This is a quick follow-up post to my last article on the big fat loss secret. After a full year of doing a great deal of one-on-one phone conversations, I keep wanting to share some of the calls. I get some really interesting cases, and I often find myself wanting to start recording some of the really good calls and publish them for a general audience to listen to. They really are that interesting, and the lessons often strongly reiterate some of the basic messages of 180DegreeHealth. I haven’t recorded any calls yet, and I don’t know if that’s something I’ll actually do, but I thought I could at least share some of the things that I discussed with Coldmember – a 20-year old Dutch kid that ran into serious health trouble after pursuing extreme body composition goals and extreme eating.
In his case, we were really looking at true eating disorder recovery, which is theoretically pretty simple and straightforward – but in practice it is one of the most difficult of all things to achieve. It is also made much trickier by the fact that he is taking hydrocortisone, thyroid, growth hormone, and testosterone – we ran into what seemed like hyperthyroid symptoms by the 4th day for example, and he had to lower his dose (something that I of course cannot give counsel on, but something his endocrinologist was able to support). Today he has come off of it completely, 9 days after our first conversation.
Some of the reasons eating disorder recovery is so difficult:
1) Digestion is weakened (weaker digestive secretions, delayed stomach emptying, thinner intestinal walls, potential bacterial overgrowth, etc.), and when appetite is extremely high this is a big mismatch. For Coldmember to switch from his most recent diet to eating to the point of appetite satisfaction meant suddenly going from 1800 calories to 7000. I recommended starting out with 3000 and slowly increasing it. Easier said than done. He’s eaten well over 5000 each day since the beginning, starting with a phenomenal first day of 7000 calories – all of them “clean” by his choosing. He mentioned eating a couple pounds of beef and a dozen eggs in addition to several pounds of sweet potatoes and stuff like that.
2) Glucose metabolism is impaired. It’s typical to experience dramatic blood sugar fluctuations when you begin refeeding after extreme leanness. Moods are extremely unstable. He’s already experienced bouts of anxiety and other weird moods, although overall he’s seen a dramatic improvement, including even laughing for the first time in many months. Others experience much more extreme fluctuations, only making it easier to talk oneself out of eating and gaining weight – something a person with an eating disorder is already at odds with from the get go.
3) Sanity is compromised. A frantic, obsessive compulsive type of mind state is the norm for those with an eating disorder. Most think that’s just the type of person that ends up with an eating disorder, and there are certain predispositions (such as being a perfectionist), but few realize just how much your mental state is affected by extreme leanness and a low metabolism. In today’s day and age, it’s hard for someone with an eating disordered mind to stick to one, steady, sane approach (it’s hard enough for a sane person with all the information overload on the internet). At the point where Coldmember is at, it’s hard not to be on your 4th or 5th dietary experiment by dinner time. That is an exaggeration, but not a very large one. He really needs to eat, and any food will work, more or less. Still, he contacts me frequently to discuss PUFA, macros, body fat percentage, various types of training, and that kind of thing. You can see the game of dietary ping pong being played in his mind in the messages he sends me, which is COMPLETELY normal in the state he’s in.
4) Catecholamine Withdrawals. Starving yourself in some way is invigorating in a sense, even euphoric. That’s due mostly to the burst of catecholamines secreted during major stress. Eating more and sleeping more shuts catecholamine production down and leaves people typically feeling the opposite of invigorated and euphoric, for a while. Aches and pains set in. The fatigue can be overwhelming at first. Mood is calm but the mind is foggy and fuzzy and unfocused. Basically, these catecholamine withdrawals feel like a stronger version of what a coffee addict experiences when he or she wakes up in the morning and hasn’t had his or her coffee – grumpy, tired, foggy, and achy. It’s hard not to resort to hard exercise, meal-skipping, stimulants, purging, or other endorphin-releasing “drug” to ease the withdrawals. Getting past an eating disorder is like getting off of a high-powered stimulant drug like cocaine. It’s not easy and probably the main reason eating disorders are self-perpetuating with a high rate of relapse (and why the guy in the picture in this post, Jeremy Gillitzer, is dead). Coldmember, fortunately, seems like he isn’t having much trouble in this category compared to others I’ve communicated with.
Anyway, that’s just the short list of complications. But as you’ve probably already gathered, the approach we discussed is incredibly simple and very effective if the complications don’t interfere. Coldmember also mentioned a strong desire to accommodate his body composition goals as well, and we discussed that at great length. Here are some of the main things I pointed out to him and suggested he try playing around with…
1) Most of the physiques we admire are not of men who weigh 54 kilograms (about 119 pounds) – his weight when contacting me for the first time. Most, at his height, weigh closer to 90 kg (200 pounds). I suggested that going through a long building period of at least a year, despite the initial fat gain, would actually be an important first step in moving towards that aesthetic ideal. He has weighed 80kg before, and I suggested that he probably wouldn’t reach his full normal state until he approached that weight.
2) I suggested slowly increasing calorie intake over several weeks and then transitioning to eating to the point of complete appetite satisfaction. He was unable to do this as I kind of suspected. The drive to eat when you open up the floodgates is absolutely incredible, another great challenge during eating disorder recovery because people don’t understand how temporary this is, and worry that they will continue to eat at that calorie level and balloon up to 500 pounds.
3) I told him to expect to gain fat in his abdomen first, followed by fat in the rest of the body, followed by replacing lost muscle, bone, and organ mass as the main metabolic portion of the rehabilitation process reaches completion several months from now. I didn’t say it quite so succinctly, but this general process is something that I take time to describe to a lot of people pursuing refeeding.
4) I told him to try to get the basic anti stress foods worked into all of his meals – salt, sugar, starch, and saturated fat.
5) I told him to eat 3 structured meals daily with a “carby, salty snack” any time, day or night, that he felt cold – especially in the hands and feet, or started urinating frequently (before contacting me he was drinking 5 liters of water daily with completely clear urine passed hourly or more). One of the reasons I recommend this over going fully “intuitive” as to when and what to eat is to keep him from having to think about it so much – instead allowing his eating to be on “autopilot.” The body can adjust to regular rhythms too, and thrives off of regularity and consistency.
6) I told him to reduce his water intake dramatically, or consider drinking a beverage with salt and sugar added to it in place of water, and not so much of any beverage that his urine was absent of a normal yellow color. I did remind him that as his food intake increased, and his metabolism increased, that he would need to steadily increase his fluid consumption once more – based mostly off of changing urine color and general levels of thirst in the future.
7) I told him to stop working to failure during his Body By Science-inspired workouts, and slowly increase the volume and/or intensity of his exercise over time as he felt like it.
8) I told him that he would probably be able to work with his endocrinologist to get off of all his hormone replacement therapy (hrt) in 2-3 months at the most. He’s already off of testosterone and thyroid after 9 days. At first his endocrinologist refused to believe that his dieting had anything to do with his hormone levels, and diagnosed him with hypopituitarism. I chuckled when he asked me if he thought his hormone levels looked like someone with hypopituitarism. Five days later he went to see the endocrinologist and the diagnosis was overturned.
9) I told him to work on increasing the quantity of his sleep as his metabolic state allowed, and rely as much on sleep, and as little on food, as is possible many weeks and months from now. I also told him to try to adhere to a regular bedtime as much as possible, and eat plenty of dense calories (foods with a lot of calories as well as salt per bite) when he goes out and drinks with his friends.
10) I told him it would probably take a full year to complete full metabolic and chronic dieter rehab, and another year after that to get to the point of having a muscular and lean physique that he can be fully comfortable with. He was probably thinking that sounds like an eternity. Everyone reading this probably thinks that sounds awfully quick. He is 20 ya know.
So, very simple, yes. Eat the food. Get some sleep. Don’t overexert yourself. It was the extensive coaching required to keep someone like Coldmember on track, and focused on a long-term vision of health, a high metabolism, AND an attractive body that engulfed most of our 90 minute phone call. I didn’t talk much about food specifics, as they just aren’t that important – other than to say to reconnect with what you want to eat, not what you think you should eat.
He is already panicked about his change in body composition in less than a week and a half. He’s got a long way to go to fully complete this process, but hopefully with everyone’s encouragement, a long-term vision that expands far beyond the changes that have taken place in the first 9 days, and having his case discussed publicly will help serve as a powerful reminder when he looks in the mirror, can’t find his abs, and has wistful thoughts of Durianrider.
Hopefully I can give everyone an update a year or two from now.