216) of those who said they do not belong to any of those 3 subgroups reported previously having undergone a non-medical DEXA scan.

Respondents who had not previously received a non-medical DEXA scan were asked whether they would be interested in doing so in the future. Views were broadly divided:

• 46% expressed an interest
• 48% said they were not interested
• 6% preferred not to say

Reasons for using non-medical DEXA scans

Respondents who had previously undergone a non-medical DEXA scan were asked about their reasons for doing so. They were able to select multiple reasons. Of the 256 responses to this question:

• 47% said physical health monitoring, including non-medical weight loss
• 38% said sports performance assessment and physical health monitoring, including non-medical weight loss
• 65% said general fitness
• 5% said sports performance assessment
• 11% said research

These findings indicate that body composition monitoring and weight-management objectives are important drivers of demand for non-medical DEXA services.

Frequency of use

The 256 respondents who had previously received a non-medical DEXA scan were also asked how many scans they had undergone within the previous 3 years. Of these respondents:

• 73% said one to 2 scans
• 17% said 3 to 5 scans
• 5% said 6 to 10 scans
• 3% said no scans
• 1% said more than 10 scans

This suggests that, for most respondents, non-medical DEXA scanning is undertaken infrequently and is often used periodically to monitor changes in body composition over time rather than as a routine or high-frequency investigation.

Qualitative free-text responses highlighted a range of perceived benefits associated with non-medical DEXA scans. Respondents frequently described using, or wishing to use, DEXA to:

• monitor visceral fat and metabolic health
• support healthy ageing
• monitor body composition changes during weight loss
• monitor the effects of weight loss medications
• identify early signs of osteoporosis and sarcopenia

A recurring theme across responses was the perceived value of DEXA in supporting weight management and informing healthy lifestyle choices. Respondents frequently described DEXA as providing a more accurate and reliable assessment of body composition than alternative measures, such as body mass index (BMI). They considered this information useful for monitoring health and evaluating progress towards personal health and fitness goals.

Some respondents also referred to uses including monitoring the effects of weight-loss medications and assessing bone health. It should be noted that certain applications may constitute legitimate medical uses of DEXA under the current regulatory framework, for example:

• assessing osteoporosis risk through measurement of bone mineral density
• supporting clinical management during weight-loss treatment

In contrast, body composition assessment undertaken solely for sports, fitness or wellness purposes is not currently permitted under existing regulatory framework.

Views on non-medical DEXA use

This section summarises respondents’ views on non-medical DEXA use in different settings, including elite sport and wider sports and wellbeing applications. It also looks at views on potential safeguards and restrictions should such use be permitted.

Elite athletes

All 397 respondents were asked whether DEXA scans should be permitted for non-medical sports and wellness purposes for elite athletes.

For the purposes of this consultation, an elite athlete was defined as (one of the following):

• an individual who makes a living from competing in a sport
• a senior representative nominated by a relevant sporting body
• a member of the senior training squad for a relevant sporting body
• aged 16 or above and on an elite development pathway

Question

To what extent do you agree or disagree with the following statement? DEXA scans for non-medical sports and wellness purposes should be allowed for elite athletes, for example to support their training programme.

Responses indicated strong support for permitting non-medical DEXA use in elite sport. Of all respondents, 87% either agreed or strongly agreed with the proposal, while 8% disagreed or strongly disagreed.

The views on permitting non-medical DEXA scans for elite athletes was:

• strongly agree: 70%
• agree: 17%
• neither agree nor disagree: 6%
• disagree: 4%
• strongly disagree: 4%
• prefer not to say: 0.3%

Support was similarly high among the 135 respondents who reported expertise in ionising radiation. Within this group, 76% were in favour (agreed or strongly agreed) that non-medical DEXA should be permissible for elite athletes, while 15% were not (disagreed or strongly disagreed).

Free-text responses highlighted the role of DEXA in supporting athlete health, injury prevention, rehabilitation and management of conditions such as RED-S.

Several respondents emphasised that, if permitted, non-medical DEXA use in elite sport should be undertaken within structured programmes supported by appropriately qualified professionals. Respondents frequently suggested that elite athletes represent a comparatively lower-risk group due to the availability of specialist medical and performance support, established governance arrangements and routine health monitoring.

It should be noted that some of the applications referenced by respondents may constitute medical uses of DEXA and are therefore already permitted under the current regulatory framework, for example:

• assessment of bone health
• diagnosis and monitoring of osteoporosis
• injury management
• rehabilitation
• investigation of suspected RED-S where clinically indicated

In contrast, the use of DEXA solely for body composition assessment, performance optimisation, fitness profiling or general wellness purposes is not currently permitted.

General sports and wellbeing

All 397 respondents were also asked whether DEXA scans should be permitted for wider non-medical sports and wellness purposes.

Question

To what extent do you agree or disagree with the following statement? DEXA scans should be allowed for any non-medical sports and wellness purposes. This includes monitoring body composition for non-medical weight loss, general fitness or as part of sporting programmes.

Overall, respondents were supportive of permitting non-medical DEXA use in wider sports and wellness settings. Of all respondents, 80% agreed or strongly agreed with the statement, while 16% disagreed or strongly disagreed.

The views on permitting non-medical DEXA scans for wider sports and wellness purposes were:

• strongly agree: 66%
• agree: 14%
• neither agree nor disagree: 4%
• disagree: 8%
• strongly disagree: 8%
• prefer not to say: 1%

Support was lower among the 135 respondents who reported expertise in ionising radiation. Within this group, 59% agreed or strongly agreed that non-medical DEXA should be permissible for wider sports and wellness purposes, while 35% disagreed or strongly disagreed. In contrast, respondents without expertise in ionising radiation responded with 92% agreeing or strongly agreeing, while 6% disagreed or strongly disagreed.

Qualitative responses from members of the public, service providers and sports-related stakeholders frequently cited the perceived benefits of DEXA for:

• monitoring body composition
• supporting weight-management goals
• informing fitness programmes
• providing individuals with detailed information about their health and physical condition

By contrast, targeted engagement with radiation experts suggested that concerns regarding wider sports and wellbeing applications largely reflected concerns on whether the risks associated with non-medical exposure to ionising radiation can be adequately justified and managed. Participants highlighted the risks of a lack of clinical oversight and defined health objectives, which are often managed in elite sport settings.

Restrictions on use

Many respondents supported restrictions on the use of non-medical DEXA scans, including age limits, restrictions on scan frequency and additional safeguards for individuals who are pregnant.

Age

All respondents were asked whether access to non-medical DEXA scans should be subject to age restrictions.

Question

Should there be age restrictions on DEXA scans for non-medical sports and wellness purposes?

Overall, many of the 234 respondents (59%) supported introducing age restrictions, while 24% opposed them and 17% were unsure. These findings suggest broad support for age-based restrictions on non-medical DEXA use. However, views differed across respondent groups.

Respondents with expertise in ionising radiation were generally more supportive of restrictions (81%) than those without such expertise (47%). Individuals who had previously undergone a DEXA scan expressed more mixed views, although support for age restrictions remained higher than opposition overall.

Respondents who supported age restrictions were asked what the minimum age threshold should be. The most selected option was to restrict access to people aged 18 years or over (71% of respondents). Around one-quarter (24%) favoured a lower age threshold of 16 years or over.

The views on the minimum age threshold for access to non-medical DEXA scans were:

• people aged 16 years or older: 24%
• people aged 18 years or older: 71%
• don’t know: 1%
• other, please specify: 2%

Among those who supported a minimum age threshold or exemptions to age restrictions, respondents often referred to circumstances involving elite athletes, structured sports programmes, or situations where scans were undertaken with appropriate professional oversight. Others suggested that younger individuals should only have access where there is a medical justification.

Pregnancy

Overall, there were mixed views on whether the use of non-medical DEXA for sports and wellness purposes should be restricted for individuals known to be pregnant. 

Question

To what extent do you agree or disagree with the following statement? Non-medical DEXA scans for sports and wellness purposes should exclude individuals known to be pregnant.

Over three-quarters of the 396 respondents (76%) agreed or strongly agreed that individuals known to be pregnant should be excluded from receiving non-medical DEXA scans. By comparison, 4% disagreed or strongly disagreed, while 17% neither agreed nor disagreed.

The views on restricting non-medical DEXA scans for individuals known to be pregnant were:

• strongly agree: 57%
• agree: 19%
• neither agree nor disagree: 17%
• disagree: 2%
• strongly disagree: 2%
• prefer not to say: 3%

Support for restrictions was strongest among the 135 respondents with expertise in ionising radiation and among those who had not previously undergone a DEXA scan. Within these groups, 90% and 91% respectively agreed or strongly agreed that non-medical DEXA use should be restricted during pregnancy. By comparison, the 262 respondents without ionising radiation expertise and those 256 respondents who had previously undergone a non-medical DEXA scan were less likely to strongly agree, although support for restrictions remained substantial, with 69% and 68% of each group agreeing or strongly agreeing.

Feedback from targeted engagement with medical experts, including regulators and professional bodies, further supported restrictions during pregnancy. Participants generally considered the potential benefits of non-medical DEXA scans during pregnancy to be limited, noting that physiological changes associated with pregnancy reduce the usefulness of body composition measurements for sports and wellbeing purposes. Consequently, respondents considered exposure to ionising radiation difficult to justify in the absence of a clear benefit and viewed restrictions as a proportionate risk-management measure.

Scan frequency

There was strong support across respondent groups for imposing annual limits on the number of non-medical DEXA scans an individual can receive each year.

Question

To what extent do you agree or disagree with the following statement? There should be a limit on the number of non-medical DEXA scans for sports and wellness purposes that an individual can have each year.

Of all 396 respondents, 71% agreed or strongly agreed that limits should be placed on the number of non-medical DEXA scans an individual may receive, while 12% disagreed or strongly disagreed.

The views on limiting the number of non-medical DEXA scans a year were:

• strongly agree: 40%
• agree: 31%
• neither agree nor disagree: 17%
• disagree: 6%
• strongly disagree: 6%
• prefer not to say: 1%

Support for limiting scan frequency was evident across all respondent groups, although views varied. The 135 respondents with expertise in ionising radiation were more likely to support annual limits, with 88% agreeing or strongly agreeing, compared with 61% of those without such expertise. Similarly, support was higher among the 131 respondents who had not previously undergone a non-medical DEXA scan (85%) than among the 256 who had previously received one (63%).

Qualitative responses indicated broad support for introducing a defined annual limit on the number of non-medical DEXA scans. Many respondents suggested a maximum of 2 scans a year, although proposed limits ranged from one to 4 scans annually depending on the intended use and individual circumstances.

Some respondents noted that individuals monitoring changes in body composition, training outcomes or the effects of weight-loss interventions may require repeat scans over time, but it was generally accepted that these benefits could be achieved without frequent DEXA exposure due to the limitations in DEXA detecting small changes.

Themes raised by respondents

In addition to responding to the consultation questions, respondents had the opportunity to provide free-text comments on the potential justification of DEXA for non-medical purposes. These responses, alongside comments received by email and targeted engagement with medical experts, identified several consistent themes.

Overall, respondents were generally supportive of permitting non-medical DEXA, particularly where scans support preventative health, bone health monitoring, athlete welfare and informed health and fitness decisions. However, many emphasised the need for proportionate regulation, professional oversight and safeguards to manage exposure to ionising radiation.

Radiation safety and regulation

Respondents frequently noted the balance between radiation risk and potential health benefits. While many considered the radiation dose from DEXA to be very low, healthcare and radiation protection professionals highlighted the importance of maintaining appropriate safeguards if non-medical DEXA were to become a justified practice.

There was considerable support for regulating the practice, including:

• compliance with the Ionising Radiation (Medical Exposure) Regulations 2017 requirements
• professional standards
• quality assurance processes
• appropriate interpretation of scan findings

Preventative health and early intervention

Many respondents described DEXA as supporting preventative healthcare by enabling individuals to identify changes in body composition, bone health and metabolic risk factors before disease develops. Many reported using DEXA to inform exercise, diet and lifestyle interventions and expressed the view that wider access could promote healthier behaviours and reduce future demand on healthcare services.

Safeguarding

A number of respondents highlighted the possibility that body composition monitoring could negatively affect individuals with eating disorders, body dysmorphia or related conditions. Concerns were raised regarding repeated scanning, the interpretation of results and use among younger people.

Conversely, some respondents described DEXA as having supported recovery from eating disorders by encouraging a focus on body composition and health outcomes rather than body weight alone.

Alternative methods

Many respondents noted that DEXA provides more reliable and actionable information than BMI, bodyweight measurements or bioimpedance analysis. Several responses challenged the suitability of alternative methods for monitoring health risk.

Government response - next steps

This consultation sought views on whether non-medical DEXA should become a justified practice under JoPIIRR and the safeguards that would be required if permitted.

The government welcomes the responses received and is grateful to all individuals and organisations that took the time to contribute their views and evidence to this consultation.

Most respondents supported making non-medical DEXA a justified practice, with strong support for elite athlete use and wider sports and wellbeing purposes. Support among medical and healthcare professionals was generally more cautious, reflecting considerations around radiation protection and proportionality.

The government will now consider the consultation responses, alongside evidence gathered through targeted engagement with medical and ionising radiation experts, to inform a policy decision on whether non-medical DEXA should be made a justified practice and, if so, under what safeguards.