The Physician’s Guide to Fitness is a multi-part series that covers the steps you need in order to get in shape and improve your health.   Read parts 1-5 here.

 

Step 7 – General Principles and Training for Women

 

General Principles of Weight Lifting

If you want to shift the momentum further towards the promised land, you will have to put in some extra effort beyond the bedroom, desk, and kitchen. I want to declare what probably is the most important goal of your fitness: to look good! As superficial as that may sound it is an honest statement to identifying your course of action.

 

We have already covered fat loss in Steps 5 and 6 which is the first step towards reaching your goal. The second step is to start increasing your muscle definition from a very lean state.

 

When we’re deciding what should be the mainstay of the exercises to perform, you have to think about your available time and stamina. As a doctor both are much more severely limited. So I highly suggest you cut down on other athletic activities to make time for the most important exercise towards muscle building: weight lifting.

 

Cardio and your hobby sports can be fun and social but you should not expect them to change your physique. What you need is to stimulate muscle fiber with high level tension that will break them apart and rebuild with amino acids.

 

Starting with fat cutting phase in Step 5 it is recommended that you start weight lifting to expedite the process. Follow these guidelines.

 

While following the fat loss protocol, incorporate a good training program that can be used in the gym 3 to 4 times a week with 45 to 60 minutes at a time.
Eating in caloric deficit using the intermittent fasting schedule will hasten your waist reduction
For beginner weight lifters, the first 6 to 12 months will actually yield good muscle growth and fat loss. This is called the newbie gain (fitness lingo for rapid initial muscle gain). If properly done this initial gain can be quite significant. However keep in mind that muscle growth tapers off after it is over. Anyone sophomore athlete would know fat loss and muscle gain has to be separately.
Strength training during fat cutting is very important to preserve the muscle mass you already possess. If you lose fat with nutrition alone, you will reduce in size but be left with a very unimpressively lean look known as skinny fat.
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Form: Good forms concentrate the contraction and activation of target muscles to generate growth. If you use bad forms or cheat (fitness lingo for compensating by using whatever muscles you can to move a weight from point A to point B), you are sabotaging your results. If you are new to weight lifting, take some time to go on Youtube and study the motions of the exercises. A good program usually has 4-8 exercises prescribed on a given day so take a few minutes to memorize them before going to the gym. Take your phone to the gym and look up videos if you forget how to do them. If you feel uncomfortable with an exercise for potential injury, start very light or ask someone to spot you. Do not be afraid to ask other people in the gym for help. There is a set of unwritten etiquette in the gym and respect is very high on the list. I’ve been training for over a dozen years and I still have to look them up sometimes and study forms of advanced lifters.

Sets, reps, and rests: An exercise is created in sets, reps, with insertions of short rests. For example an incline bench will be written as 3 sets of 8 reps with 60 seconds of rests. That means you’ll lift 8 incline bench presses, rest 60 seconds between, and do that 3 times total. Your time is limited. Refrain from chatting and texting too much and take good pace by using a stop watch to take the rest periods. Try to finish all the reps with each set. The real progress comes at the final 2-3 reps when your muscles are fatigued and the lactic acid piles up. However if you do feel concerned for injury then just stop and reassess.

• Progressive overload: This is an incredibly important metric to track. As you repeat your exercises throughout many weeks, you have to lift heavier as you go along. If you’re performing lunges with a pair of 20 lbs dumbbells, try a pair of 25 lbs the following week. If however your form is broken because it’s too heavy, drop back to 20 lbs during the next set then try again with the heavier set. Write down your weights on a note pad like I mentioned in Step 4. This is a notoriously ignored practice at the gym. So many people just allow their memories to dictate their progress and end up lifting the same weights for weeks which does not lead anywhere. During muscle building, you will run into plateaus very often. If you are still making progress by lifting heavier, it’s a sign that you’re on the right track and you are potentiating muscle hypertrophy if you are a men and muscle definition if you are a women. Strength = Progress.
• Workout all body parts: A good workout program will usually pair up two body parts a day and target all major muscle groups throughout the week. Some of the usual pitfalls of training is skipping lower body workouts that create more anabolic hormones. You do not want to build an imbalanced body. Another major mistake is obsessing over abdominal workouts. Abs are generally unimpressive if your overall muscle definition is weak. More importantly you cannot even see them if you have not cut down enough body fat. A big Zen principle I have come to embrace is worry about your abs until the very end.
Once you have cut down your fat with a deficit followed by reverse dieting as I explained in Step 6, you have to adjust your nutrition to work towards muscle building. The traditional building has been known as bulking which involves taking a huge caloric surplus, lifting heavy weights, and gaining both muscles and fat. What we want to do is take our time to slowly adjust and build muscle incrementally while keeping the fat level as minimal as possible. This is a concept known as lean building.

 

• Maintain your BMR for at least 4 weeks using the 12:12 split IF. During muscle building 12:12 split is the best choice to maintain a steady dose of fasting to keep the fat level down.
• Once you have seen some results with your BMR, you can raise your calories to enter a caloric surplus state. The recommended surplus is an extra 200 calories at most. MY BMR is 2200 a day so I have been making the most progress with ideally at 2400 calories per day. The easiest way to do this is to eat the same amount of food for BRM and just take 1 or 2 more scoops of Whey protein. One scoop of high quality Whey protein has about 20-25 grams of protein with 100-125 calories. While cutting I get 50 grams of protein from food and another 50 from Whey. With lean building I would take either 75 or 100 grams from Whey protein and get 50 grams from food. When my waist got a little bigger I simply reduced one scoop of protein and I was able to bring the fat level back down. Always keep things simple.
• Continue to track your waist to make sure the fat gain is prevented. Unfortunately there will be some fat gain if you’re on a caloric surplus. The truth is you need a little extra fat during building phase because lifting heavier weight at a really ripped (similar to being cut, the term describes a state of leanness) state does not yield so much strength moving forward. My golden waist is about 30.5 inches and I have stayed at 32 inch waist for months while making steady increase in strength and muscle mass. The recommended wiggle room is to allow about 1 to 1.5 inches of waist increase in the waist. If you are regressing too much during weekly checks, reassess and cut down your caloric intake.
• Carbs: I already explained this in Step 5 and I will reiterate its importance. To lift heavier weights, you need to maintain good glycogen storage. More importantly you need a steady boost of serotonin for motivation to go to the gym and follow through your workout while fighting through fatigue and stress. Carbohydrate is the fuel for all of them. Do not skip your carbs.

 

 

• Sleep: Once again I will hammer this concept hard. You must sleep on time! Muscle building has a narrower margin of error because you are targeting multiple goals: keep your fat down with fasting, recharge your stamina daily to hit the gym, balance your inflammatory reactions from the exertion, regulate your hormones for anabolic state. One night of disturbed sleep will offset everything.
• Repeat fat cutting: Once your muscle building is over or there is a vacation season coming, repeat the caloric deficit with a 16:8 split and reverse dieting with a 12:12 split to cut down the little amount of fat you may have gained. Take an after picture for your progress and enjoy. If you are not quite done, repeat the lean building and cutting for a good 3-6 month interval depending on your schedule until you are finished.

 

Advice for Women

While the guideline I explained above is a generally applicable for both genders, women have a separate standard for physical beauty which must be addressed. Evolutionary psychologist Geoffrey Miller elaborates the importance of physical attractiveness for many reasons. To women attaining physical beauty is extremely important. Beauty was literally the sole means of survival for the female gender for a long time. Circumstances have significantly changed as intangible values of intelligence and cooperative attitude play much larger role in modern times. Nevertheless there is a deeper biologically driven instinct to look and feel the best which often transcends men’s need for beauty.

 

Sadly the mainstream media has skewered and misinformed women with the most awful standards and advice for feminine beauty for decades. The traditional advice is to eat little like a bird and do hours of cardio. That model may work to a degree but it is too unsustainable and it generally leads to the skinny fat look. Such severe level of caloric deficit (in the range of 800-1000 calories per day) and cardio exertion has a high probability of disrupting menstrual cycles for pre-menopausal women. Furthermore because there is such little systematic education for nutrition and fitness, women are ill-prepared to reverse the effects of pregnancy after child birth.

 

The desirable body for most women is one that is mostly slim, fit with adequate hints of muscles, and sexy. The steps to attain such body are not very dissimilar to men’s training. The term toning does not mean you take a soft and half-hearted effort to move light weights in the air. It means you are lifting hard and heavy as you can build muscles to create said tone. Another horrible misconception that strikes terror in women is the fear of looking bulky when they lift weights. Women’s endogenous testosterone, the key hormone for muscle synthesis, is but a fraction of men’s level. If you understand that the average adult male who carries 10-20 times more testosterone than an average adult female has a very difficult time putting on muscle (0.5 lb per month after newbie gain), you can understand how ridiculously difficult it is to gain a bulky looking muscle mass for women. The only way a woman can look bulky with muscle building is if she has not properly cut down fat or if she is abusing a lot of drugs. Review Step 5’s comparison of Russell Crowe and Michael Fassbender.

 

These are the recommended tips.

• Fat cutting: Follow Step 5 and 6 and trim your fat down to your calculated golden waist. Women’s muscle definition is showing a thinner layer of muscle tone underneath the skin and fat so shedding excess fat takes care most of the work.
• Progressive overload: Strive towards lifting as heavy as you can with the best form.
• Forget cardio: Though cardio has its benefits, the amount of hunger generation and exhaustion just does not merit its effort. With 4-6 hours invested towards fitness per week, use them for lifting weights and recovery like stretching. The amount of walking during rounds and seeing patients is plenty of cardio that can burn up to 300 calories without making you hungry and sleepy. I have tried all sorts of cardio for years and I can confidently say it is pathetically useless.
• Gluteal exercises: The butt is a highly coveted female body part to master. While following your program, put in careful and utmost effort to achieve good form and strength with squats, lunges, and dead lifts.
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• Female Golden Ratio: Though it is up to you to decide what your final goal is, a golden ratio for women can be a good final measuring stick. In addition to the golden waist from Step 6, you will add two more metric every week measuring the widest shoulder and hip circumferences.
o Golden waist = Height in inches x 0.382
o Golden shoulder = Golden waist x 1.618
o Golden hip = Golden waist x 1.42

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The best example of a slim and athletic female celebrity that I have seen is Canadian actress Missy Peregrym who starred in Stick It as a gymnast and a police officer in TV series Rookie Blue. The photo indicates built and defined shoulder width and a slim waist and hip fitting into her jeans.

 

For attaining such body, here are some of the most highly recommended female fitness programs (weight lifting routines) that can be purchased from the Internet. The programs are based on the knowledge and track record of the program creators. Review the instructions thoroughly and adhere to them as closely as possible.

 

Thinner Leaner Stronger by Mike Mathews – Mike is a scientist at heart whose successful fitness blog Muscle for Life contains a plethora of articles that heavily relies on scientific journals to back his various fitness concepts. He focuses on the inner game quite heavily before preparing his athletes ready for working out. His book contains a year’s worth of workout routines to follow and he is very responsive to questions in his blog and social media.

 

Goddess Toning Program by Greg O’Gallagher and Dell Farrell – Greg and Dell truly believes in lifestyle emphasis towards flexible nutrition and fitness with intermittent fasting and minimal but concentrated workout hours to spend as little effort as possible to get the most results. Greg runs a blog called Kinobody and Dell has a blog called Ice Cream Gal.

 

Venus Factor by John Barban – The program ditches the scale based tracking and emphasizes the Golden Ratio for measure of success that definitively follows the loss of fat and growth of muscles. Again flexibility is emphasized and the program comes with a nutrition calculator that gives the adjustable caloric intake data every week.

 

Jason Haynes – Jason is my fitness mentor who has extensively helped me overcome my fitness obstacles along with the rigors of medical school. He has a very mature perspective and a patient approach to reaching fitness goals which has translated into my general attitude towards life. He has worked with fitness experts John Barban and Brad Pilon in the past and mastered his craft to the highest level. If you wish to minimize your learning curve short cutting the trial and error, he is the best option to start seeing results ASAP.
From what I’ve observed in my life, women often relegate their attractiveness to externalities. Instead of objective analysis, they sometimes become victims of a toxic notion that people are either born beautiful or not. I wish to put my foot down and persuade everyone to explore their potential by properly educating themselves and put in a concentrated effort to master their own fitness so that they won’t have to feel this way.

 

Mike Mathews have worked with many women and he reports that a consistent effort will require only about 1 to 2 years of hard work to attain 10-15 lbs of lean muscle and reach 17 to 18 % body fat which will give the ideal slim and athletic body. Rest assured because this doesn’t have to take too much time to accomplish. You are doctors. You got the brains and resources to build a great life. You just have to get this little aspect taken care of and you can truly have it all. You will never know who you can be until you have fully tried. Be the beautiful women you were born to be.

 

Resources: Muscles for Life by Mike Mathews, Kinobody by Greg O’Gallagher, Venus Factor by John Barban, Eat Stop Eat by Brad Pilon, Knowledge for Men podcast interview of Geoffrey Miller


Donghyun John Kim

Donghyun John Kim

DO, Founder of Doctors of Steel

John Kim is a Family Medicine Resident and founder of Doctors of Steel. John is passionate about helping medical students and physicians achieve fitness and work-life balance. Learn more at DoctorsOfSteel.com