Measurements

From https://www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/abdominal-obesity/

My current measurements, approximately:

3/26/22    w:58"    c:54"

2/20/23    w:55"    c:50"

Krista Varady (Someone who _has_ published!)

 Dr. Varady has done extensive research on alternate day fasting, intermittent fasting, and other strategies, both in mice and in humans.  

I complained about "mumbo jumbo" in lay analysis of scientific research before, so I won't engage in it here.  Varady did publish a diet book based on her research.

The main thesis is that in alternate day fasting, people don't eat back 175% or 200% of the calories to make up for fast days.

She is featured in Eat, Fast, and Live Longer, the fasting documentary by Michael Mosley.  I'm not sure this was part of the dynamic, but I felt a bit like Dr. Mosley stole the fasting thunder from Varady - popularizing his work in his own book, while the basis was entirely her research.

Why haven't Jason Fung and Meagan Ramos published, and do I care?

Except for one letter in the BMJ, a cursory search of Google Scholar doesn't return any academic results for these two.  I have to admit that that is a little bit scary to me.

On the other hand - alternate day fasting just from the first-person lived-experience feels great.  I am sharper and have more energy on fast days.  Psychologically I feel like I am doing something for my health which helps me, despite a BMI over 40, hold my head up high. 

Alternate day fasting is helping me to lose some weight, at least in the short term.  There are side effects though, constipation and at times diarrhea.   It would be nice to know, through research, that I'm not giving myself colon cancer, or doing something else injurious to my body.

There are other luminaries in this community who vocally support fasting as an option beneficial to health and longevity like Peter Attia MD.   However, again, no evidence produced.

Pre workout

 On the subject of bullshit...  look at the ingredients in some of these pre-workout mixes.

You would get the same effect with a cup of coffee and a mini snickers bar.

(I got the idea of the snickers bar from the 6-time winner of the CrossFit games)

"Body Habitus"

Body habitus: 

The physique or body build. For example: "The metabolic complications most commonly reported (with HIV infection) are hyperlipidemia, hyperglycemia and altered body habitus."

The term "body habitus" is somewhat redundant, since habitus by itself means "physique or body build."

from: rxlist.com

The high order bit from "The Biggest Loser" study is not the RMR, it's the resource cut from the show ending.

 Fothergill, Erin, et al. "Persistent metabolic adaptation 6 years after “The Biggest Loser” competition." Obesity 24.8 (2016): 1612-1619.

Read it here

Look, I just don't know what the lived-experience of a morbidly obese person is with the resting metabolic rate (RMR) of a morbidly obese person, versus the same person with an RMR of someone who is reasonably trim and fit.  Does one feel energized, and one lethargic on a certain number of calories?  I don't know.

All of that aside.  (I mean it, let's forget entirely about metabolism right now as if it is the health equivalent of the financial practice of trying to time the market.)

What resources went into the 30-week weight loss of these contestants?  What resources went into their weight maintenance after the show ended?

During the 30 weeks:

• Full time videography
• Full time chef
• Full time trainer
• Well-supported support group
• Formal and social accountability sessions
• Top of the line fitness machines
• Residential focus on the goal 

After the 30 weeks training:

????

It's obvious to me, having participated in reasonably resource-rich sports teams, that a big part of the problem is the lack of cash put into maintenance.  If you want to think of it another way, ask: "What am I relying on for this weight loss, and is that something I can maintain in terms of time, finances, will, boredom/fun, challenge, interest...etc when the time comes to maintain my weight?".

If the answer is a $100/hour personal trainer and you have a salary of $30,000 a year, I'm going to guess that you are going to have trouble maintaining. 

--edit--

If I had to point to another major factor it would be the length of time over which the contestants lost the weight.  If I read the charts right the average weight loss was 130 pounds, and the length of the course was 30 weeks.  To me that's a really, really intense crash diet.

Medium-range goal - Class II Obesity

There are a few criteria for Class III Obesity

• BMI above 40
• Over 100 pounds above normal weight
• BMI above 35 with health complications from obesity.

For my height, a BMI of 40 represents a weight of 263 pounds.  I've lost 12 since starting fasting at the end of January (assuredly some of that is water weight), and am currently at 317 pounds.  That is about 54 pounds away from being out of the Class III category.

One of the things I don't understand -- and this may be just a case of body eumorphia (the opposite of dysmorphia) -- is why some people have class III obesity and look it, and some people are built differently.  Certainly I have a background in athletics, which might just mean I'm used to liking what I see in the mirror.  

https://www.cdc.gov/obesity/adult/defining.html

   

Edit:

One thing I left out here is that many many people cite BMI as a "U-shaped" curve.  On Peter Attia's podcast with David Allison I also heard the idea that the curve shifts to the right as we age.  30 might be a perfectly reasonable BMI for a man in his 60s.

Breaking a fast early

 My intention yesterday was to fast for 36 hours, but I broke the fast at 24 hours.  I had a meeting a couple of hours away today, and didn't want to risk having the runs (a side effect that I hear is common in fasting) on the expressway.

Someone I respect said that if you are going to break a fast, and have made it to 24 hours, then that's a real accomplishment -- not to worry.

I don't think this is going to completely derail my program, but we will see over the next few days.  I'm fasting now and it feels approximately like it did before I "fell off the wagon".

--edit: I'm right back on it!

I got through my first 6 fasts!

 

Welp, I got through my first 6 fasts on the 3-day-a-week 36-hour fasting program.

This is what my weight trend looks like (technically the two local minimums are at the same point and represent the weights at the weeks end of fasting before the weekend.  I'm not too worried though, because I feel you _can_ put stock in the moving average.):

When you start something like this, you have to fully expect weight loss to taper off after about the first or second week.  Once your body has adjusted its water balance, the weight just doesn't come off as quickly.

Another future goal is to work in some regular cycling.  I haven't felt like doing that, which might be problematic.  Remembering that the body has two approaches to dealing with a fast day: 1) Burn fat, 2) Slow the metabolism way down.  I can use how much I'm dreading cycling, and how I feel after doing it as a gauge of what my body is doing.  

Maintaining weight loss is possible: National Weight Control Registry, Wing, and Hill

There are a bunch of studies on Google Scholar by these two with generally the following conclusion:

"There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. "

Range of motion after 1 month away from gym

Getting better!  I can cross my legs without too much pain.  Still planning to take some more time off, especially as I am getting situated with a new fasting routine.

--edit: Got on the exercise bike for 20 minutes this afternoon.  Felt pretty good.

The inevitable lapse

I posted the following on The Fasting Methods discussion forum, we shall see what comes back: 

Inevitably, I'm going to break a fast day.  Even conceptualizing the fast as 'treatment', rather than 'diet', it is a sure bet that I will find myself having eaten on a fast day.
This type of lapse makes it very hard to get back with the program.  I'm sure however, that successful people chalk an 'oops' up to just a passing thing, and keep on going. 

Nobody is perfect.

Do you have any strategies or mindsets for dealing with this type of thing?

What came back

One way to think about a lapse:

I lapse regularly Tuesday, Thursday, Saturday, and Sunday.  It's built into the program.  So adding an extra off day shouldn't really be a big deal.

"Don't slash the tire"
If you get out of the car and the tire is flat, look for a way to re-inflate it.  Don't say "well, it is flat, so I might as well slash the other tires."   (Mess up in a controlled way.  If you want to completely let yourself go, then choose to do that, but it's a choice.)

"Am I working toward my goal or away from my goal?"

"I'm not going to binge 'right now'."

Not never again.  Just one moment at a time.  The lower brain never gets to win.

"Dial it up, dial it back"

You have the option to dial the plan up, and dial the plan back.  An example of dialing it up would be increasing the fasting time, or cutting out carbs.  But there are also examples of dialing it back -- choose to switch to making the next 3 fasts 24 hour fasts (assuming you were doing 36 hour fasts), choose to allow fat fasting.

An additional idea

When I did my first 36 hour fast last week, it felt like I had unlocked a skill.  The first one demonstrated to me how (not) hard it was.  I felt like with one under my belt, I could do it.

In some ways the lapse does the same thing.  It's hard to get back on the wagon, because I'm not sure if I can do it after a lapse.  I feel like it's insurmountably hard to get back on the wagon.  Viewing it as a challenge though, something to prove to myself, once I do finish the first fast after, I'll know I can do it!

Another thing to consider is, like in rowing, if you have a few strokes where you just give up, keep going and finish the race - you might get it back.   This might translate to lapsing using a fat fast (which is really just a fasting aide), eating what you need to, and then finishing out the fast.

The danger is if you break the fast and say, "welp, it's broken now", give yourself permission to just let yourself go, it's hard to get back on the wagon.  It's the slippery slope mind.

This isn't introducing the ambiguity of "am I allowed to eat anything on the fast", I'm still going for complete abstinence for 36 hours, it's just that if things are going to fall apart, I can dial in the degree to which they do that.  Dial it back a bit, i.e. convert a full fast into a fat fast, an intermediate step to just jumping off the horse.

Wisdom from the 2020 Gary Taubes interview with Jason Fung

Gary Taubes is the famous author of Good Calories, Bad Calories, one of the first books since the Atkins diet to look at obesity, carbohydrate, and insulin.

Dr. Jason Fung is a Canadian nephrologist who has popularized intermittent fasting as a diabetes treatment and weight loss method.

There's a lot to this video, but I pulled out a couple of pieces that I found interesting and paraphrased them below:

..

"Why did the plane crash?"

"It was a lift imbalance issue."

The thermodynamic theory of weight loss is "Calories in, calories out", which Fung and Taubes characterize as "not even wrong," meaning "irrelevant."  The issues for them is not why the plane's down force exceeded it's lift, but what was going on with the pilot, the computer systems, and the maintenance of the plane that caused it to crash.  They will consistently talk about insulin in this talk and what Taubes calls the "hormonal hypothesis for obesity."

..

"When you eat protein and fat, there are well known satiety hormones that get activated [omitted consciously, I don't want this to get into "bro" science], which tell you to stop eating.  If you are eating foods that tell you that you are full and don't want to eat more, that's a good thing.  If you are eating a bagel with jam, pure carbohydrates, a slice of toast and jam, you aren't activating those satiety signals.  That's why at 10:30 you are looking for a low-fat muffin."

One of my pet issues is that I wonder whether you have to be in ketosis to get the benefit of a low carb meal.  Meaning, if you eat pancakes at 8am, is there any benefit from eating low-carb for lunch?   If you think about the waves of hunger that come and go that Fung talks about in other places, maybe it makes sense that on some level each cycle of hunger / feeding / satiety is a little bit atomic.  If you eat low carb at a meal, you are more likely to eat less energy, have less of an insulin response, and shunt energy into fat, at that meal.  This is me, and not Dr. Fung though, so take with a grain.

Fasting - I got through my first 3 fasts!

Three things really helped: 

1) I read a Meagan Ramos podcast where she talked about going through chemo, and then subsequently treating fasting like a treatment rather than a diet. "I wouldn't miss a chemo session to have lunch with my girlfriends!"

2) In the same podcast Meagan suggested a bit of non-sugar pickle juice as a substitute for bone broth on the day. This if feeling like electrolytes are out of balance, or just generally miserable.  It is easy to stomach and kept me feeling pumped up throughout the day.

3) I saw a youtube video with a Registered Dietician going through fasting.  She suggested an electrolyte water, which kept me hydrated without worrying too much about it.