For years, getting a DEXA scan or a VO2 Max test meant scheduling an appointment at a sports medicine clinic, a university lab, or a specialized testing center. The DEXA scan, which uses low-dose X-rays to measure bone density, body fat percentage, and lean muscle mass with a level of precision that no bathroom scale or handheld device can match, typically ran between $75 and $150 per session depending on the market. A VO2 Max test, which measures the maximum amount of oxygen your body can use during intense exercise and is widely considered the single best predictor of cardiovascular fitness and longevity, cost between $150 and $300. If you wanted both done regularly, say quarterly, to track your progress over time, you were looking at $900 to $1,800 a year before you even factored in gym membership, supplements, or coaching.
That math changed this week when Custom Fit, a San Francisco-based gym chain, opened its fourth location and became the first gym in the country to offer unlimited DEXA and VO2 Max testing as part of its standard membership package. Members can schedule a scan or a test as often as they want with no additional fee beyond their monthly dues. The company has not disclosed its membership pricing for the new location, but its existing clubs charge in the $200 to $350 per month range, which positions it in the premium tier alongside Equinox and Lifetime but with a data-driven value proposition that neither of those chains currently match. The bet Custom Fit is making is that access to clinical-grade testing will drive member retention and attract a specific type of customer who is willing to pay more for measurable results.
The timing of this move is not accidental. The fitness industry in 2026 is in the middle of a fundamental shift in how people define and measure fitness. The ACSM's top trend for the year is wearable technology, and the broader conversation has moved from aesthetics toward longevity and functional health. Grip strength, balance, VO2 Max, resting heart rate, HRV, and body composition have replaced six-pack abs and bench press numbers as the metrics that serious exercisers care about. That shift has been driven partly by research, including a Lancet study of 140,000 adults across 17 countries that linked grip strength decline to a 17 percent increase in cardiovascular death risk, and partly by the cultural influence of longevity advocates who have made terms like healthspan and biological age part of the mainstream vocabulary.
What makes DEXA and VO2 Max testing particularly valuable is that they tell you things your wearable device cannot. Your Apple Watch or Whoop band can estimate your VO2 Max, but the estimate is based on algorithms that use heart rate and motion data as proxies. A lab-grade VO2 Max test measures actual gas exchange during a graded exercise protocol that pushes you to your physiological limit. The difference between the estimate and the real number can be significant enough to change how you train. Similarly, a body composition estimate from a smart scale uses bioelectrical impedance, which is affected by hydration, time of day, and a dozen other variables. A DEXA scan measures body composition directly and can tell you not just your overall body fat percentage but where that fat is distributed, which matters for metabolic health risk assessment.
The question for the rest of the industry is whether this model scales. Custom Fit is operating in San Francisco, where the market for premium fitness is deep and the willingness to pay for health optimization is higher than in most cities. Replicating this in Nashville, Atlanta, or Dallas would require different pricing and a different member profile. The equipment itself is expensive. A DEXA scanner costs between $75,000 and $150,000, and a metabolic cart for VO2 Max testing runs between $30,000 and $60,000. Staffing trained technicians to administer the tests adds payroll. For a gym operating on thin margins, those are real capital expenditures that need to be justified by either higher membership fees or significantly better retention rates.
But the direction is clear even if the timeline for widespread adoption is longer than a single year. Commercial gyms have been struggling to differentiate themselves in a market where boutique studios, home equipment, and app-based programming have all carved out significant market share. Offering something you cannot get at home or from an app is the obvious competitive advantage, and clinical-grade testing is exactly that. You cannot do a DEXA scan in your garage. You cannot do a real VO2 Max test on a Peloton. That scarcity gives brick-and-mortar facilities a reason to exist beyond providing a room full of equipment, and in 2026, that might be the most important competitive insight in the fitness business.