Body recomposition refers to the process of gaining muscle and losing fat simultaneously. It is not a specific diet or exercise plan. Rather, it is a set of principles and practices that help people build muscle and strength, lose fat, and establish healthy eating and exercise habits.
When followign the 5 main pillars of body “recomp,” people will not only grow stronger and lose weight, they will be able to keep the weight off for the rest of their lives.
A body recomposition program is indicated for patients all across the scale from morbid obesity to sarcopenic obesity, aka “skinny fat.” An excess of visceral fat aroudn the organs paired with degeneration of lean body mass can lead to a myriad of mental and physical illnesses such as: Diabetes, Alzheimer’s, Hypertension, Coronary Artery Disease, Thyroid dysfunction Depression, Anxiety, Cancer, and Sleep Apnea Syndrome.
How many times have you heard a variation of the following: “I’ve tried everything. I just can’t seem to lose the weight or keep it off!” or “My weight is OK, but I just have this fat around my belly that I cannot lose no matter how many sit-ups I do.”
Muscle tissue burns more calories than fat tissue, even when the body is at rest. By the very fact that your patients gain muscle, they will automatically burn more calroies even when they are sedentary.
Many diet or exsercise plans tout their successes, and how they can work for anyone. Too often, these are false promises. Ultimately, there is no catch-all plan you can hand your patients and guarantee them success.
Weight Loss vs Fat Loss
When broken down to bare bones science, weight loss results from burning more calories than are consumed. This is known as CICO–Calories In, Calories Out.
But there’s a big caveat here: at a caloric deficit, the body will indeed lose weight as it burns its own fat and muscle for fuel. But if CICO is not paired with resistance training, the person is unwittingly sacrificing muscle tissue along with the fat tissue in the name of “weight loss.”
This is a significant problem, particularly for people with sarcopenic obesity. These “skinny fat” people often have no weight to lose, though they have significant amounts of visceral fat.
Since true fat loss is the goal, there must be other puzzle pieces. Exercise, and specifically, load-bearing resistance training needs to be incorporated. This not only retains lean body mass, it also spurs muscle and bone growth. Incorporating moderate cardiovascular exercise assists in burning excess fat and increases cardiopulmonary health.
At a caloric deficit, the body will indeed lose weight as it burns its own fat and muscle for fuel. But if CICO is not paired with resistance training, the person is unwittingly sacrificing muscle tissue along with the fat tissue in the name of “weight loss.”
Load-bearing resistance training puts a stress on muscle and bone tissues. A lot of energy from calories consumed goes into repairing these stresses, on top of the energy burned in normal daily functions.
As energy is directed toward these stress repairs, the body will burn its fat stores for fuel. Load-bearing exsercise on top of normal daily activity will burn the excess fat in favor of muscle while also building strength and endurance in the muscle tissue and density in the bone.
Ideally, you want to establish the twin goals of fat loss and muscle retention and growth. The union of these two concepts is the foundation of body recomposition.
For a successful body recomp, a patient must be willing to make significant lifestyle changes. But these changes may be made slowy and incrementally over time, leading to greater sustainability of the program. and often, one good habit naturally leads to the next.
For example, when patients begin exercise programs, they often do not wish to undo their hard gym work with bad food choices. Once they notice the benefits of a healthful diet–such as improved bowel movements or clearer skin–the office donut holds much less appeal.
5 Pillars of Body Recomp
There are five main “pillars” to a successful recomp plan:
- Resistance Training: A minimum of three 30-90 minute sessions per week, with each muscle or muscle group worked at least once.
- Eat at Maintenance Calorie Levels: The term “maintenance calories” refers to the amount of calories a person needs in order to maintain his or her current weight. This is, of course, highly individualized. Caloric intake can be adjusted as needed. I like to have clietns eating at a 100-300 calorie deficit. Online calorie counters can serve as a starting point, but food intake needs to be adjusted as someone gains muscle, loses fat, and changes activity levels.
- Moderate to High-Intensity Cardio: One to three sessions per week consisting of either 12-16 minutes of high-intensity interval training (HIIT) or 30-60 min of steady-state cardiovascular exercise.
- Drink Water: Water intake remains a debated topic in the fitness world. The general recommendation is to consume between 0.5 and 1.0 ounces of water for every pound of body weight. For example, a 130 lb woman should drink between 65-130 ounces each day. But active days require more water than sedentary days. I advise clients to hydrate throughout the day, in the form of food, plain or sparkling water, coffee, tea, etc. Urine color best determines hydration: pale yellow to clear is the goal.
- Restorative Activity & Sleep: Yoga, foam-rolling, and other slow, restorative practices should be part of any body recomp plan. of course, good healthy sleep is also very important.
Each of these pillars can be adjusted and individualized to a patient’s needs and preferences, which often shift over time.
Patients desiring a change in their body composition will benefit greatly from having the support of a team. Nutritionists, dietitians, and personal trainers can work in tandem to help people organize their diet and exercise plans. In addition, therapists can sometimes be helpful in identifying and addressing any underlying mental health issues that could be blocking a patient’s willpower or self-efficacy.
Nutritionists or dietitians can sometimes be found through a patient’s insurance company in-network provider list. Certified Personal Trainers can be located through reputable certification programs such as the American Council on Exercise (ACE) or the National Academy of Sports Medicine (NASM). The two certifications are recognized worldwide for their excellence. Therapists likewise can be found through a patient’s insurance comapny.
Load-bearing exsercise on top of normal daily activity will burn the excess fat in favor of muscle while also building strength and endurance in the muscle tissue and density in the bone.
Building a referral system of these experts will be invaluable for your practice.
If building a suppor team is not possible, there are many apps and online tools available to assist people on the recomp journey. Here are a few that I myself and my clients have found helpful:
- Skimble Workout Trainer: A free app that comes with in-app upgrade options, Skimple guides patients in building their own workouts, or gives them options for several pre-made workouts based on their goals.
- Nike Training Club: Another free app with premium upgrades, patients can access on-demand classes, get nutrition tips, or advice for recovery and mindset.
- HIIT Workouts: This app provides many customizable workouts. Patients can also track their progress and set goals in the calendar.
- My Fitness Pal: A classic calorie tracker from the Under Armour sportswear company, with a huge database of foods and beverages. This tool is free, with upgrade options. Patients can use it tot rack progress and connect with friends. They can enter their own foods and scan barcodes to upload new information. This app is consistently rated #1 across the board.
- LoseIt! Another free app also in the Top 10 best-rated. The database is not as large as MyFitnessPal, and it is not as customizable.
Calorie Counters: I’ve found these two websites are the most accurate calorie counters. Most apps calculate on the low end of calorie needs.
- My Water: A free app with premium upgrades, this one has a very basic design. Patients set water goals and keep track of water consumed. They can also set alerts to remind them to drink throughout the day.
- Water Lama: Another free tool, Water Lama is customizable, and the outline of the llama or other adorable animal is “filled up” as the user logs water intake. This app can also set reminders.
- Drink Water: Like the other apps, this one is also free, with premium upgrades. An outline of a male or female figure fills up as the user logs intake. Users can view their stats for the week, month, and year.
- Sleepscore: Patients can set sleep goals and receive detailed analysis of their sleep cycles. The app can also provide relaxing white noise to help people fall asleep.
- SleepCycle: Patients can select alarm melodies, and these can be set to go off only when the user is in light sleep phases of their cycles, thus avoiding disruption of deep sleep. SleepCycle can be used with the phone next to the bed; there is no need to wear a fitness watch or keep a device under the pillow.
There are countless benefits from body recomposition as a fitness approach. A few include:
- No fad or extreme dieting, reduced yo-yoing and fewer restriction/binge cycles
- Fewer dietary restrictions; allowances for “treat” meals, and incorporation of favorite food and beverages into calorie counts
- Ease of adaptiation to individual body needs
- Encourages healthy and sustainable weight loss
- Establishes healthy eating and exercise patterns
- Assists patients in building positive relationships with their bodies
- Sets a foundation for basic movement patterns
- Increases proficiency and efficacy in activities of daily living
- Promotes a healthy, balanced metabolism and hormone production
- Gets people involved in thei rown care
- Increases self-esteem and confidence
- Lowers risk of all disease and injury
- Increases endorphins
Muscle tissue burns more calories than fat tissue, even when the body is at rest. By the very fact that your patients gain muscle, they will automatically burn more calroies even when they are sedentary. Weight training also affects the cardiovascular system, hence there’s no need for excessive cardio workouts.
For example, squats are a full-body movement that taxes nearly every ssytem in the body. This exercise alone requires an incrdible amount of strength, power, and stability from the whole body. Consequently it benefits all the organ systems.
Winning Patient Buy-In
A point worth mentioning to patients is that the type of sustainable change that comes with body recomp does not happen overnight
“Non-Scale” victories such as noticing higher levels of energy, or dropping a pant size, are worthy of celebration. And celebration of small positive changes increases compliance. Big changes are comprised of many small steps that all add up. It is important to recognize and reinforce all of these small victories.
A reasonable time frame for most patients working with body recomp programs is:
- 2-3 months for noticeable change
- 3-6 months for significant change
- 6-12 months for transformation of body composition
- 12-24 months for transition to maintenance or to higher-level athletics
Over the years, I’ve met clients who are skeptical that these positive changes are possible for them. I explain the process using the analogy of building a house.
You cannot build a house out of nothing. You need materials such as lumber, nails, screws, glass, etc. In order to put those materials together, you need tools like a nail gun, drill, saw, etc. It is also helpful to have a contractor and team of carpenters and electricians and the like, who know where and how to place each piece.
Likewise, you cannot build a healthy body or strenthen the muscles without materials and tools. Food–protein, carbohydrates, and fat are the building materials. The exercise routines, both strength training and cardio, are the tools. Nutritionists, trainers, and even therapists are the “contractors.”
“Non-Scale” victories such as noticing higher levels of energy, or dropping a pant size, are worthy of celebration. And celebration of small positive changes increases compliance. Big changes are comprised of many small steps that all add up.
Often obesity is a symptom of an underlying issue, either medical or mental. Many people do not believe they can change. They do not believe they are worthy of the time, money, and effort. Some hold a belief that they are “vain” if they dedicate time to the gym or to meal preparation.
If you can listen with compassion, and you are able to provide resources and encouragement, you will be able to assist these patients in overcoming the obstacles. This type of holistic, preventive medicine will decrease the levels of obesity in your patients and their families, and greatly improve mental, emotional, and physical wellbeing.