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The first one I will go over is the type A overachiever under eater. She is 50 years old, 5’5″ and 130 lbs. She has been lean most of her life, over the past 10 years she’s been gaining and losing the same 5 pounds.

Recently she has had trouble losing those 5 pounds and has gained 5 more, so she wants to lose 10 pounds. She’s a busy professional who often works long hours. She says there’s just not enough time in the day.

She goes for a 3 mile run, 5 days a week after work, to deal with her stress and then a long run on Saturday. She tracks calories at around 1,300 a day, keeping her fat in the lower range. She has worked out and eaten this way for years. She is wondering why it’s just not working for her anymore anymore when it used to be so easy.

She has some issues with her digestion (constipation, bloating) and sleep (has a hard time staying asleep). She’s experiencing mood swings, thinning hair and erratic menstrual cycles. To say that she’s stressed out is an understatement, she says she eats stress for breakfast.

This is what I would do for this hypothetical client.

This client is dealing with some adrenal and possible thyroid issues with her cortisol and estrogen being high and progesterone being low. What I would recommend is balancing her hormones and bringing cortisol down while also increasing her metabolism.

To do this we would first address her diet and spend some time bringing her up to maintenance calories. Since she’s so low this is going to take time and this client is most likely going to be resistant to the idea of eating more at first.

We also need to address the stress levels as that is what’s driving unstable hormones and high cortisol levels. High levels of cortisol affect not only weight loss but also will dictate where fat is stored, predominantly in the midsection. This is done through diet as well as implementing some changes to her current training protocol and lifestyle.

This client will be able to reach her weight goals once we address the hormonal imbalances. This is what I would recommend for this client’s diet and exercise protocol.

I would recommend increasing calories. I would start by bringing her up to 1500 calories. This may take time for her to get used to and she will gain a little bit of weight. Once the body adjusts to getting more calories, the weight will start to even out. We can add calories in 100 calorie increments every couple of weeks until she gets to about 1900. This could take anywhere from 6-10 weeks depending on how quickly her body adjusts to these changes. Incorporating nutrient dense foods as well as healthy fats will improve her hormone balance and metabolism. Once we get her to 1900 calories for a bit we can then go into a deficit. Her body will be adjusted to the higher calories and will be in a good place and ready to release that weight. She should be able to lose ½ pound per week to get her to her goal in 2-3 months from this point. This is why it’s so important to eat enough calories to support your body and avoid this scenario in the first place.

I would also recommend she trade those stress-inducing runs for something like walking or yoga and use that as her stress release. She is probably not going to be too happy about not going for her runs, but this is an important piece to bring her stress levels and cortisol down. I’d also like to see her going to the gym to train two days a week, ideally three.  Her week could look something like this:


Monday- yoga to get ready for the week 

Tuesday- Weight training

 Wednesday- go for that run 

Thursday -Weight training

Friday- yoga to end the week

Saturday she can do her long run.

By implementing this schedule, she will find that she’s going to sleep better, she’s going to be less stressed, digestion issues will be less frequent and her cycle won’t be as erratic.

You might be thinking that she would gain weight by not running. She wasn’t burning as many calories as you might think that she was due to the metabolic adaptation. She’s also taking a lot of stress off her body which is going to help her metabolism. By adding the weight training she’ll be putting on calorie burning muscle and those calories will be used to build those muscles. Getting her body into a relaxed state instead of in a constant state of activity will improve her overall health and well being. Those extra calories are going to go a long way to improving those markers as well and we should see a great improvement in hormones and metabolism.

The next common scenario is the weekend binger.

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