Exercise 101 – Part 2

I wanted to follow up on my article “Exercise 101.” In that article, I discussed the benefits of exercise and starting a walking program. However, research shows that conditioning and resistance training are the keys to greater weight loss and improvements in your metabolism. In Part 2 of my Exercise 101 series, I plan to delve deeper into the science and benefits behind resistance training.

Last November, I attended Obesity Week in Nashville. This is the annual conference held by the American Society for Metabolic and Bariatric Surgery. I had a wonderful opportunity to speak with a researcher, Dr. Maria Fernandez Del Valle, who is affiliated with Southern Illinois University Edwardsville. Her expertise is in exercise science, and she is specifically looking at the beneficial effects of resistance training. At the conference, she presented some preliminary findings comparing aerobic activity to resistance training on females. I was impressed with her results.

Dr. Del Valle was looking into the effects of high intensity resistance training (HIRT). To be honest, I had never heard of HIRT prior to meeting her. Like high intensity interval training, the work out sessions are based on circuits of high intensity followed by short periods of rest. However, in HIRT, you are focused on performing only a few exercises that involve more than one joint (i.e., performing a leg press, where you are bending at both the knee and the hip). With this training in mind, Dr. Del Valle compared two groups, one which performed HIRT and the other performed simple aerobic activities. Both groups’ activities were matched in intensity and in number of daily calories consumed. Both groups worked out three times a week for three weeks. In just this short amount of time, her pilot studies have shown that patients ** who performed HIRT had a reduction in their cardiac fat and visceral abdominal fat ** significantly in excess of those patients who performed simple aerobic exercises. (Visceral fat is the fat contained inside your abdomen around your organs as opposed to subcutaneous fat which is found between the skin and muscle). She also has found that weight loss seemed to occur first in the chest (thoracic cavity around the heart). Next, internal/visceral fat loss occurs in the upper region of the trunk and moves down in response to high intensity. Interestingly, she did not find any change in subcutaneous fat.

So, what made these findings pique my interest? For one, visceral abdominal fat is associated with high rates of:

While calorie restriction causes overall weight loss, I was excited to find an exercise regimen that could zero in on areas of body fat that pose the most risk to my patients. So often we hear that there is no such thing as exercises to “reduce fat in one area.” While HIRT might not solely target your saddlebags, the research does seem to show that you can target that hard-fought belly fat. Her research also supports what I find clinically. I often have patients that tell me that after surgery, they seem to “lose weight from the top down!”

My next question was “how do I do HIRT??” I have read articles online, read Dr. Del Valle’s research, and even had my first personal training session. Initially, I tried to do an online HIRT video…..to no avail. It’s hard! You really need to know what you’re doing!! (See my before and after video of my first session…)   I want to share with you the HIRT regimen that was used in research. I also want to share with you the information from my fantastic personal trainer, Anthony. I plan to focus on my personal experience in Part Three of this series.

What the internet says….

HIRT is based on performing exercises at high intensity with periods of rest.   In HIRT, you perform shorter reps with the goal of getting to near complete exhaustion (to momentary muscular failure). For example, when performing a leg press, you first select a weight and for 4 seconds you perform your first press. You will repeat this 8-12 times.   You need to focus on good form and control. If you get to your 12th rep and you feel like you can do more, then you probably needed a higher weight in the beginning.

What the research showed……

In the study listed above, participants in the HIRT group performed the following regimen three times a week which lasted 50 minutes. The workout started with 5 minutes of warm up (full body) – this can be moderate speed on a tread mill or elliptical machine, followed by a conditioning circuit of seven exercises. Participants performed 3 sets of 10 repetitions at a moderate rate. They would rest 30 secs between each exercise and then 2 minutes between each set.

Warm up (moderate speed) 5 minutes
Leg press 10 reps at moderate pace and good form, then rest 30 secs
Row 10 reps at moderate pace and good form, then rest 30 secs
Back Squat 10 reps at moderate pace and good form, then rest 30 secs
Weighted Crunches 10 reps at moderate pace and good form, then rest 30 secs
Deadlift 10 reps at moderate pace and good form, then rest 30 secs
Bench Press 10 reps at moderate pace and good form, then rest 30 secs
Squat jumps with weights 10 reps at moderate pace and good form, then rest 2 minutes
Repeat above set two more times



  1. Fernandez-del-Valle, Maria, et al. (2018). Effects of resistance training on MRI-driven pericardial fat volume and arterial stiffness in women with obesity: a randomized pilot study. European Journal of Applied Physiology.
  2. www.hituni.com


Bariatric Support Group

Dr. Hodges highly recommends patients attend monthly support group meetings. The meetings are led by Dr. Collins Hodges, both a licensed clinical psychologist and someone who has had bariatric surgery himself. The support groups are offered on the first Monday of every month from 6:30pm – 7:15pm CST via an online GoToMeeting. The meetings are open to the public, and there is no charge to attend.

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