In other words, her lack of strength did not allow her to recover properly even from her minimum expenditure of energy. She was like a big car with
The more relaxed we are after we exercise, the more fat we burn a small engine. To get stronger, she would need to become more muscular, and for that she would need to do proper exercise.
We explained to Susan that, because it is more difficult to gain muscle mass than to lose fat, it takes more time, and we would have to work with her in two stages. The first stage would be for her to lose 10 pounds overall to bring her down to her Ideal Body Weight. At a weekly loss of 1% of her Ideal Body Weight, that would take her approximately nine weeks (10 + 1.19 = 8.4).
Then, in the second stage, we would work to get her to her Ideal Body Weight Proportions. This second stage would last at least two years, because people can gain, at best, 10% of their Ideal Body Weight in muscle every year. In Susan’s case, that would be 12 pounds per year (119 x .1 = 11.9). Once, after nine weeks, she got down to 119 pounds overall, she would adjust her diet so that she stayed at that weight, with her fat decreasing and her muscle increasing by the same amount.
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Susan’s problem was more extreme than Michael’s. He had two options, whereas she only had one. That is, he could have chosen to do only one surgery a day, which would have left him with enough strength and time to recover for the next day. However, that would have cut his income in half, and so was not a realistic option for him. He had to become stronger. Susan, on the other hand, had no energy reserves whatsoever, so she would not have been able to recover even if she spent the whole day in bed. Her only choice was to become stronger.