Hi Doctors,
First off, a little bit of background. This is the case of someone close to me. She’s 50 ish years old, around 5’5’’ (165 cm) tall and weighs 207 pounds (94 kg). Waist circumeference 40.5 inches (103 cm) and completely sedentary. She did some strength training during the lockdown in april and may. She then stopped when “normal life” resumed. Weight has been slowly creeping up during the last 23 years. She had a knee operation last year because of broken cruciate ligaments.
She has recently decided its time to lose weight. However, due to covid and her business being heavily affected, this is not the best time to hire a coach. So I tried to help her lose some weight, at least to get started, and later refer her to a professional if we did not get to lose weight. I have been strength training for roughly 2.5 years and consume a lot of your content on training and nutrition.
Thanks to your articles and guidelines we started by taking a normal week and counting everyhing she put into her mouth. I was not sure she’d do it right because she’d never counted calories before, so I did it with her for 2 or 3 days to show her how to do it. I have recently lost 20 pounds counting calories and macros, so I have a bit of experience on this. The average calories were 1250, with protein being around 45g per day. I first thought this was what Jordan always says, that usually people underreport their eating. However, I counted it with her for the most part so I was about 50% sure the numbers were right. Her weight during the week went up a bit (1 kg).
My understanding was: Taking into account that eating 1200 cals is not a lot, I did not think that reducing calories was wise because weight loss would stall at some point only to then reduce calories even more. We discussed it and she is on board with the idea of losing weight by increasing daily activity.
With all this in mind, we started the path to behaviour change. We maintained the calories, but increasing protein at first. We first tried to be on the lower end of the reccomended amount (1,6 g/kg) but it was too much protein for her. She struggles with that much filling food because she’s used to eating more calorie dense foods in less amount. At the end we established the following: 1200-1300 cals and minimum of 100g of protein, just to start somewhere, 3 servings of red and processed meat per week, 5 servings of fruit and vegetables per day
As for training, we started strength training 3x a week at home with a set of loadable dumbbells (the training is inspired on the beginner prescription article). Apart from that, using the case studies detailed in the article “to be a beast”, she started as well doing 30 min walks 5x a week. Daily step count goal was set to 4500 steps. We added a bit of unilateral quad work, to help gain some muscle mass, as she consciously unloads the operated knee.
She finds it difficult to do the 30 min walks, so from what I have learnt through your content, I think we’d first need to continue what we are doing for a while in order for her to be able to change her behaviour and construct a new habit she’s never had, exercising regularly.
As of right now, we’ve been doing this for 3-4 weeks. She lost a couple of pounds when we started exercising, but since then she’s stalled around 94 kg. The overall balance is that she struggles to eat 100g of protein, and to do the walks 5x a week.
Sorry for the long background, here comes the question. The future plan is to keep strength training, increase the step count, increase protein intake up to around 120-130 g/day, and to work her up to some LISS cardio instead of the walks. I have as well thought of adding a session of HIIT. In short, to keep increasing activity until we see that she loses weight consistently at 1200-1300 calories. You can imagine as well that this is mentally hard for her.
Are we on the right track? Would you have any other suggestions? Is this too complicated and we should seek professional advice? Are her daily calories just too low?
Thank your for your time,
martilopez