5/2 - Health Goals
Last month I laid out the 5/2 document and what it's for. Two questions: What do I want? and What do I do? Ten life categories, five timelines, one sheet you reference daily and modify rarely.
This is the first category walkthrough, and I'm starting with health and physical because it's home turf. It's also the category people get most wrong, which is a strange thing to say about a list of goals written by people who are paying a doctor to help them stay healthy. The mistakes are consistent enough that I can predict them before I read the sheet.
Everything I do here transfers to the other nine categories. Watch the method more than the content.
Start at Twenty Years and Work Backward
Most people build goals forward. Here's where I am, here's a little better, let's go. That produces a sheet full of incrementalism and no direction. Twenty pounds lighter than what? Stronger for what?
Build it backward instead. The only question at the twenty-year line is what you want to be physically capable of doing. Not what you want to weigh. Not what your labs should say. What you want to be able to do.
For me that's still training jiu-jitsu, and I want to be able to finish a triathlon. Those two answers do an enormous amount of work. If I want to be training BJJ in twenty years, I need shoulders, knees, and a neck that still functions. This means I cannot spend the next two decades training like I'm trying to win something. I need a body composition that doesn't load my joints unnecessarily. I need to still be able to sprint and recover. Every other line on my sheet is downstream of those two capabilities.
This is the part people skip. They write "lose 20 pounds" at the top and then wonder why the sheet feels arbitrary. It feels arbitrary because it is. A number with no capability behind it is just a number, and numbers without a purpose get abandoned around week six.
Function Is the Goal. Numbers Are the Instrument Panel.
There are two kinds of physical goals and you need both.
Performance goals are things you do: run a marathon, enter a powerlifting meet, compete in pickleball, finish the hike your family already booked for next summer. They're objective because either you did it or you didn't, and they come with a date attached whether you like it or not. That last one is underrated. A vacation hike in eleven months is one of the best training goals a sedentary person can have, because the deadline isn't negotiable and the consequence of missing it is social rather than medical. People train for that.
Then there are the measured goals: a body fat percentage, a body weight, a VO2 max, a squat or deadlift number relative to bodyweight. These are the instrument panel. They tell you whether the engine is doing what you think it's doing.
The mistake is treating the instrument panel as the destination. Body fat percentage is not a goal. It's a readout that tells you whether you're likely to be able to do the thing you actually want to do in twenty years. When I write that I want body fat under fifteen percent and visceral fat under a pound and a half at the twenty-year line, I'm not chasing a physique. I'm stating the condition under which I'm still training and not managing three chronic diseases.
A word on VO2 max, since it's become the number everyone wants. Cardiorespiratory fitness is about as good a predictor of all-cause mortality as anything we measure — a 2024 meta-analysis pooling 42 studies across 3.8 million observations found the association held whether fitness was measured directly or estimated. A separate review found that fit people with a higher BMI outlive unfit people with a normal one. So the enthusiasm is warranted. But most of you don't have a real VO2 max. You have an estimate from a wrist device using heart rate and pace, and those estimates are directionally useful and individually imprecise. If you're going to put a VO2 max number on your sheet, either get it measured properly or use a field test you can repeat under the same conditions. A 5K time is an honest proxy and it costs nothing. Mine says under 25 minutes at twenty years and under 21 at five. Same information, no equipment, no argument about calibration.
SMART, With One Correction
The standard advice is that goals should be SMART: specific, measurable, achievable, relevant, and time-bound. I've seen the R written as "realistic" plenty of times, including in my own notes, but achievable and realistic are the same requirement wearing two hats. Relevant is the more useful R, and it's the one that connects to everything above — relevant to what, to the capability you named at twenty years.
That's the whole framework. It's a checklist, not a religion. Its only real job is to stop you from writing "get in shape" and feeling like you accomplished something.
The Boring Half
Here's where the sheets I read fall apart. People write the performance half and skip the maintenance half entirely.
Normal blood pressure is a goal. Normal lipids are a goal. Normal fasting glucose and a normal A1c are goals. Sleeping seven hours is a goal, and it may be the highest-leverage line on the entire sheet. Hormone levels in a normal range are a goal — and I'll add the caution that "normal" is the target, not "optimal," because the pursuit of optimal hormone numbers as an end in themselves is one of the more expensive detours available in my field right now.
Then there's the half that isn't even physiology. It's logistics. Routine dental visits. An eye exam. A primary care visit that actually happens. Age-appropriate screening — a colonoscopy, a mammogram, a skin check, whatever your risk profile calls for. These belong on the sheet as explicit goals with timelines, and almost nobody puts them there, because scheduling a dental cleaning doesn't feel like a goal. It feels like an errand.
It's a goal. Errands you've deferred for four years are goals. The five-year column on my own sheet has "get vision checked" and "get a colonoscopy" sitting directly underneath a sub-21-minute 5K, and I don't think that's a contradiction. I think that's the point. One of those keeps me competitive. The other one keeps me alive to be competitive.
The older you get, the more the weight of the sheet shifts toward this half. Not because performance stops mattering — I'm arguing the opposite — but because after a certain point, maintenance is performance. The screening you didn't get is the reason you can't do the hike.
Walking the Timelines
Here's my own sheet, and I want to show it with the ugly parts intact, because the polished version wouldn't teach you anything.
Twenty years is capability, stated above: still training BJJ, able to complete a triathlon, normal blood pressure, seven hours of sleep, body fat under fifteen percent, visceral fat under a pound and a half, squat at two times bodyweight, bench at one and a half, deadlift at two and a half, 5K under twenty-five minutes. Notice the strength numbers are expressed relative to bodyweight rather than as absolute loads. At twenty years out I don't know what I'll weigh. I know what ratio keeps me functional.
Five years is the frequency and the structure that gets me there. Training jiu-jitsu twice a week, wrestling or striking once. Lifting two to three times a week. Cardio three to four times. A 5K under twenty-one minutes, body fat under twelve percent. Vision checked, colonoscopy done. This column answers the question the twenty-year column can't: what does a normal week look like if that's the destination?
One year is repair and reset. Full function after a pec tear. Muscle mass back to where it was before surgery. Maxing out the Army fitness test. A full blood panel. And then two lines that I'm publishing on purpose: find a doctor and get a physical, and find a dentist you like.
I am a physician. I had, at the time I wrote that, no primary care doctor of my own. This is depressingly common in my profession and it is not a flex. If you want a single illustration of why the maintenance half belongs on the sheet, it's that the guy writing the article had to put "find a doctor" on his own one-year list.
Two months is the training block. Back to BJJ twice a week. Follow the program as written. Drop five pounds of fat, add three pounds of skeletal muscle. Fifty push-ups, twenty pull-ups. This is the column that changes most often, and it's supposed to. The motivation that comes with starting a new program burns off somewhere between four and twelve weeks, so the two-month block exists to be swapped before boredom does the swapping for you. The twenty-year line hasn't moved in a decade. The two-month line changes six times a year.
This week is behavior, and it's the shortest column and the most important one. Follow the workout program. Hit all the workouts. No phone after nine. Three meals a day. Eat around training. Floss.
Floss is on there. It's on there because it's a daily behavior with a documented downstream effect and it takes ninety seconds, and because a weekly list made only of heroic items is a weekly list you'll abandon by Thursday. Most of what's in that column I already do. That's deliberate — it's the credit-first rule from the intro, and it's the difference between a sheet that reminds you you're already moving and a sheet that opens with an accusation.
The Most Common Mistake
Every post in this series names the one error I see most in that category. For health and physical, it's this: people write the twenty-year line as a fantasy instead of a capability.
"Be healthy at 65." "Still be active." Those aren't goals. They're moods. They can't be reverse-engineered because nothing in the five-year column follows from them.
The fix takes about four minutes. Picture a specific day twenty years out and describe what you're physically doing on it. Playing on the floor with a grandchild and getting up without using your hands. Carrying your own luggage through an airport. Skiing a full day. Getting through a round of golf walking. Then ask what has to be true of your heart, your muscle, your joints, and your labs for that day to happen — and write that down.
Do that and the rest of the sheet fills itself in almost mechanically. Skip it, and you'll spend twenty years chasing numbers that never belonged to anything.
Three Practical Suggestions
Write the twenty-year line as a verb, not a number. Describe a specific physical thing you want to be doing, on a specific kind of day. Every measured target on the rest of your sheet should be traceable back to it. If you can't trace it, cut it.
Put the errands on the sheet. Dental, vision, primary care, and the screenings your age and risk actually call for, each with a timeline. If you've been deferring one for years, it goes in the one-year column, not the five.
Pick a repeatable field test instead of a device number. A timed 5K, a max push-up set, a loaded carry for distance — something you can run twice a year under the same conditions. It'll tell you more about your trajectory than a wrist estimate, and it won't change when you buy a new watch.
Three Primary Takeaways
Function is the goal and the numbers are the instrument panel. Body fat, VO2 max, and lift totals matter because of what they let you do, not on their own. Numbers without a capability behind them get abandoned.
The maintenance half counts. Normal blood pressure, normal glucose, seven hours of sleep, and the appointments you keep putting off are goals in exactly the same sense as a marathon, and they get more important, not less, as the timelines stretch out.
The long lines hold and the short lines move. Twenty years shouldn't change much in a decade. Two months should change six times a year. If you find yourself rewriting the top of the sheet every season, you wrote a mood up there instead of a capability.
Next in the series: relationships.
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