This is doctor talks. Real talk from real doctors. Only issues that matter to you most. In this doctor talks, we are going to dive into strength training.

Resistance training, what it is, why you need it, what you most might want to do. And with me, I have a guest doctor, Kerry Holland. She is a family physician who also has additional certifications in personal training, health coaching and life coaching.

So we are going to cover strength training and also some of the mindset around starting with exercise, starting with lifestyle changes. Thank you so much for joining me.

Doctor Holland. Thanks so much for having me I appreciate it. It's great to be here. So let's start off with a little bit of the basics. We have always heard.

I think that exercise is important. It seems like there's been an emphasis, on cardio, on walking and running and that sort of thing. And we're hearing a ton about resistance or strength training right now.

Why are we hearing that? Why is it important? Well, I think the tides in medicine are turning, and this is a good shift for sure. And it used to be the you're right, I agree.

It used to be that everything was about cardio and that if you want to get fit, you go sweat your tail off. But now we're learning that the cardiovascular piece is just one small piece of that puzzle, and now we're seeing more and more.

That muscle is really the key to our longevity. It's the key to living a strong and like full life. And so now now the focus is not just on cardio but also on building muscle.

And so now we're seeing it all over the place, which is awesome. Yeah. Can you talk a little bit more about what some of those health benefits and why it is important to longevity?

Living longer, living better? Absolutely. I mean, if you think about our function of muscle, like what does it do all day, it contracts and relaxes all day long to get us through all of our daily activities.

So getting up the stairs, picking up a box of groceries from the back of the car, putting on your shoes, all of those things are foundational. Reaching overhead to put your suitcase in the overhead compartment in your plane.

All of those are functional moves that unfortunately, we are going to lose the capacity to do as we get older. If we don't hang on to our muscle. So there's simply just the function of function that we need muscle in order to function as we get older.

And also we want we want to feel good. Having muscle can also help us to feel better. So now we know that even just a simple bout of exercise, it used to be the whole idea of the runner's high.

But now we know that we can get that same runner's high from strength training, and so you can walk away from a single bout of strength training feeling better.

And that's and that's beyond all of the health benefits that we've had, like combat sarcopenia. So the natural age related muscle loss that we have, we can combat that by strength training.

There's improved insulin resistance by strength training. There's obviously the impact potential on our weight, which we can get into into a couple of minutes.

But there are so many reasons that strength training is where it's at now. Well, let's this you know, the theme of this summit is medical weight loss.

So when we think about strength training and its role for weight loss, can you tell us more what that role is. And I'll also ask you if you can cover, is it possible to gain muscle while losing weight or losing fat?

Sure. So let's talk about the first one. So can you, can you repeat the first one again? Cause I want to make sure that I address them each separately.

Yeah. So what is the role of strength training for weight loss. Oh yes. Okay. So when we're talking about muscles and strength training and weight loss it really is coming back to our metabolism.

So the way that I like to look at this is when we go about strength training. The idea is, is that we're adding to our metabolism. So if we what we know about medicine and what we know about the human body is that muscle takes more energy to sustain itself than does fat.

And so the goal in any weight loss and for me, is really to try to increase the amount of muscle that we have, because that is ultimately going to have a huge impact on your metabolism.

So I think of it less as taking fat away and more of building muscle. And so sometimes when I'm working with people, sometimes I will suggest to them that rather than being so focused on losing fat, that we instead focus on building muscle first, because we know that the more muscle that you have, the higher your resting metabolism is going to be, and so if you have somebody, for example, that does not have a lot of muscle to begin with, and then we're trying to create a caloric deficit on top of that, we don't have a lot to work with.

And so instead of trying to take calories away from somebody who already doesn't have a high calorie need, instead my goal would be, hey, let's put on some muscle, because the more muscle you have, then we're working with your metabolism and we're boosting your metabolism.

So I think of it as coins in a bank. The more muscle you have, the more coins in your metabolism you're putting in that bank. And so we really want to bolster that.

So that's where I really start. And that's a huge mindset shift because so often we're so busy worrying about losing fat, losing fat and getting smaller.

But it's not about getting smaller, it's about getting stronger. And there's a huge difference I love that. That's really powerful. And I actually don't know that I've heard someone ever describe it that way before.

So, to think about, you know, if you are one of those people who already kind of has low muscle mass, has a low metabolic rate, maybe older postmenopausal or maybe just in general.

Right. Like that's just your body type. You don't naturally have a lot of muscle that maybe one of the first steps you might want to do is actually increasing that muscle, increase your metabolic rate, improve your strength and energy.

And then maybe you focus on the other stuff when you already have this better foundation. I love that strategy well, and it's two fold, right? Because there's the physical piece. It feels good to put on muscle.

Like muscle just feels good. I mean, there's just nothing quite like feeling strong and knowing, hey, I can lift that box myself. I got it. But then there's also the psychological piece because again, we're just talking about taking away, taking away.

When we think about fat loss, what do we think of? We think of, oh, I'm not gonna be able to eat this. I'm not going to do that or all these things. I'm not going to be able to eat. I'm not gonna be able to have.

But instead, we're talking about adding to your body and adding to your body in the most, like, healthy way possible. We're adding muscle, which is what we're meant to have.

So I think the psychological piece of that also is super important. And it also just gives us a different framework. It's like, oh, I'm not. I actually need to I actually need to eat to fuel my muscles instead of I need to not eat so that I can lose all this fat.

It's a huge mindset shift. Yes, instead of coming from this place of restriction, which is often where we have so much mindset struggle and physiologic struggle when it's time to lose weight, right?

It's like, what if we're adding stuff to our life instead of focusing on taking things away? I love it 100%. Absolutely. And I think, too, that that's a good transition to the other part.

I was asking, is it possible for people to be losing fat while putting on muscle at the same time? Yes. So we're talking recomposition here, and I feel like that's another word that's kind of around in the fitness and medical literature.

And it comes up all the time. So is it possible to do both? Can you lose fat and put on muscle at the same time? And the if the quick and dirty answer is yes.

But there's always a caveat, right? It can be complicated, and a lot of it depends on where you're coming from. So if you already are at a healthy weight and don't have a lot of muscle mass, then yes, it is absolutely possible to do it.

But it may mean eating a little differently. So we have to look at how much food you're taking in, and it may mean that you eat in a slight caloric surplus in order to build muscle.

And as soon as I see that, I see the eyebrows go up because everybody's like, well, what does that mean? Right? And so we really have to dive into that because again, I'm talking about mind here and what diet culture and diet history has told us.

It means if I want to lose, I have to take away something. I have to eat less, when in fact, sometimes if the goal is to build muscle while losing fat at the same time, especially in somebody who's already at a normal weight, it may mean that we're eating a little bit more, because again, you have to fuel your muscles.

Think about what muscle building is. It's an anabolic process we're building. What does that require? It requires calories. So where are those calories going to come from.

And you're if you're in a severe caloric deficit, that's not going to work. And so it may be an uphill battle. And so we really have to wrap our minds around, okay, I want to build muscle, but I have to eat in order to fuel my muscles.

And so and when I say eat, I don't mean bonbons and candy, I mean whole grains, I mean protein, I mean adequately fuel your muscles with solid proteins and full whole grains so that this process is supported because otherwise you can be working against yourself.

So that's where the recomposition piece can get fuzzy. But it's crazy because there's literature that has shown recomposition in all three scenarios in a caloric deficit, in caloric maintenance, and in a caloric surplus.

So what this tells me is that there's still a lot that we do not know about recomposition. So I would stay tuned because I think that the tides are going to, again, turn on this because it can happen in all three settings, which to me is just fascinating.

And I guess my interpretation of that. I haven't looked at that specific data, but seeing similar things in different populations, we see that, you know, for example, women, gain and lose weight differently with pregnancy and different hormonal responses. Right.

And like we used to, does not believe women who couldn't lose weight after a pregnancy or gained weight in menopause or whatever. And now we realize people's bodies respond differently.

And so that could be part of it is that we're not all the same. And so there may be some people who do need to change what they're eating, increase more in this process.

And then there's some people who might be able to restrict what they're eating and put muscle on at the same time. But I think, you know, the key here probably is look at what's happened to you, right?

Believe your body. If your body is not responding to what you're doing, then you should do something differently. And if you can't figure out what that is, that's why we have this summit.

We have a whole host of experts here who are people who can help you figure out why the thing that worked for your friend isn't working for you. Yeah, absolutely.

I love what you said about believing your body because it's absolutely true. There is no I mean, zero time. There is no one size fits all for weight loss.

And so we have to look at each person as an individual. And it may be like you said, that what worked for my friend or my sister is not really going to cut it for me.

And while I had to cut my calories drastically in order to put on muscle, your friend may have to do something entirely different. So it really is so very individualized.

It's so fascinating. And it just tells me again, there's things that we still don't know. There's so much we don't know. And I love. It's important for us to be humble about that. Right.

Like we know what we know. And then there's like a lot we do not know. And at the end of the day, like, you know your body best, right? So if you're like, no, I tried that.

It didn't work for me. Well, let's try something else. Yeah, a little bit back to this concept of, strength training. Can you break it down? What what counts is strength training or resistance training, because I think for some people who are less experienced in the fitness world, they may not even know what counts towards strength training or resistance training.

So what sort of movement are we even talking about here? Sure. And really, it's very simple. Like I like to keep things very simple. So when we say resistance, it's really just that it's moving your body against resistance.

And the best part about it is that if you have a body, you can create resistance. So you can start with your own body weight. So for anybody who is new to strength training and it's like, what do I do?

If you have a body and you can count, you can do strength training. So I mean, for some of my very resistance training, naive individuals, I'll just start straight out with the simple stuff like squats and lunges and push ups, because even those three moves in and of itself, that will get you a lot of functional movement right there.

So if you're new to strength training, starting with your own bodyweight, that's perfect. And then once that gets easy. And in fact, I say it's easy because you've gotten stronger, then you can start adding implements.

And it doesn't have to be fancy expensive. It doesn't mean that you have to go buy a gym membership, doesn't mean you have to buy really anything. You can start with simple tools like full water bottles or full cans.

You can use that for dumbbells. And then if you want to get something simple, you don't even have to get a set of dumbbells to start. You can get tubes and loops.

So resistance tubes that have handles, you can get quite a bit done with those. And again it's all about adding resistance so that once your body acclimates and that stress gets easy, then you up the ante and make it a little bit harder.

So again start with the body weight. Then go to tubes and loops and then one that once that gets easy then yeah. Then maybe we're looking at dumbbells and maybe we're looking at more fancy equipment.

But it doesn't have to start out that way. It can be very simple to begin with. And then how often should someone be strength training or resistance training?

Sure. If you go by Toe recommendations right now, it's pretty. It's pretty simple. They recommend that you lift all major muscle groups twice weekly. So all of the big muscle groups twice a week.

That's all it has to be. They don't even give a set of time. So we know for cardiovascular purposes they recommend 150 minutes of moderate activity or 75 minutes of vigorous activity.

And that's from the cardiovascular standpoint. But as far as the strength training, they don't give numbers they don't get. They just say move all body parts twice a week.

So and it probably makes sense that there's not a number for amount of time. Right. Because with strength training we're looking at a little bit of different variables like reps.

Right. Like how many squats did you do. We might be looking at resistance. What band did you use. Or once you're if you're using weights how much weight did you use.

And so resistance training probably it doesn't make as much sense to measure it based on time as opposed to did you use all the major muscle groups, and did you get that necessary resistance to pull on and build those muscles? Yes.

And you're speaking to the key foundational principle of building muscle, which is progressive overload. And so really, whenever I'm talking with anyone about building muscle, that's it.

It always comes back to progressive overload. And it sounds fancy, but it's really not. It basically just means that in order to build a muscle, we subject the muscle to an increased stress over time.

So I always use the example of bicep curls. So if you're starting with 5 pound dumbbells and you do three sets of ten reps with 5 pound dumbbells, eventually that's going to get easy.

And so in order to continue to build a muscle, then we increase the stress. And then you pick up the 8 pound dumbbells. And so that is the increased stress on the muscle.

So really it's not so much about you're right. It's not about time. It's about volume. And so I think about the numerics of it. So three times ten times five if you're doing three sets of ten with 5 pound dumbbells that's 5150 right.

There's your there's your volume of stress, 150 pounds of stress. Now let's take it to three sets of ten with 80 growth 8 pounds. So that's eight times 1080.

That's 240 pounds of stress that you just put on your muscles. So really think about it in a volume sense versus a time sentence. And you can get to progressive overload in a lot of ways.

The most fun way obviously is going up in your weight. But you can also do more reps. You can do more sets, you can take less reps time. There's loads of ways to do it, and that's where it can get fun.

Yeah. And I think, you know, great point. Like it is fun. And some of those different challenges are more fun to different people. Some people definitely like the like how heavy can I go?

Some people like the reps. I ama how fast can I go? You know, like how efficient can I get these done? Can I superset like, you know, can I do CrossFit?

And we just like, you know, go all out doing functional movement for seven minutes and call it a day. So, so different ways to challenge yourself. And probably ideally we're doing a mixture of, of you know, of time and volume and intensity.

Okay. So two days a week is sort of the world health standard, getting all the major muscle groups in, and then the time isn't as important. You kind of talked about how people get started.

When we think about strength training, I think there is a lot of misconceptions. So again, we kind of talked about like what it is, what are some of the most common, like myths and misconceptions that you see about strength training?

So many I mean, the first I'll attack, the first one that I hear all the time head on because unfortunately, it still comes up, is that lifting weights will make you bulky.

And I mean, that one needs to go away, but it still does come up. And there's still concern that especially for women, that if I start to lift weights, I'm going to get big and I'm going to get bulky and I'm going to look like a bodybuilder.

And I promise that that is not going to happen. So instead, you will get strong as heck and you will feel really good. But lifting weights does not make you bulky, and especially when combined with proper nutrition, what it does is make you lean.

It makes you more muscular. It can make you tone, and it just feels good. So that would be like the first and biggest myth that I would, I would debunk.

Second is that I think there's this misconception, you know, we're talking about time and that you have to spend hours and hours in the gym in order to build muscle.

And really, what you said, it's about being efficient. I never intend for anybody to spend hours in the gym like I love to go to the gym, but like, even I want to get in, I want to get out, I want to be done and I want to be efficient.

And so I can speak really quickly. I always tell people, if you don't know what to do, there are five key moves that I would have every person do. And these are like the big five.

And these are the most foundational strength training moves that I feel any person should know how to do. One because they require multiple muscle groups, but two, they're foundational.

They're things. If you sit in a chair that's a squat, if you pull up a suitcase from the floor, that's a deadlift. If you put something in the overhead compartment, that's a shoulder press.

And so those these moves. So here's the five. So it's squats deadlifts chest press or bench press rows or pull ups and overhead shoulder presses. So those five moves and if I tell somebody if you have no time for anything else, those five twice a week, you're good.

And people will say, well, what about my biceps curls? Or what about me? You're going to get them in your rows. You're going to get them in your pull ups.

Those are accessory muscle groups that you will get with these large compound multi joint movements. So if you have no time it's those five. So I think if this is a new concept I think it's important to recognize what this functional movement term means.

Because you know a bicep curl like nothing wrong if you like doing those. But how often throughout your day are you just doing a bicep curl? Like pretty rarely. Right.

That that's something we have to do. But you mentioned some great examples of, you know, like a deadlift every time we're picking up our groceries or picking up a kid's car or picking up our keys or our purse off the bat off the ground like we are doing a deadlift, right?

Anytime we're sitting down, whether it's to get into our chair or get on to a toilet, get on and off a couch like we are doing that squat movement, right?

So those are real movements that we want to be able to do for the rest of our life. As opposed to the bicep curl, which may have a very specific goal.

But like most of us, are not like bicep curling multiple times throughout the day, like we are using these more functional movements where we're picking up our heavy bag or we're putting that heavy bag up above us somewhere.

Yeah, absolutely. And then just for completeness sake, a couple of other things that I hear all the time, about myths is that you do not have to be somewhere in order for it to be a good workout.

I hear that all the time, and unfortunately, there is no science that I have found. Maybe you have that. There's no science that I have found that suggests, like how sorry should you be and how often.

And so what I will tell people is if you're never saw, that may be a sign we need to step it up. But if you are always sore, then perhaps we need to step it back.

I think there's a Goldilocks place in there where it's just right, but I don't always. And in fact, nobody should aim to come out of every single workout feeling annihilated, because that's no fun.

And your body does its best work afterwards. Because what we know about strength training is what happened. What are we doing? Strength training. We're building micro. We're we're making micro tears in the muscles, taking them through these movements.

And then it's during the rest period that our body goes and recovers and builds that muscle to make it come back stronger. So if we're never giving ourselves that opportunity to recover, we're going to be shooting ourselves in the foot and not building as much muscle potential as we could.

And so I always take a look at that, because if you're always saw that mean there's some bells going off for me that we need to talk about this, I think I'm glad that you also have not found information about how sore should you get?

A few years ago, I had a patient who had not done a lot of working out before, and she came back and she said, yeah, but you know what? I'm always sore afterwards.

And I had a med student working to me with at the time, and I said, you know, we out on this because how sore should you get? And we, we researched and we couldn't find a good answer.

So we kind of came up with our own rules. But we should expect some soreness occasionally. And the way I'll sometimes tell people is if you're so sore that you can't do your regular daily activities the next day, that was maybe too much, right?

Like if you're to the point where you're like, I can't walk up the stairs, like it's really uncomfortable. I'm in pain getting in and out of my chair all day.

And that's happening to you on a regular basis. That may be too hard, right? Like that may not be a good fit for your body, but if the next day you can feel that you exercised like you're like, oh, like my arm feels a tiny bit like, ooh, tighter sore, or my legs like I can feel it.

Like that's part of strength training. Yeah, I don't know. That's all we came up with. That was the best answer we could come up with. But there's no official rule of, like, how sore should you get?

Yeah, no, I agree, I have, I have looked because I've definitely been asked like you and I couldn't find an answer. So I like I said, I came up with the Goldilocks strategy like we've got to find like the just right.

So so let me know okay. Okay. Yes. Maybe we'll maybe we will combine our resources and see if we can, we could become the standard of what the answer is.

Here we go. Yes. One of the things I'll also see is a barrier for my patients. And I know you're a life coach and a health coach as well. Is this feeling that they can't do it, that they physically can't do it?

Or sometimes that they don't have time to do it? How what are some of the mindset challenges that you see for your clients, and how do you help overcome those?

Absolutely. I mean, again, for me, really everything that I do comes down to three pillars eating, moving and thinking with heavy emphasis on the last one.

That is, that is what I'm about. If you engage with anything that I do, it's going to come to one of those three things and often a combination, because I truly do not feel and I've said this multiple times, I'll say it again here.

You can be the most jacked person in the room, but if you're not taking care of your brain, you do not have wellness. And I've learned that from my own life experience, and I've seen it every time a client tells me she just needs to get down to 150, or just needs to get into the size six and everything will be better.

No, no. Right. So it has to start with our brain. And I feel very, very passionately about that. And part of what I do is help people find their limiting beliefs.

So I gave this example and I'll give it again. I just got off a call with someone who told me straight out, she thinks that she's lazy. And so she said it enough times and I really picked up on it and it gave us an opportunity to dive in.

And I just asked her, how does it feel when you think that way? How does it feel when you think I am lazy? Probably doesn't feel super good, right? And it would make sense then that if you feel or believe I am lazy, it's probably not going to drive you and make you feel empowered to go get your workout done.

It's probably not going to empower you to make a salad instead of having French fries and burgers, right? And so it really comes back to how you think about yourself.

And so if I can get in and help you address your limiting beliefs and see how those are playing out in your life and what results they're producing for you, then we're somewhere, then we can get somewhere, because it's only when we start to pull apart those limiting beliefs that we can change them, right?

But we have to be able to recognize them and see how they're either helping or hurting us in our lives. And then we can work to change them. But that isn't that. That's not easy.

That's harder than going in and doing your squats. That's harder than making a salad. But that's that's the work. And that can take time. It can take months, because those are long lived patterns that have probably been in that brain for a long time.

So that's the real in my mind. That's the real work right there. Right. And that, I think, is where I'll see my patients have long term success is when they tackle those things, because those short term goals of getting to a certain size or a number on the scale, they give you a hard reason to keep going.

And so we have to find like other reasons why we keep going. And we have to sometimes find that internal drive a little bit more. That isn't about just achieving a specific goal.

Right? It's like, what is the mindset here? I also love what you said about you can be the most jacked person, but like if your mental space is not in the right place, do you really have health or fitness?

And I think that that's really key too, right? We can't just put all of our health and our well-being on one metric that we're looking at. Right? And most patients do this too.

This is maybe going a whole new direction here, but people will come in and they're like, oh, but my blood pressure is good. I'm like, great. That is one metric of health, right?

Like, that's good and that's important. But like, what else? Right. Like what else? We have to look at health in so many different dimensions. And that mental part is, is a huge part of it as well.

No. And I tell people that all the time, like, I mean, I know you read my bio and like I have a personal training certification. I got the health coach, I got to leave because if we get it, anybody with the proper certifications can put together an appropriate meal and exercise plan, right like that.

That's not super duper hard, to be honest. Right? Like there's nuance to it. And we have to look at you as an individual. But honestly, it's here. It's our minds.

Like you need if you're not getting there. And there's limiting beliefs that are getting in your way, that's not going to go away. By finding a new protein bar, it's not going to go away with a different macro split or a different workout plan.

That's going to shift only when you are willing and have the space to be able to get into your brain and come at it with curiosity, because often what happens is people will come at it, but then they start beating themselves up over it, and that doesn't get us anywhere.

So if we can come at it with curiosity, but then also self-compassion like that is huge because so many of the people I work with have so much self-hatred that's just sitting in there.

And if we can't pull that apart and start treating ourselves with some compassion and kindness rather than harsh self-judgment, that's key there. And we have you read Tiny Habits by BJ Fogg.

It's so happens now, so it's another great there's so many great habit books, but that is one of them. And one of the first things he said, I obviously it's stuck because of it's been years and I'm still seeing it.

And he says it so well. He said, you change best when you feel good. You change best when you feel good. And I was like, yes, like, say that louder for the people in the back because you cannot beat yourself up into your next best version.

It doesn't work. You can't restrict yourself and put yourself on the treadmill and try to sweat your tail off and cut out all the carbs from a place of self-hatred.

One is going to be miserable, and two, you're going to rebound. But if you know that you are taking care of yourself both in brain and in body, and are being kind to yourself and compassionate towards yourself, that's different.

And then you may be more willing to take action from a place of self kindness rather than self-hatred. And the action from self kindness is going to last a whole heck of a lot longer and be much more sustainable.

I love it, I couldn't have said it better myself. Really powerful stuff. I will tell my patients the same thing. Nobody's ever lost weight and kept it off from beating themselves up.

It just doesn't work. So if that has been your strategy, time to try. Try something new because it doesn't work. And, you're not going to mentally feel well when you're constantly just being hard on yourself.

Yeah. As we wrap up here, Doctor Holland, any, anything we didn't cover that's important in terms of strength training or mental strength, which is, I think, a big part of it, too.

I would say really that it doesn't matter who you are, what your titles are, how old you are or what your past has been. If you've been an athlete or no, if you've never walked or raised a day in your life, it doesn't matter if you don't even know what a bicep curl is, I don't care.

The time to start is now and there are so many ways to get started. Don't let that stop you. And again, a part of it is finding what moves you, right?

Like find movement that you enjoy and then it won't feel like a chore. It won't feel like I have to. It will be I get to and that's it. When fitness becomes your way of life, it operates in the background.

It just runs on autopilot and so you don't have to worry about, oh gosh, I just missed a week because I was on vacation. I'm done. When it's part of your life, when you find the things that you love or can at least tolerate and you make it part of your life, then it just operates in the background and it's something that you can always come back to.

And that's the best, I love it. Thank you so much. If people want to find you or connect with you, where can they find you? Sure. I have a website, it's Kerry Holland, imdb.com.

So you can reach out to me that way. I'm on Facebook, LinkedIn and Instagram under Kerry Holland, M. D. and then I'm also, the host of a weekly podcast.

It's called Strong Is a mindset. So every week, as I said something, it will be something about eating, moving and or thinking, and that's a weekly podcast that I've been putting out for a couple of years.

So that's am thank you so much. Thank you for tuning in to Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health.

Each day is a new opportunity to make choices that empower your wellbeing. For more insights and strategies, subscribe to our podcast and visit our website w ww dot.

Doctor Talksport.com. Stay connected. Stay healthy and join us next time on Doctor Talks. Real talks from real doctors on the issues that matter to you most.

Strong is a mindset: Building a strong mind and a strong body

Carolynn Francavilla, MD, FOMA, D-ABOM

Carrie Holland, MD, CPT

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