You may have seen John Romaniello's articles in Men's Health or T-Nation. Or maybe you've seen his image in various supplement or underwear ads. But the New York-based personal trainer and strength coach is best known as the creator of Final Phase Fat Loss, an advanced program for those trying to lose those last five to fifteen pounds after hitting a plateau. The program focuses on counteracting the negative effects of hormones--or counter 'bad' hormones with 'good' hormones. I spoke with Romaniello in mid-June to get the scoop.

What are you working on now?

Right now, because the online stuff is sort of taking off I've transitioned all of my clients to just two days a week, I'm only in the gym two days a week now because my travel schedule is so hectic, and also because I need more time to write. So I've just been in the gym Tuesdays and Fridays and while I haven't exactly fired clients I've kind of phased people out. I've had people with me for a while that I just kind of felt were ready to kind of graduate. So I have those two days when I was in the gym that are extremely full. So I had to be very selective about the clients that I was taking on. Really I'm almost exclusively working with people who really need my help.

I have some people that are brides who have upcoming weddings or people with upcoming events and I wasn't really ready to let them go because they were depending on me for those things in particular, and then other than that I really have my athletes and a couple of models on the roster. It's really gone from a business that had a very eclectic mix of clients to one that has a specific mix of clients. So I'm really working with highly motivated individuals. At the same time, I won't say that it's not selfish; I have a lot of clients that it's good for me to be associated with like professional athletes are always good clients to have on the roster. So that's what I'm doing now, and what I'm really focusing on now is the online training which I really think is kind of the wave of the future, a lot of the bigger guys are doing that now. And I'm just working on the blog, and writing for magazines, and that's about it--trying to get into as many places as possible and get my face out there even more.

Are you selective about your online clients also?

It really depends. I have a roster; I just increased it. When I first started out I started doing just ten, then twenty but now I'm up to about forty people. I try to work with people who I think are going to be interesting because that'll make it more fun for me. So while I'm definitely selective, it's very different. From a business perspective, when I first opened the program, I really selected the people who I thought based on their applications could make the most dramatic changes and bring in more business down the road. Now, there are people who I think would be better with personal supervision, if they have a series of injuries or things like that. If they've got three surgeries and a bad shoulder then I don't want to take that person on because they'll need a lot more personal attention. But I do take on a lot of very general fat loss clients and I do take on a lot of high school and collegiate athletes who are not close to the area and want to do something very specific, and for those guys there's a lot more involved.

Generally speaking for the online stuff, we kind of do an online pre-assessment, but for the athletes and especially guys who are trying to do things to increase performance I have them do a lot of video stuff. They start their own youtube channels and I have them get videotape of them doing some of the exercises and then I go on and critique their form. So I'm a little more selective like that.

How would you modify a training program for losing those last few pounds rather than just general fat loss?

Well, it gets tricky with those last few pounds and this is the whole thrust of really how I broke into the mainstream with Final Phase Fat Loss and I try to consider a couple of things. When you look at the first few pounds, let's say that someone loses 10 pounds and they still have 60 to go. Those ten pounds are a very small percentage of fat on their body. So it's what's considered expendable and not essential for fat. The leaner you get, to lose that same absolute number, that same ten pounds, becomes a greater percentage of the total fat on your body. Your body doesn't "want" to lose any essential fat because there's all sorts of hormonal ramifications of getting leaner. So if you look at the hormone leptin which has been used in fat cells, the less fat you have on your body the smaller those fat cells or the less leptin you're going to produce. Now I call leptin the anti-starvation hormone. And so essentially that means is that the less leptin you have, the slower the metabolic processes responsible for fat loss will be, primarily because your body "thinks" that it is going into starvation mode and this is 10,000 years of evolution prompting your body to shut down unnecessary fat loss and prompt fat storage in order to survive during a famine. Obviously that's not the case, but those are some of the things that happen.

Further to that, as you get closer to the last few pounds, what you're seeing is that they're generally kind of localized. Very few times do you see someone with only 10 or 15 pounds to lose where it's spread all over their body. It's usually, you'll hear people say they need to lose the last five pounds in their thighs or guys saying, okay I've just got to get rid of my love handles or bring my abs out or whatever it is. And usually, if someone is only five or ten pounds from their goal you're going to see that it's kind of concentrated in one area. And that's really what Final Phase Fat Loss is about, and so much of what I do. So to modify a program you're really going to have to do some training that is really dedicated towards addressing whatever hormonal indicated fat source problem that they have.

Usually what you're going to see is that women are going to store fat in their hips, thighs, and butt and that's because women obviously have higher estrogen levels and estrogen leads to fat storage in the hips and thighs. Guys are usually going to have trouble with one or two things, and the first is generally belly fat and as we know that's a cortisol issue. If you have high cortisol you are more likely to store fat in your midsection. And then there's insulin and insulin resistance and if you are insulin resistant then you're going to show a lot of fat in your love handles. And that's really what we're looking at, those are the major three hormones and what they indicate. So if you're someone like myself who is insulin resistant; I was a fat kid and ate crap carbs for the first 18 years of my life, as I get leaner... If I was ever going to get up to twenty percent body fat again, which I hope to never do, you might see general fat storage patterns--fat everywhere or fat on a relative scale. But as I got back down to 6% or 8% or even 10% what you'd see is that the generalization of those patterns is gone and the specificity is back which is more obvious. So I may have broken up all the fat, for me I'll have a total six pack and I'll still have love handles which you can still grab so obviously there's something going on there. And it'll vary from person to person depending on their fat storage. So modifying the program is really about identifying where they're storing their fat and addressing that through training.

So how do you address that through training?

Another thing we have to consider is where they are storing their fat. So for example, looking at the example of insulin, one of the things that we need to do is, I always like to say, "fight hormones with hormones," and look at what hormone will overcome or offset the hormone that's causing the issue. So for insulin we look at IGF. IGF works in a similar chemical structure to insulin, it's got some differences that are a little bit beyond the scope of this conversation, but IGF-1 is insulin-like growth factor 1 and it is produced when you do a lot of full-body movements and basically just get as many muscles moving together as possible particularly with resistance then you produce a lot of IGF-1. And over time what that does is offset the insulin and, more specifically, increases insulin sensitivity which obviously is decreasing insulin resistance and over time that will lead to you being able to lose fat in your love handles more easily. I'm not really talking about site-specific fat reduction, you can't really just lose fat from your love handles, it's just a way of modifying the training. In order to produce IGF-1 then what we do is what I call dynamic training. And this is a lot of combination movement, a lot of complexes, and it's what makes up the greater bulk of what I do with my clients in the gym. So it's a lot of lunges; we don't do a lot of movements where you're standing still, so you're doing as many movements as possible. You're not just doing an overhead press where you're standing there and doing it. So instead of doing just a lunge you're doing a lunge with an overhead press or a lunge with a bicep curl and we do four to five exercises with short rest periods, similar to what you'd see with Turbulence Training or to a lesser extent P90X or Crossfit, or some of the other popular training programs but for me it is intentioned more specifically to the increasing of insulin sensitivity and the reduction of insulin resistant fat storage.

So for other things, let's say the estrogen-related fat storage, you could use a little more testosterone. The research is still out, but we're seeing results and that's kind of what we go by in my facility. The estrogen-related fat storage seems to be offset by density training, particularly in the lower body, particularly by women. It's basically doing as much work as you can in a given time period, and then trying to do more than that amount of work the next time you do the exercise. Most people are probably pretty familiar with Isolated Density Training by Charles Staley, and that was my first introduction to it, and three to four years after that I came up with my own spin on it and that's what I've been using and it's been very successful with my clients, the preponderance of people who are losing a lot of fat and seeing a lot of offseting of the estrogen-related fat storage whether that's through the actual decrease of estrogen or a slight decrease of estrogen and interaction with a lot of other mechanisms obviously we don't have the equipment to test, but that's the working theory that we have.

Finally, we have cortisol and for that what we do is try to increase growth hormone. So that's kind of tricky; you can't just increase growth hormone. One of the things that we're doing, and it's one of the things I'm well-known for, is lactic acid training. So when you do training that increases lactic acid there's a corresponding increase in the production of growth hormone. Through lactic acid you create the kind of training that's involved in the creation of microtrauma. Growth hormone is very very good for muscle building and fat loss; it's one of the more powerful compounds in the body, more specifically it does address cortisol in a lot of ways and to help the reduction of belly fat which is probably the reason why it is used by so many competitors and athletes and it helps you lose fat, particularly in your belly because it addresses cortisol there.

So to just briefly discuss lactic acid training, there's really a lot of ways to do it but the way that we do it is kind of based on the old Don Alessi method which is bringing a weight up very very slowly and then bringing it down quickly. Lactic acid is produced primarily through the lifting or concentric phase of movement, so we try to exaggerate that and stretch it out as much as possible, so usually lifting a weight over a period of four or five seconds and then lowering the weight quickly just so we can get back to the lifting phase.

Alessi first introduced that in an article called Meltdown Training on T-Nation in 2001 or 2002. Really really intelligent guy, he caught some flak for that article and looking back at it now I don't like that program as written because it just has you doing the lactic acid based training for six weeks, and if you lift weights slowly for six weeks it makes you really really good at lifting weights slowly and getting more proficient at it, but if you're getting really really good at lifting weights slowly you're probably getting really bad at lifting weights quickly and I think just doing that type of training for six weeks means you'll probably have to play catch-up before you get your strength back.

So if you're working to address one of the specific fat storage patterns all you really need to do is decide which one is there and then pick a style of training.

Is it always just one hormone that's dominant?

It'll vary from person to person. Anyone who's been fat for most of their lives is probably going to have some insulin issues, so usually it's insulin resistance and high estrogen, or insulin resistance and high cortisol, or insulin resistance and some other wacky thing. It happens sometimes with people who have had very stressful lives where you see a guy with high estrogen and high cortisol. I'm not really sure why that happens. We do see guys with high estrogen and estrogen-related fat storage patterns, like they'll have man boobs so they're going to store a little bit more fat in their chest or store fat in their lower body. It becomes really really apparent when you do skin fold testing with body fat measurements. If a guy's got a relatively low abdominal pinch, let's say he's 10% bodyfat and he's pinching at like a thirteen on his abs but his quad pinch is also a thirteen, that's extremely high. Most guys are pinching low on their quadriceps but fairly high on their abdominals or love handles, so that's kind of a good indicator and we can adjust training accordingly.

So do you just work with what seems out of balance or is there a specific order?

Well, the way that Final Phase Fat Loss works is that you're addressing all four hormonal things. Most people can benefit from lactic acid training because it's a great fat loss method, and most people can benefit from density training because it's a great muscle building method and most people can benefit from dynamic training because it's a great conditioning method. And also in Final Phase Fat Loss you have a strength-based training day so that you can increase your strength or at least maintain it during the course of a dieting phase. So the way that program works as written is that you're actually rotating four training modalities over the course of a given training week because each person can stand to benefit from each of those four things. As you get more specific, if I'm working with someone one-on-one, if it's a woman we might cut out the lactic acid training towards the end of a six-week cycle because she might not benefit as much from that and maybe she needs another density training day. So in general I recommend that most people start out using that program as written, and as they see themselves progress and see more and more things kind of pop out and become more apparent then from there they can really make more adjustments as necessary and throw in another day of one and perhaps cut out some of the others.

Do you modify supplements based on specific hormonal imbalances?

Yeah, a little bit. It depends on how involved my clients want to get. Charles Poliquin is really dealing with insulin management, so he's got a lot of cool supplements like Insulinomix, and he's done some work with fenugreek which has been shown to really combat insulin resistance, so we do throw some of that in but by and large most people I'm just having use high doses of fish oil. Most of my clients are getting at least twenty grams of fish oil per day. And Christian Thibedeau from T-Nation has a really cool method; his recommendation is that your dosage should be one gram per percentage of body fat per day, so if you're 14% body fat you should have 14 grams of fish oil per day. I think that's a great recommendation until you get to about twenty percent body fat because after twenty percent you don't need to take that much fish oil. So anybody who's taking above 15 grams I have take half of it through liquid and the rest are capsules throughout the day. So we have high doses of fish oil, and everybody's using protein supplementation and post-workout stuff. I don't get too crazy with the supplements because I think most people should be focusing on their diet, and really there's not that much they're going to gain from supplements.

How would you define the last few pounds?

The last few pound of a fitness competitor are a lot different from the last few pounds of fat for the average person. So if we're talking about the average guy it's really getting to 8% bodyfat or below is the last few pounds. So if you're starting at twelve percent, and you need to get to 8 and maybe that's ten pounds, it's really just getting to leaner than you ever have before. It's the final frontier. So for most guys that's really leaner than they've ever been before. For most women, 15% or 14% is good. It's getting to a low bodyfat percentage where you can kind of see your ideal physique.

For more about John Romaniello, check out his blog