Aadil Mamujee

I’ve been overweight for most of my adult life, having flipped-flopped from various extremes (mildly to considerably). Managing my weight has been a constant source of struggle and cyclical focus. I enjoy eating and drinking, but I’ve also always enjoyed playing sports and exercising (it’s not a chore).

My goals have evolved to become less focused on just my body weight as it’s an imprecise measure of health and a singular focus on the number moving up or down can be demotivating. I’m focused instead on improving my overall health and enjoying physical activities that I love pain-free. As a father of two young boys, I’d like to play games and sports with them as they grow up and be around and healthy for my family.

For overall health, I am picking a few biomarkers and want these to be in the top 20% for my age, height, and gender (mainly body fat and muscle mass). In terms of activities, I’d like to run (street, barrys bootcamp) and play racquet sports (squash, tennis) without pain in my right ankle and knee, which I’m currently only partially able to do because of chronic injury flare-ups.

Throughout this process, I’m planning to leverage more experts (e.g., personal training, physical therapy) and specialist doctors (sports medicine, cardiology, weight loss) as well as utilize all the measurement and preventative screening technology at our disposal.

I started working on these things last year (2023) and will summarize my approach below and post a bunch of follow-ups as I execute my plan and learn more / see results (hopefully!).

Metrics to Measure

I’ve broken it down into the following categories where I can actually gather reliable data:

Body Composition: Weight is a directional measurement but does not tell the whole story. We really care about how much body fat and muscle we carry.

• Test: A DEXA Scan is a test that tells you your body fat, lean mass, visceral fat, and bone density. This was the first test I did in March 2023 and catalyzed this initiative.
• Results: I was in the bottom 30% for body fat, middle 50% for muscle and my bone density was in the top 10% for my height and age. I don’t know what my visceral fat (fat around organs, which is no bueno) percentile is, but I’m sure it’s not great. I was basically less strong and carrying more fat than I expected.

Fitness: Fitness is a measure of how effectively we can use oxygen to generate power over a sustained period of time.

• Test: V02 Max Test (and RMR Test). I did a test to measure how fit I am and my resting metabolism.
• Results: I had a good resting metabolism (2150 cal/e day) which means I don’t really have a “slow metabolism” excuse and my V02 max was 43 mL/kg which puts me in the top 35% for my age. Because it’s a per/kg measure and I was pleased to see strong results despite carrying excess metabolically inactive tissue (fat) so if I lose fat my V02 max will improve even without any additional fitness improvement.

Long Term Health Biomarkers: These are indicators from blood tests, blood pressure, blood sugar which I basically get from my annual physical plus a few extra for heart health.

• Tests: Blood Tests, Blood Pressure, ApoB/LDL Testing (Cholesterol/Heart Health).
• Results: I had a short period in 2022/3 of high blood pressure, but this has normalized now with some fat loss/lower stress. My cholesterol (LDL and ApoB is elevated, and South Asians are genetically more predisposed to heart issues, so this is something I’ll need to investigate/intervene. My blood sugar (diabetes indicators) were all fine.

Levers to Pull

Now that I have a good idea of all the metrics that I am going to measure, I also wanted to categorize all the different levers that we can pull in order to improve these metrics.

• Nutrition: I spent time with a nutritionist and a weight loss doctor. The recommendations were consistently the same – more protein, more fiber, less alcohol, and eating an early dinner.
• Training: I am working with a personal trainer for the first time. The key changes are to reduce the weight I’m lifting while slowing down the reps and increasing the range of motion. This will result in better hypertrophy (and muscle growth) while reducing injury by increasing time under tension. I have a program of a lower/upper body split that I’ll do 1-2 times a week each.
• Physical Therapy: I am spending time with a few physical therapists to figure out the issues with my right knee and ankle. The clear areas of deficiency are weak stability muscles (hip flexors) and core strength. I also have poor posture, which means suboptimal spinal loading, which is something I need to correct.
• Medication: There are drugs that can help with fat loss (e.g. metformin and semaglutide) which are worth considering but each have side effects and may need to be taken over a very long time to be effective.
• Supplements: Supplements can help with any deficiencies in nutrition. I am currently taking fish oil, vitamin D, psyllium husk (fiber), creatine (new), protein powder, a multivitamin, and magnesium.
• Preventative Screening:I got a number of preventative screenings and tests done, such as a. Prenuvo scan (full body MRI), Detailed MRIs of the ankle/knee with chronic issues, and detailed cardiology tests (Echo, Calcification). Will summarize learnings in a more detailed post.
• Sleep: I’m a pretty good sleeper but find I get GREAT sleep when I have an early dinner, don’t drink alcohol and I’m in bed by 930pm. I try and do this 4 days a week and although it makes me more boring, it’s great for recovery.

Goals/Areas of Investment

Now that I know the metrics and the levers, the next phase is to devise a plan to improve where I have the most significant gaps to get to top 20% for my age/height/gender. Here is what I’m doing in order of priority:

1. [P0] Reduce total body fat (and visceral fat)
   1. Goal: Reduce body fat to <20% (which is top 20% for men 40-50)
   2. Impact: Reduce ApoB/LDL, reduce blood pressure, and reduce force on joints during activity.
   3. Plan: Caloric restriction while increasing protein and fiber. Small/early meals in the evening.
2. [P1] Improve flexibility, mobility, stability
   1. Goal: Run and play squash without pain once a week.
   2. Impact: Fewer injuries, more efficient loading of my body (reduced long term wear) of my spine and joints.
   3. Plan: Improve stability (ankle, hip flexors), improve posture (walking, desk set up), improve core strength (lots of floor work).
3. [P1] Increase strength and muscle mass
   1. Goal: Get to top 20% in strength (measured as skeletal muscle mass)
   2. Impact: Improved muscle balance, improved metabolism, better injury prevention.
   3. Plan: I have weaker “pushing strength” than pulling strength. I also need to build my supporting muscles as well as the bigger muscles.
4. [P2] Cardiovascular fitness
   1. Goal: Achieve top 20% V02 max for my age (48 ml/kg), but given I’m in the top 35% already, this is a lower priority.
   2. Impact: Better heart health and performance in athletic activities.
   3. Plan: Invest in Zone 2 training by riding my bike, playing padel and swimming in the pool. Do Zone 5 training with things like Barrys Bootcamp (sprinting) and playing squash.

Mental and Brain Health

An obvious missing area of both understanding and intervention is my mental health – this entire plan is focused on my physical wellbeing (although they are both obviously related). I think mental health includes three things:

1. My brain’s physical characteristics: Is the size and shape of my brain normal? Do I respond to stimulation as expected? Are there any other irregularities like tumors?
2. My cognitive ability: How good is my brain at performing cognitive tasks (calculation, memory, interpretation, verbal reasoning, creativity) and how does it benchmark for my age/education level?
3. My emotional health – How am I doing emotionally? How happy am I? How anxious am I?

Some of these things are hard to quantify and / or benchmark but I plan to investigate these in more detail after I’m done with the “physical phase” – can’t do everything at once!

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Detailed Posts and Experiences

As part of this journey, I’ll write up detailed posts on the following areas if it’s helpful. I’m still “midway” through a lot of it, but I expect to post these all in the next 3-6 months.

1. Stability/Injury Prevention: My experience with physical therapy, improving my posture, incorporating yoga, and slowly picking up high impact sports again (while preventing and monitoring pain).
2. Preventative Screening: My experience with detailed cardiology tests, full body mri (cancer detection), and deeper understanding of joints with chronic issues.
3. Changing Body Composition: My experience with improving my body composition by reducing fat and increasing/preserving muscle.

Follow along if this is of interest at all — look forward to documenting and sharing this journey with you.