Q: Hi, I am asking about some advice... I was recently (this last year) severly underweight at just 6 stone 10 with a height of 5 foot 8. I have now managed to regain my weight and weigh a healthy 9 stone 7, however I am unhappy with the way I look. I exercise regulary, atleast 3 times a week and more if I have time. I try to combine resistence with cardio. I would like to lose a few pound and tone up to look more leaner however I am wary of starting a diet or regime in case I end up underweight again. Would you have any advice on how to go about this? I usually eat a balanced diet and find it best if I eat 3 meals and 2 snacks due to my lifestyle. I find I either eat too healthy or not so much (which was required to gain weight). Thanks.

A: Congratulations on getting to healthy weight! It sounds like you are doing everything right as far as eating and exercising. And you are also right to be worried about losing weight again because even at 9 stone 7 (133 pounds) at your height of 5 foot 8 inches you are still quite close to being underweight. This presents a bit of a problem -- it's very difficult for somebody in your condition to lose fat without losing weight. And of course if you start losing weight then you'll quickly be underweight again and you don't want to do that either.

So you have two basic choices here since outright weight loss is not advisable. First choice is to stay at more or less your present weight and try to ever so slowly burn fat and build muscle through exercise. This will definitely be a very slow process, but over a year or two it's possible to make some noticeable progress. If you choose to go this route, then I would advise minimizing cardio and focusing on heavy whole-body weight training. Cardio is no doubt great for your overall health but for somebody specifically in your condition it does burn valuable calories that could be going toward building muscle. If you were looking to lose weight, then cardio would be a logical addition to the exercise program. But in your case it is simply not necessary. I would recommend you either minimize it or, better yet, replace it with HIIT (High Intensity Interval Training) which is basically running sprints -- see http://www.mikesfitness.com/content/cardio-and-hiit-to-lose-fat . And for your weight training, if you are not doing it already, you will want to focus on exercises that have the greatest potential to burn fat and build muscle. These include squats, lunges, deadlifts, rows, pulldowns, and presses. A lot of women make the mistake of choosing weights that are too light (if you can do more than 15 reps in a row on any one set of any one exercise then you should probably increase the weight) and exercises that are too insignificant (such as bicep curls or shoulder presses). You will reap the most benefit from weight training by exercising your biggest muscle groups -- which happen to be your legs and back -- with fairly heavy weights (which means heavy enough that you can only do around 8-12 reps of the given exercise before being physically unable to do any more). Make sure to read http://www.mikesfitness.com/content/weight-training to get maximum value out of your weight training.

The second choice you could make is to ever so slowly increase your calories and start gaining weight, while still continue to exercise (minimizing cardio or replacing it with HIIT while maximizing your weight training as I described above). The downside here is that with new weight you will almost certainly gain some new fat as well as new muscle. The upside is that this new weight and muscle gain will rev up your metabolism and after gaining 10-15 pounds in this fashion you will be able to restart on your weight and fat loss and come back down to your current weight with more muscle and less fat than you have now. If you choose to do this you will need to continue to be careful about just how much you eat -- if you gain new weight too fast then it will be mostly fat. You will need to overeat just a bit, around 200-300 calories per day, to gain weight as slowly as possible -- ideal pace is 1 new pound of weight gained every 2 weeks or even slower. In parallel you will be doing heavy whole-body weight training as I described above which will make most of your new weight gain be muscle (though some new fat is pretty much unavoidable, as I said). This way after 4-6 months months you should have gained 10-15 pounds of mostly muscle and have much higher metabolism than you do now. Then you would cut the calories back down and start on losing weight and fat, ideally no faster than 1 pound per week. So within 6-9 months you will be back to you present weight but with more muscle and less fat. And after that period you will find it easier to continue to burn fat and build muscle as well.

So it's up to you which one of these two ways to proceed. If you don't mind some temporary new weight and fat as a way to accelerate progress towards becoming leaner than the second option is the way to go. If you really can't stomach the idea of gaining new weight and fat, then you pretty much have to stick with the first option. In either case, as I mentioned above, you will want to minimize your cardio or replace it with HIIT, while focusing on heavy whole-body weight training. And in either case make sure to read http://www.mikesfitness.com/content/nutrition to optimize your diet plan. Good luck!