A Doctor's 8-Week Evidence-Based Fitness Plan for Sustainable Weight Loss

My patients are often overwhelmed by the avalanche of supposed best fitness plans for weight loss. From health influencers to your next door neighbor, it feels like everyone has an opinion!

As a physician who's navigated the challenges of weight management both professionally and personally, I decided to compile some of the best evidence in this field for sustainable weight loss. My goal for this fitness plan is for it to fit a busy lifestyle, having one myself!

This is meant to be an 8-week intro fitness plan for those getting started. It’s a good pairing with GLP-agonist treatment (Wegovy, Ozempic, Mounjaro, or Zepbound) in case that is part of your toolkit for weight management.

1. The Foundation: Aerobic Exercise

Aerobic exercise is the cornerstone of any effective weight loss plan. The American Heart Association recommends moderate-intensity aerobic exercise for improving cardiometabolic health and facilitating weight loss [1][2].

Your 8-week plan:

• Weeks 1-2: Start with 15-minute brisk walks, 3 times a week
• Weeks 3-4: Increase to 20-minute sessions, 4 times a week
• Weeks 5-6: Aim for 25-minute sessions, 5 times a week
• Weeks 7-8: Build up to 30-minute sessions, 5 times a week

Research shows that this gradual increase in aerobic activity can lead to significant reductions in body weight, total fat, and visceral fat [3].

Some practical tips for getting into “zone 2” or this moderate pace.

1. You want to get your heart rate up to the point where you can still talk with some discomfort. If you can speak in full sentences, you’re not walking fast enough. If you are gasping for breath, you’re overshooting (which is fine for higher intensity cardio but possibly not so sustainable for an introductory pace).
2. To increase your heart rate, you can carry an ergonomic backpack with a weight like a rucksack. You can also increase the incline on your treadmill if that is an available feature.
3. Try a stair master for a change if you’re tired of the treadmill. I do this myself once a week!
4. If you prefer, you can try cycling or rowing to get your heart rate up. If you have significant joint pain that restricts all of the above, elliptical machines are sometimes more manageable.
5. Finally, if you’re lucky enough to have access to the great outdoors, I highly recommend trying your walks outside! It’s a wonderful way to get some exposure to the sun and foliage, which is health-inducing in itself.

2. High-Intensity Interval Training (HIIT): Efficiency Meets Effectiveness

HIIT has gained attention for its time-efficiency and effectiveness in reducing body fat percentage and improving cardiorespiratory fitness [6]. Although not the topic of this article, it’s also fantastic for heart and brain health!

Your 8-week plan:

• Weeks 1-4: 1 HIIT session per week (e.g., 30 seconds high intensity, 30 seconds rest, repeat for 10 minutes)
• Weeks 5-8: 2 HIIT sessions per week, increasing duration to 15-20 minutes

If you find yourself running out of time, you can do a HIIT workout instead of the walking workout once or twice a week.

3. Building Strength: Resistance Training

Resistance training is crucial for preserving lean mass during weight loss. The European Association for the Study of Obesity recommends incorporating resistance exercises to maintain muscle mass and strength [4].

Your 8-week plan:

• Weeks 1-4: 2 sessions per week, focusing on bodyweight exercises (push-ups, squats, lunges, planks)
• Weeks 5-8: 3 sessions per week, introducing light weights or resistance bands

So what is better for weight loss, cardio or weights? Trick question! Recent research highlights the enhanced benefits of combining different exercise types. A study in the New England Journal of Medicine found that combining resistance training with aerobic exercise and a reduced-calorie diet was most effective for improving physical function in older adults with obesity [5]. A network meta-analysis found that combined aerobic and resistance training is superior to single-modality exercise for improving various health outcomes in overweight and obese adults [7][8]. Plus, it is far less boring when you switch it up!

Some practical tips:

1. There are plenty of freely available bodyweight workouts on platforms such as Apple Fitness, YouTube, and Instagram. And don’t like the gym bros get you down - you can get a lot out of bodyweight. However, it gets easier if you use weights, so you might want to consider that if you’re finding it difficult to build strength through bodyweight alone.
2. Work with a professional once in a while, or regularly for a month or two. This is because form is one of the most important things to get right to prevent injury and promote healthy strength gain. Find a personal trainer or rehabilitation expert who you feel comfortable with and who listens to your personal needs.
3. If you are already familiar with strength training, just aim to get in 3 sessions of full-body training in each week. This can look like 3 full-body workouts, or shorter splits. I personally do shorter splits and just make sure I’m doing resistance training 5-6 days a week.

Additional Considerations

1. Personalization and Enjoyment

While this plan provides a structured approach, it's crucial to find activities you enjoy. Adherence is key to long-term success, so don't hesitate to modify the plan to include exercises or activities that resonate with you personally.

Some people prefer group exercises, which are fantastic! Just make sure you’re not ignoring either strength training or aerobic exercises if you are primarily doing one type of activity. Also, be sure you’re getting a balanced workout for your muscles (important if your chosen activity is excluded to a part of the body).

2. Realistic Goal-Setting

Set achievable milestones based on the recommendation of losing 1-2 pounds per week. Remember, sustainable weight loss is about long-term lifestyle changes, not quick fixes.

Not to mention, overall health benefits occur over a lifetime. This is meant to be a fitness scaffold that you can build on over time. Lifelong exercise helps you use your body so you don’t lose it!.

3. Recovery and Sleep

Quality sleep and adequate rest between workouts are essential components of a successful fitness plan. Aim for 7-9 hours of sleep per night and listen to your body's need for recovery.

A quick way (although not always accurate) to tell if you need to rest a certain set of muscles is to gauge soreness. Another is to give yourself 48 hours before training the same set of muscles again.

4. The Nutrition Component

While our focus here is on exercise, it's crucial to acknowledge the role of nutrition in weight management. A balanced diet rich in whole foods, lean proteins, and ample vegetables complements your fitness efforts. Stay hydrated (with electrolytes if you’re losing weight relatively quickly) and focus on getting enough fiber and protein.

Conclusion

This 8-week fitness plan is designed to kickstart your weight loss journey in a sustainable, evidence-based manner. Remember, the key to success is consistency and gradual progression. It may seem boring as you’re reading through this guide, but it’s all about consistency. As both a doctor and someone who's been through this process, I have seen this work!

Always consult with your healthcare provider before starting a new fitness regimen, especially if you have existing health conditions or concerns.

Here's to your health and well-being. You've got this!

References:

1. Fletcher GF, Ades PA, Kligfield P, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013;128(8):873-934. doi:10.1161/CIR.0b013e31829b5b44
2. Fletcher GF, Balady GJ, Amsterdam EA, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104(14):1694-740. doi:10.1161/hc3901.095960
3. Petridou A, Siopi A, Mougios V. Exercise in the management of obesity. Metabolism: Clinical and Experimental. 2019;92:163-169. doi:10.1016/j.metabol.2018.10.009
4. Oppert JM, Bellicha A, van Baak MA, et al. Exercise training in the management of overweight and obesity in adults: synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group. Obesity Reviews. 2021;22 Suppl 4:e13273. doi:10.1111/obr.13273
5. Villareal DT, Aguirre L, Gurney AB, et al. Aerobic or resistance exercise, or both, in dieting obese older adults. The New England Journal of Medicine. 2017;376(20):1943-1955. doi:10.1056/NEJMoa1616338
6. Wang H, Cheng R, Xie L, Hu F. Comparative efficacy of exercise training modes on systemic metabolic health in adults with overweight and obesity: a network meta-analysis of randomized controlled trials. Frontiers in Endocrinology. 2023;14:1294362. doi:10.3389/fendo.2023.1294362
7. Batrakoulis A, Jamurtas AZ, Metsios GS, et al. Comparative efficacy of 5 exercise types on cardiometabolic health in overweight and obese adults: a systematic review and network meta-analysis of 81 randomized controlled trials. Circulation: Cardiovascular Quality and Outcomes. 2022;15(6):e008243. doi:10.1161/CIRCOUTCOMES.121.008243
8. Oppert JM, Ciangura C, Bellicha A. Physical activity and exercise for weight loss and maintenance in people living with obesity. Reviews in Endocrine & Metabolic Disorders. 2023;24(5):937-949. doi:10.1007/s11154-023-09805-5

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Until next time - Cheers to your health!

Hillary Lin, MD