A Physician and a Biochemist Get Honest About What Is Actually Holding Women Back

Introduction

I have been in medicine long enough to know when something is being ignored, and the under-eating epidemic in women is one of the most ignored things I have ever seen. We talk constantly about women eating too much, about portion control, about restriction, about willpower. What we do not talk about nearly enough is what happens when women eat too little for too long, and how quietly devastating that is for their metabolism, their muscle, and their ability to lose fat at all.

That is why I brought Zach Rana onto Gloves Off. Zach is a biochemist, a competitive bodybuilder, and the founder of Gladiator Strength Health and Fitness Coaching. He comes at this from a fitness and performance angle. I come at it from a physician and weight loss angle. And we landed in exactly the same place. This conversation surprised me in the best way, and I think it is going to surprise you too.

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About the Guest

Zach Rana holds a biochemistry degree from UC Irvine and built his career at the intersection of performance science and practical coaching. He is the founder of Gladiator Strength Health and Fitness Coaching, a premium program built specifically for traveling professionals: executives, consultants, and healthcare leaders who are losing the battle with their health not because they lack discipline, but because every fitness system they have ever tried was designed for people who sleep in the same city every night.

Zach has traveled to over 20 countries while maintaining 12 to 15 percent body fat year-round. He did not start there. He gained 25 pounds during a period of 60 to 80 hour work weeks before engineering his way out of it, and that personal experience became the foundation for a methodology that has since helped hundreds of high performers lose fat, build strength, and reclaim their energy without meal prep, restriction, or willpower.

His clients have achieved results ranging from 29 pounds lost in six months to complete metabolic resets, all while managing demanding careers and heavy travel schedules.

The Real Problem Has Nothing to Do With Discipline

One of the first things Zach said in our conversation that stopped me in my tracks was this: the women he coaches are not failing because they are undisciplined. They are failing because they are under-fueled. And the two things look almost identical from the outside, which is part of what makes this so hard to untangle.

Women have been conditioned by diet culture, by social media, by well-meaning but wrong advice, to believe that less is more. Less food, less space, less appetite. The idea that hunger is something to manage rather than something to honor is deeply embedded in how women relate to their own bodies, and it is doing real metabolic damage.

From my side of the table, I see this play out in the clinic all the time. Women who are restricting, who are exhausted, who cannot lose weight no matter how little they eat, and who have been told to eat even less. The problem is not their effort. The problem is that chronic under-eating disrupts the very hormonal and metabolic systems that make fat loss possible.

What Under-Eating Actually Does to Your Body

Let me give you the science because it matters. Insulin is a storage hormone. When it is chronically elevated because of blood sugar dysregulation driven in part by poor nutrition timing and inadequate fuel, it makes fat burning significantly harder. Your body literally cannot access stored fat for energy when insulin levels are too high.

Under-eating also disrupts two of the most important hormones governing hunger and metabolism: leptin and ghrelin. Leptin tells your brain you have enough fuel and it is safe to burn fat. Ghrelin drives hunger. When you chronically restrict, leptin drops and ghrelin rises, which means your brain is getting constant signals that you are in a famine, and it responds accordingly by holding onto every calorie it can.

Add cortisol into the picture, which is elevated in almost every high-performing woman I know, and you have a hormonal environment that is almost perfectly designed to stall fat loss and prevent muscle gain. Cortisol raises blood glucose, which worsens insulin resistance and promotes visceral fat storage. This is the direct biochemical link between chronic stress and the body composition changes so many women cannot explain.

And then there is the muscle piece, which is where Zach's angle becomes so important. Muscle is your metabolic engine. It is also your best defense against insulin resistance because muscle tissue is one of the primary sites where glucose is taken up and used. When women do not eat enough protein, when they chronically under-fuel, they cannot build or maintain muscle. And without muscle, metabolism slows, fat loss stalls, and the cycle gets worse.

Why Society Is Part of the Problem

This is the part of the conversation I did not want to gloss over, because the biochemistry does not exist in a vacuum. Women eat less than they need partly because they have been told to their entire lives, and that messaging is not neutral. It is tied to ideas about women taking up less space, being smaller, being more acceptable when they require less.

Zach said something that I want every woman listening to hear: the system was not built for you. The traditional fitness and diet industry was largely built around male physiology, male hormones, and male performance goals. What works for a man in his 30s in terms of caloric intake and training stimulus does not automatically translate to what works for a woman in perimenopause, or a woman managing a high-stress career, or a woman whose relationship with food has been complicated by decades of diet culture messaging.

Getting enough fuel is not indulgence. It is a non-negotiable biological requirement for the results most women are killing themselves trying to achieve.

Three Things That Stayed With Me

First, the permission conversation. So many women are waiting for someone to tell them it is okay to eat more, to fuel their training, to stop performing deprivation. Zach gives that permission from a science and fitness standpoint, and I give it from a clinical standpoint. If you needed two doctors to sign off on it, here we are.

Second, that muscle is the long game. Zach reframed strength training not as an aesthetic goal but as a metabolic investment. Every pound of muscle you build improves your insulin sensitivity, raises your resting metabolism, and gives your body more capacity to handle stress. That landed for me as a physician in a way I want to carry into every patient conversation I have.

Third, that under-eating looks like a lot of things that get misdiagnosed. It looks like fatigue. It looks like a mood issue, a thyroid problem or a hormone imbalance or just getting older. Sometimes it is under-eating masquerading as all of those things, and no one is asking the right questions.

Want to Go Deeper

📺 Watch the public episode right here: The Under-Eating Trap: Stalling Fat Loss and Fitness for Women

The full unfiltered conversation lives inside the Vitality % Wealth private community’s Executive Circle. Join here and the episode is waiting for you inside: https://www.skool.com/life-mastery-2022/about

About Dr. Kalpana Sundar

Dr. Kalpana Sundar is a physician who spent 20 years in ear, nose and throat and head and neck surgery, and owned her own medical spa, before leaving clinical medicine to build something she could not find inside the system. After experiencing burnout, moral injury and a growing frustration with a medical model that managed symptoms instead of transforming lives, she walked away from the OR and toward a new mission. Today she works at the intersection of vitality, wealth and impact, helping entrepreneurs, high performers and professionals reclaim their health and live on their own terms. She is also the author of Beauty Unbound and is currently writing her second book Who Told You That: Unlearning the Rules of Sex, Money and Power in Midlife. drkalpanasundar.com

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