You Lost 20 Pounds… But Did You Get Healthier?

Two people lose 20 pounds. One becomes stronger, healthier, and more resilient. The other loses muscle, slows their metabolism, and increases their risk of injury. What's the difference?

In this episode, we unpack the growing conversation around GLP-1 medications, rapid weight loss, and the often-overlooked importance of preserving lean muscle mass. From protein and nutrition to strength training and core stability, we discuss what it takes to lose weight in a way that supports long-term health.

We also cover:

•  Why muscle is your body's metabolic engine 
•  The risks of losing lean mass during rapid weight loss 
•  Protein and nutrition priorities while dieting or using GLP-1s 
•  How weight loss can affect strength, posture, and low back pain 
•  The best types of exercise to maintain muscle and prevent injury 

If your goal is more than just a lower number on the scale, this episode is for you.

Transcript

SPEAKER_01 0:00

Riddle me this two people lose twenty pounds. One gets healthier and the other gets weaker. What's the difference?

SPEAKER_00 0:10

Very interesting you bring that up. I have a lot of ideas.

SPEAKER_01 0:14

Yeah.

SPEAKER_00 0:14

In this society, all we want to do is it seems like people just want to shrink down, shrink down. Eat less, shrink down. Oh great, I'm gonna take this drug, it'll help me eat less, and I'll shrink down, and my world will be better and my health will be better. You can be healthier, but there's a lot of people in this world of GLP1s and losing weight, not doing it the healthiest way can actually make you weaker and you know lead to health issues down the road, too. Yeah. Not just weakness, but other stuff.

SPEAKER_01 0:46

And what I hear you saying is there's weight loss, you know, can be healthy weight loss or it can be non-healthy weight loss. And I think that's the real topic that we want to dive into. One, what might be going on with weight loss that is less healthy? And two, how can we do weight loss in a healthy way? Or and how can people, you know, GLP ones are not going away. Right. And in fact, I'm happy because that is a huge opportunity for America to get to a weight that is healthy for their body, right? And it's a it's a great tool that we can use to support a healthy transition to a healthier lifestyle. But we have to do it the right way. And so that is what we really want to dive into. So when we lose weight, we're not just losing fat, we are also losing lean muscle mass.

SPEAKER_00 1:41

And in fact, that's usually what happens first, or it's a combination where the scale's going down. It could be initially water weight, which could be muscle loss as well. Because it's we know it's very easy to lose muscle quickly. So that's why we talk about that all the time.

SPEAKER_01 1:54

What is glycogen? Yeah, one gram of glucose, three to four grams of water. Yeah. Yeah.

SPEAKER_00 1:59

So if you you know initially losing weight, you're seeing progress, and that's why the scale is so frustrating because you could be doing all the right things and you're not losing weight, where it's like, well, maybe that's good because you're retaining your muscle, doing it the right way, retaining muscle, and then after a few weeks, you might see some fat loss. But a lot of times you you are just naturally going to lose the muscle with the fat, some of it.

SPEAKER_01 2:21

And with the GOP one, I mean, what we're really talking about, like the mechanism is really calorie restriction. And there's the side effects, like the most common side effects that we hear about is nausea and just like your stomach doesn't really feel good.

SPEAKER_00 2:37

So we've gotten better with that too, though, because from you know, talking to different clients on it and stuff, it's like I feel like they're they're figuring out like the different dosing, the the ramp up into the higher doses, being more cautious with that so that that's not an issue, or different drugs work better for different people.

SPEAKER_01 2:54

Yeah. And I've also heard that the more recent ones that have the double, and I think now there's like a triple agonist. Like, you know, first it was a Zipic, that was like the single agonist, and then there was Zetbound, and that's the double agonist. And now I think there's a newest one that has the triple agonist. And so I think the, you know, at least the second generation I've heard has much less of those nausea side effects from what I've heard. But still, you know, if we are having less food, the food that we have becomes way more important. Right. Our selection criteria needs to be very, very sharp. And we're all creatures of habit. So we're all naturally picking foods that, you know, we go to the grocery store and like, you know, I'll be honest, I'm eating almost the same thing every single day for breakfast.

SPEAKER_00 3:44

Well, but that's how it's that's how you can be healthier too. And it's more sustainable. If you find things you like, that works. You know, it fits within your macros, it fits within the goals you're trying to create. Um, but it is hard for anyone to get all the nutrients we need, even on a 2,000 calorie diet, 2,500 calorie diet, whatever. And so when we are going into a calorie deficit, whether it's through you know, medications or not, if we're just trying to lose some fat, maybe we're on a slight calorie deficit and doing training and tracking, it's hard to get the nutrients that your body needs. Um, meal prep is successful, or like doing the same things day to day is helpful for that. So that you don't like so that you always have a plan, because that we know that helps a lot, the psychology of you know, eating and sustainable um habits. But it's hard enough, and that's why sometimes supplements are beneficial, or even if you're doing all the right things, like I might still recommend official supplement because it's just hard to get that in, right? Um, and we're not, you know, with the GLP ones, it is the calorie restriction, like you said, when it comes to things like bariatric surgery, you can have that malabsorption part as well. So we're not gonna talk as much about that, but that's a whole nother thing where protein is even harder, you know, more important. And there's a laundry list of supplements and vitamins to take because they are having that malabsorptive component with part of the colon taken out, um, them not absorbing all the nutrients they are eating on a very limited calorie diet. With general weight loss or dieting or GLP1s or you know, time restricted eating, yeah, intermittent fasting. That is all, I mean, that's harder and harder to get the nutrients that your body needs as it is. Um and so if you're having like major calorie restriction with the GLP one or your appetite's down, or you're going alone. Or you're going alone and start and literally starve. It is hard to get the nutrients your body needs. So we have to make sure. So it becomes even more important to see a dietitian, maybe, or really think about your diet because every bite that comes in is even more important.

SPEAKER_01 5:51

Or just what it is. And it'll like make a plan.

SPEAKER_00 5:53

Yeah.

SPEAKER_01 5:53

So, you know, when we're having dramatic weight loss, you can expect that 30 to 40 percent of that fat loss or of, I'm sorry, of the weight loss is going to be lean mass.

SPEAKER_00 6:06

I think the studies are still showing depends on where you're starting out too, the the weight, how much weight you have to lose. But yeah.

SPEAKER_01 6:11

And I think obviously, like, yeah, how much fat you have versus how much lean lean muscle mass you have is gonna determine the percentage of lean muscle mass that you lose. I think from what we understand, a lot of the weight that's being lost is primarily fat in the beginning when people have a lot of fat to lose. They have a lot of excess fat. So, you know, definitely uh it's definitely, you know, some of the things we're talking about are, you know, unintended side effects. We are all in agreement, though, that the side effects and the problems of being you know morbidly obese or just like carrying around a ton of extra weight, it's it's better to be dealing with these things than to be dealing with those things. So overall, we're saying this is a good thing, but we want to be cautious about how we're approaching it and make sure that we're being attentive. And so, you know, when we lose lean mass, not only are we losing strength, but we're losing our body's primary metabolic engine, which is our muscle. And we talk about that all the time. How important muscle is for our metabolism, because every time we move, we're burning that glycogen and our muscles are sending out that GLUT-4 receptor and just chewing up any available blood glucose that's that's in there. Yeah. And so we're not having to take it through that lipogenesis or getting it turned into fat storage because our muscles are just taking it up right away, as well as our liver.

SPEAKER_00 7:43

And it's more, yeah, you're revving up your engine. As you have more muscle mass, you can get away with having more calories or you can eat more foods, uh a wide variety of foods because you are burning more calories day to day.

SPEAKER_01 7:54

And also a big thing about like why people are so obsessed with muscle mass and just like creating a big tank of muscle is that there will come a day where you need to dip into that rainy day fun. You know, some you're gonna get sick. You know, I remember you know, I I got sick just a few weeks ago, and you know, this thing went around our entire GI bug.

SPEAKER_00 8:22

It was weird, like it it came it was not like the 24-hour yeah, nobody threw up really except Tali.

SPEAKER_01 8:28

Tali's, yeah. But like almost nobody threw up, and then but you were like feeling nauseous, lots of diarrhea, stuff like that. Appetite, yeah, no appetite for anything. And so I remember I lost like five pounds. Now there's no way that's like five pounds of fat. Like you're losing some muscle during that time.

SPEAKER_00 8:46

But you're also like good taste in bed, yeah, just not eating.

SPEAKER_01 8:49

And so you want to have some eck some extra muscle mass for that rainy day fun when you get injured, when you have um an illness that takes you out of the game for a little while. You know, you know, every, you know, every week, I mean, in a week is a long time to spend in bed, but like there's some studies that show like for every week that you spend in bed, it takes you like eight weeks to get back to baseline.

SPEAKER_00 9:14

Well, that's why it's so scary when older people that are frail and naturally like it's harder and harder to have a lot of muscle when you're 85 years old, but that's why it's scary because they're already if they're already thin and frail, you don't have the muscle, it's scary when they're in the hospital bed or getting injured or you know, having surgery because they don't have those muscle stores.

SPEAKER_01 9:33

And so, yeah, loss of lead muscle mass, loss of strength, loss of metabolism, and then that finally is that loss of resilience when things happen. And so, you know, this is especially concerning in people that are over 40, if you're already sedentary, or like we just talked about, if you're post-injury, or if you're you know something happens to you, you know, you're dealing with an illness, or you develop like a chronic illness. Um and sarcopenia is already it's you know, so it's almost something that like no one ever really talked about that much until like the last couple years, but that sort of chronic loss of muscle mass as we age, we know that older people are more subject to that sarcopenia, and that just you know, frailty is a huge problem and a huge uh cause of more of mortality, and so under muscled, understrength, that rapid weight loss compounds that issue.

SPEAKER_00 10:34

And so as you're shrinking down, and I just say that because it's like the common thing, oh yeah, I want to shrink down, like this is great. But if we don't do it in a planned, strategic, healthy way, this is what you're talking about. Your metabolism is going down, you're losing muscle stores. Whether you're doing things at your best in a healthy way or not, you're gonna be losing muscle. Um, but if you don't really get on, get after it or think about all these pieces of the puzzle, this is what you're talking about. Like these are this is the unhealthy way when you're losing a lot of weight. Like it's not actually gonna be as healthy for you.

SPEAKER_01 11:10

What do you like? How do you hierarchy the list of priorities for your patients when they're going through dramatic weight loss? Like what priority do you put things into um that they should be thinking about from a new just a pure nutrition standpoint?

SPEAKER_00 11:28

If it's rapid weight loss, like on a drug or just in well, for I guess it might be interesting to talk about, you know, maybe some of the bariatric patients or I would say across the board it is, I mean, across the board it is protein because we know you're gonna lose muscle already. So protein, protein. All we talk about is protein, I know, but like, and I even get sick of talking about it, but it is so important. So bariatric world, that was the number one. Well, fluids, you know, fluids, because also with volume, same with bariatric um surgeries, shrinking the stomach, um, and GLP ones, if it's a volume thing or an appetite restriction and slow digestion, slowed gastric emptying, that's gonna impact your fluid too. So one hydration, dehydration is very concerning as well. Um, drinking your water. Yes, yes, sip that water. Um, so dehydration is one that's kind of like a uh, you know, a different category, but not really. And then protein. So we we want to avoid losing as much muscle as possible. We know there's gonna be some muscle loss, but protein, you know, the easiest forms of protein. I know we've talked about this before, but like the gentler, you know, easier to eat proteins like that are softer, maybe, or you can eat more volume and get more protein, the most efficient sources too. So for some people, like appetite-wise and what they're craving um after surgery, or while on a GLP one, it might be just getting what sounds the most appetizing to you. But also we want to think about what's the most protein per gram or per ounce. Like what is what's actually like I know you don't love you know chicken thighs or chicken breasts, but like shredded chicken breasts is gonna get you the most protein for the less amount of food. Right. So you might want to stick with that.

SPEAKER_01 13:16

And you're also not getting the fat. And I know that that's you know, kind of fat is satiating, and so it's gonna fill you up. And so if you're having a meat or a protein source that is also really high in fat, you're not gonna be able to eat as much of that because you're gonna be filling up much more quickly.

SPEAKER_00 13:33

Right. And that's that's a predicament too, because when you lose a lot of weight, you you know, you don't want to push the fat, it's gonna fill them up a lot quicker. At the same time, we need fat to absorb vitamins. We need fat for hormone function, especially sex hormones. We need um fat is so important for our body. So you still want to get some, but maybe at the end of the meal or you know, doing the order of eating. So I would say fluids, protein. Um, and then I try to get those good micronutrients through Whole Foods in as best possible. So with limited appetite and less eating in general coming in, focus on protein and produce, like getting some vegetables, getting some fruits. Again, maybe in a form that's easier. Um, we don't want to spike the blood sugar all day long. So I'm not saying like a juice or a smoothie, but whatever is easiest to eat more of like cooked down steamed vegetables versus a bunch of raw vegetables, right? That's gonna be easier to eat and not take quite as much effort and volume. So you definitely want to get those nutrients in there. But I would also probably recommend if there's rapid weight loss going on, uh, some sort of some form of whole food vitamin to get a little bit extra in because it's just gonna be hard to get the nutrients your body needs to function. Yeah. Um, and then we don't want to be, you know, scared of carbs, but they again they're kind of like fats, they might fill you up, you know, if you're eating breads and things like that with limited appetite. We might want to save those for the end, or again, get easier to eat carbs or fruits instead of grains, you know, um heavier starches. So fruit let fruits maybe be your carbs instead.

SPEAKER_01 15:08

What are the vitamins and minerals that you know we're seeing just a little bit more of that are a little bit more concerning? Like what are the ones that you know they're really seeing a big loss of?

SPEAKER_00 15:20

I mean, it could be anything, but in general, it's hard to get if you actually log your food and there's an estimate like on a um an app like chronometer or something where you can actually see your daily totals, may not be 100% accurate every day, but there's a lot of nutrients you're probably already low on. So fiber, number one. We know fiber, but that's you know, a form of carb. Um, and then things like you know, B12 might be hard, um, or omega fat or omega-3s, um, of course, are gonna be hard to get in. Um, a lot of people could be low on vitamin A, vitamin C, like these antioxidants and um, you know, these nutrients that are really important for like our immune system. So it really depends on the person. If they don't eat a lot of meat, then the B vitamins might be down a little bit or iron might be low. I don't know how it's I mean, it's a it's it could be anything.

SPEAKER_01 16:09

How can you hit your protein goal if you're not eating meat on a GLP1? That just seems protein shakes, I guess. Impossible.

SPEAKER_00 16:17

Yeah, that's where like the liquid might come in. I mean, the liquid might be hard, but for some people, liquid's hard volume-wise, right? But for some people, it's also like kind of funnels through your stomach, it kind of falls through. So that might be a better um, especially if you don't have appetite and you need your protein, that's where protein shakes could really come into play.

SPEAKER_01 16:39

And that's tough. So, you know, one of the things I'm seeing, and one of the questions I had and as I was doing my research is like, okay, so we're seeing people become under-muscled, and like, what is the next step of that? And it's like, I don't think that there has there hasn't been a lot of research yet connecting this dramatic weight loss to things like osteoporosis, osteopenia, but you know, I know that the way bones are formed and maintained is through muscle contraction. And so, you know, naturally, and that's why osteoporosis, osteopenia is more prevalent in older adults, especially under muscled adults. But you if you don't have the muscle contracting, then you're not getting the bending forces on the bone, which stimulate the osteoblasts, which are the bone-making cells, to know where to go to fortify and strengthen that bone. And so, like, you know, part of my concern is that, you know, we're we're you know, we're dropping the weight, and that's great, but we're also, you know, there's so many people who are just like, you know, almost just like withering away and not really getting.

SPEAKER_00 17:55

I think we haven't hit that, like it's so new still, especially GLP ones, if we're talking more about that.

SPEAKER_01 18:00

And new for like it's not a new drug, but it's just new for like the wide for like the wide wider population.

SPEAKER_00 18:07

And it's widespread. So it's like, okay, you know, everyone's like, okay, this is I can talk about this now. It's it's you know, um, it's okay, and so many people are doing it, it's normalized, and it's you know, it's fine, and I don't feel embarrassed or whatever it is, which is good. And so we're in this new phase where people are using it. Some people I find still struggle with weight loss on it. Some people do very well, but it's like, great, I've lost this weight, I don't have the food noise, and everything is great, and but we're not thinking about that long-term uh effect or or how it's gonna affect you know our bodies long term, or we're getting used to the new bodies and and you know, getting the new clothes still and all this stuff. But what are you seeing in the, you know, on the PT side or the training side of those people who have lost weight, you know, over time and they're not used to it, or maybe um, what are you seeing like one of the things that's kind of interesting, and it's you know, it's definitely an association.

SPEAKER_01 19:04

It's I can't say like this is research backed or anything, but one of the things I was I was working with one of my patients that is uh has been taking a GLP one and lost, I think 30 or 40 pounds, and they were having some low back pain that had just sort of crept up and you know, they hadn't been dealing with it um for a while, and then all of a sudden it was like just little things were really causing um the low back pain, and you know, it's kind of like, well, I wonder if you know the core musculature is also part of that either loss or just the change anatomy is changing. Exactly, because yeah, you know, when we think about the core, it's easy to just think about the abdominal muscles. So you have the you know, rectus abdominis, you have the internal and external obliques, and you have the transverse abdominus that kind of wraps around from the back to the front.

SPEAKER_00 20:01

Yeah, I always forget about that. It's actually like through the back.

SPEAKER_01 20:04

Yeah, it's like a corset, yeah. Like wraps around like a corset. And then you also have the muscles of the low back, so the the multifidae, which are the uh individual uh segmental movers of the spine, but also the global stabilizers, and then you have the pelvic floor, the glutes. I mean, like all of that, I mean, all of that really is making up the the core because it's all about your ability to control your pelvis and support your back. And so when we have really good core strength, we're basically like creating a cone of muscle contraction around the spine that's helping to support the spine. And so, you know, it's always been that when we are treating low back patients, we're looking for imbalances of you know, tightness and weakness. But now, and and I it, you know, again, it's it's kind of a loose association. But if you think about like this is something so common, but you know, when a woman goes through pregnancy, they're having their abs sort of stretched out. Yeah. Well, it's it's more just like stretching out, like whether you get that like full separation or diastasis recti in the front, they're still like changing the tone of the muscle. I always say that every muscle has an ideal, and I don't I didn't make this up, I learned this in PT school, but every muscle has an optimal length tension relationship. So if we think about length, you're thinking about like point A to point B. So like just literally the length. And that can be affected by things like posture or instability, where you know, for instance, like in your foot, if you pronate a lot, like you're changing that length of that muscle. But the tone is what's really interesting. So if you think about like point A to point B being a rope, like how tight is that rope? And there's an opportunity. Optimal amount of tone where we can like move freely and things aren't on all the time, and the muscle is able to contract and relax and and just is in a good functional state. Well, you know, right after pregnancy, you know this, the core mechanics are all thrown off because you had one day you woke up and you had a large belly with a baby inside of it, and then the next day that baby's gone and the core is just like right, it's just there's nothing there anymore. And you know, that same thing isn't happening with weight loss like overnight, like it does with pregnancy, but with rapid weight loss, especially if you're not also attending to the core mechanics and that coordination of the core, it's just an easy recipe for low back pain to come on.

SPEAKER_02 22:49

Yeah.

SPEAKER_01 22:50

And so I, you know, I don't even know that it's necessarily like a loss of like core muscle mass, although there's probably some of that going on. Yeah. But it's probably just, you know, a changing of the position and a changing of, like you said, kind of the anatomy where things were once stretched out and now they're now they're being, you know, kind of restricted. And so we have to retrain that. We have to focus on the core mechanics. And a lot of people don't know this. This is what's really interesting about low back pain. The core, like to have effective core mechanics, it really starts at the pelvic floor. A lot of people are starting to learn about this. And like, yeah, when I talk to my male patients about pelvic floor exercises and kegels and stuff. Yeah, they're like, Yeah, I don't have that. I'm like, oh yeah, you do. It's just been peeing and you had to like cinch it off really quick, like that is your keegel.

SPEAKER_00 23:45

Talk about that as the uh analogy of a kegel.

SPEAKER_01 23:48

Yeah. And so um, you know, I talked to my obviously my uh female patients, they all know what a kegel is, but um, for you know, it's basically it's your pelvic floor, it's that cinching of um of uh if you were urinating, like stopping that urination, that's one way to think about it. But essentially it's that contraction of the pelvic floor. Well, the pelvic floor is working all the time. So like you go to grab the doorknob and pull the door toward you, your pelvic floor is activating like a half second. It's actually less than that, it's like just like a couple milliseconds before you go to actually intentionally pull the door. And that's what grounds your body down so that you're not pulling yourself toward the door, you're pulling the door toward you. Yeah, and so that is your core kind of firing up so that you're stabilized and you can ground yourself and pull the door. So the pelvic floor contracts first, then your transverse abdominis contracts, and then your little muscles of the lumbar spine, so those multifidae. And so without good pelvic floor contraction, without that transverse abdominus, and think it's a reflexive loop of contractions. So the pelvic floor goes, then the transverse abdominus, and then the multifidae. Well, if we've just spent all this time stretching out the multifidae, and now we've changed that behavior, you're really interrupting that reflexive loop of contractions. And so now you're relying on your on your more passive stabilizers, which is the disc and the ligaments, instead of your active stabilizers, which are the muscles.

SPEAKER_00 25:22

And I would assume this is related with rapid weight loss. You are people more uh hyperflexible all of a sudden after they've lost a lot of weight, or do they, or maybe just moving differently in their bodies, so they like might be moving in a more flexible way that they weren't used to? Because I don't know.

SPEAKER_01 25:39

Yeah, I don't know that flexibility, you know, and so there's so there's flexibility and then there's mo like mobility in general. And so we tend to think about like mobility as it more relates to, or like a hypermobility is more relates to how the joint moves, which can be a function of obviously like how flexible the muscles are, but it's also some of the stuff around like the ligaments and the capsule and things like that. So I don't know that I can draw that conclusion.

SPEAKER_00 26:10

I guess I'm just thinking about, you know, you have the stomach during pregnancy, right? So you're you're get you're used to like just not being able to move the same way. And then once it's gone, I mean, obviously there's a lot of fluid and it's not totally gone, you it takes a little while to lose it. But then people just jump right back into things maybe they're supposed to do. So maybe that's more of more of a mobility thing, but like same with losing a lot of weight. If you have a lot of weight, you're not able to move in certain ways. Yeah, you're losing it.

SPEAKER_01 26:36

I see what you're saying. You cannot like a functional mobility.

SPEAKER_00 26:38

Yeah, like now you can well, and you might take it a little bit too far or like pull some stuff or maybe strain things that aren't used to being stabilized.

SPEAKER_01 26:47

I was just reading an article the other day about like how people, you know, on GLP 1s and who are experiencing this rapid weight loss are like like ready to start their life in a certain way, like they're at their new athletic lives and enjoy their new bodies, which is what we want, right? Yeah. But they may not have the tissue tolerance yet. And so I see this with a lot of my athletes who take an off-season, yeah, and they're not doing strength training, they're not loading their joints like throughout the off-season. They get back, they start running, they get on the field, and boom, they pull a muscle.

SPEAKER_02 27:27

Yeah.

SPEAKER_01 27:27

And it's just that they haven't been giving their muscles the tissue tolerance to be able to accept those really high ground reaction forces that happen when you're running. You know, I always say like um, you know, people want to run to get in shape, and you need to get in shape to run.

SPEAKER_00 27:45

Yeah.

SPEAKER_01 27:46

Because every step you're taking is, you know, upwards of 2.5 times your body weight being driven into the ground in single leg stance. So you need to be able to absorb those forces. And if like you're someone who hasn't run in a long time and you've had some weight loss, and you're like, okay, I want to get strong, you're probably much better off doing a strength program or resistance program to start than getting into something high impact cardio like running or well there because that'd be so disappointing.

SPEAKER_00 28:20

Like you lose weight, you're feeling great, yeah, boom, you get injured. Yeah. Like, oh my gosh. Like this, maybe you wouldn't be, you know, maybe you wouldn't gain the weight that you might have used to have gained when you're injured or not as as uh, you know, exercising as much. But that's probably a buzz girl. You're like, oh, I was getting back for this and feeling feeling myself.

SPEAKER_01 28:40

So and in the weight room, I think it's also important, you know, we talk about all these different like how many reps, how many sets? And I think it's a little bit more of just like a mentality thing. When you know, I am kind of uh I'm at a weight where like I want to gain muscle, lose fat, but I don't really want to increase my weight all that much. So I'm not I'm not really doing hypertrophy training quite as much. I'm focusing more on strength and just being able to like have muscular endurance. Yeah. And so there's hypertrophy training, which is you know, sort of it's it's just a higher rep volume because you're tearing the muscle and you're you're really trying to take the muscle to failure so that you're getting that tearing of the muscle, then you give it protein, and then the muscle rebuilds itself stronger and a little bit bigger. Strength training for strength is typically higher weights and lower reps, and there's more of a focus on that neurological system. So near that neuromuscular recruitment system. So you're trying to organize more of your muscle fibers, more of your muscles in that pattern of movement together, coordinating those contractions so that you can lift heavier and heavier weight. And that's how you build strength as opposed to building size of your muscles. For our people who are having this dramatic weight loss, I think they should be prioritizing hypertrophy training over strength training, particularly because if they're having a lot of lean muscle mass, it's probably affecting some of their deep stabilizing muscles.

SPEAKER_02 30:30

Yeah.

SPEAKER_01 30:30

So until they've, you know, like I said, built up that tissue tolerance and you know, gotten some reps under their belt, then you know, it's probably more important for them to be focusing on a little bit lighter weight, a little bit more taking reps to failure.

SPEAKER_00 30:45

Yeah.

SPEAKER_01 30:46

Yeah.

SPEAKER_00 30:47

Um, so what would that look like? Like if you, what would be your biggest takeaway, you know, plan for someone if they were had lost a lot of weight, what type of training would that be? Or what type of classes would that be? What would that look like? Like HIT training, circuit style training, or no?

SPEAKER_01 31:07

I don't think I would do HIT. I think I would, I would because that's gonna be a little bit usually that's a little bit more like high impact. Yeah.

SPEAKER_00 31:14

And then, you know, and if it's quick, they and it may not be as many reps like you're saying, the hypertrophy.

SPEAKER_01 31:20

Yeah, and it's it's also like sometimes we have these, you know, post-pregnancy type workout classes that are like a lot of burpees and jumps and stuff. And you know me, I'm like, number one, you've just like filled your body with elastin, which is a hormone that makes your ligaments looser so that you can pass the baby through, right? Through the pelvis. But two, like your core is not ready to accept those loads yet. So we really need to focus, like I said, on more. I mean, I hate to say like doing more machines and stuff, but you know, things in a seated position, um, lower loads where you're you're making sure that you have good stability. I would probably still do more of my typical like split where I prioritize like a hip dominant pattern one day with a mixture of, and what I mean by that is like more of your deadlift pattern, and then with a mixture of accessory work of vertical pulls and horizontal presses, some good core exercises, and then another training day, prioritize more knee dominant patterns, so more of your squat pattern with the opposite pull. So if I just said horizontal pull, then I would say, you know, vertical pull and horizontal presses. And so, you know, just but still doing the weights in a way where you feel like you have a lot of control and you're kind of taking the rep volume up to what whatever it is where you have like one or two reps left in the tank, but you can't do like three.

SPEAKER_00 33:03

Yeah.

SPEAKER_01 33:04

Right. And so that might be 12 reps, that might be 15 reps, and maybe you do three or three to five sets of that. But you know, when we're talking about like trying to build strength, you're probably doing like three to five reps. Yeah. And you're really pushing the weight. Yeah. So that's what I would say to start with. And and then after a couple months, as you've like developed some of those motor programs and gotten used to that, then you can start like increasing the weight and dropping the reps down, depending on your goals.