HCG, Intermittent Fasting and Ketosis: the Unholy Trinity of Metabolic Downregulation

Today, for a change, I’m not going to hit you with a bunch of studies. I’m just going to tell you what I’ve learned through experience with my clients and readers. Then I give you a couple links to check out if you want to read some more sciency stuff.

My client base is made up largely of women who’ve already run the diet gauntlet. By the time they get to me, most of these women have essentially been on one diet or another for years, or even decades. They’ve done it all. They’re experts at losing weight. Trouble is, the weight always comes back. With each successive diet, they ultimately find themselves fatter and sicker. I don’t put my clients on diets: they’ve already been, to a one, on all the diets. I get my clients off diets. Get them eating a humane, sustainable amount of food, with a focus on supporting their activity and honoring their personal tastes and cultural traditions. The vast majority of my clients stabilize fairly quickly and begin making forward progress, once they wrap their minds around eating to support their metabolic health.

There are a few clients, though, who have a much harder time stabilizing. Their weight won’t budge, or it fluctuates wildly. They don’t seem to be able to build muscle mass as effectively. They begin to store more fat around their belly than they have in the past. They experience edema. They deal with anxiety and insomnia and other symptoms of starvation, even when their calorie intake is adequate. It is as if their bodies refuse to emerge from the starvation response (see my Adrenal Fatigue post for more info on the starvation response). This goes on for months, even when calories and macronutrients are all adequate and consistent. I’ve had several clients who’ve experienced this, and every single one of them had a history of one or more of the three diet philosophies that I’ve taken to calling the ‘Metabolic Downregulators’. Those three diet philosophies are: HCG, Intermittent Fasting, and Ketosis.

All three of the Metabolic Downregulators appear to provoke the starvation response by design. The first symptom of the starvation response is rapid weight loss. Subsequent symptoms are endocrine adaptations that slow the body’s metabolic processes and insure against famine by shoring up fat reserves, stopping reproductive function and reducing metabolically expensive lean mass. IF and ketosis seem to be able to do this even in the absence of a caloric deficit. HCG, of course, simply relies on extreme calorie deprivation. That initial rapid weight loss is what the dieter fixates on, and when the weight loss stalls out they wonder what they are ‘doing wrong’, and double down on the diet in an effort to get the weight dropping again. This only compounds the metabolic downregulation, and the dieter ends up exhibiting all the symptoms of starvation AND excess fat stores.

Like I said, I’m not going to throw studies at you today (I’ll let Alan Aragon, Anthony Colpo, Stephanie Ruper and others do that). I’m simply sharing the observations I’ve made amongst my clients and readers.

My clients who’ve succeeded in downregulating their metabolic function need much more time to repair and stabilize than others who’ve followed less extreme diet philosophies. 6 months is not uncommon. Some women need a year or more. The longer a person’s body has been in the starvation response, the longer it’s going to take to recover. This is a frustrating reality. The temptation to return to extreme dieting can be great. I encourage those of you who are experiencing this to remember that the diets ultimately failed, and it is exactly those diets that brought you to where you are today. There is a better way. Consistently and dependably giving your body the nutrition and energy it needs to be healthy and active will allow it to emerge from the starvation response and heal from the damage the diets have done. But it takes time. Be patient! The long-term benefits are worth it.

If you’ve gone through this, please share your experiences in the comments so that people just beginning the healing process know they are not alone. There is a vast support network out there for those ready to start on the path out of the restriction maze. Please reach out, from wherever you are, to support each other and to find the help you need.

I will add to this list as I find additional resources.

http://www.alanaragon.com/an-objective-look-at-intermittent-fasting.html

http://www.paleoforwomen.com/shattering-the-myth-of-fasting-for-women-a-review-of-female-specific-responses-to-fasting-in-the-literature/

http://anthonycolpo.com/why-intermittent-fasting-isnt-all-its-cracked-up-to-be/

120 thoughts on “HCG, Intermittent Fasting and Ketosis: the Unholy Trinity of Metabolic Downregulation

  1. This is a new concept for me and one I feel I maybe suffering from. Are there any books on this subject or advice on how to recover.

    • Matt Stone’s stuff is great. 180degreehealth.com
      Also, http://www.youreatopia.com/ has a wealth of information about restrictive eating disorders. It’s geared toward women, as women tend to be the primary victims of these disorders, but the info there is valuable for everyone.

  2. I recently (3 months ago) completely modified my diet to cure a candida albicons overgrowth, which involves removing all starches and sugars, so I basically came down to quinoa chicken and vegetables, but after reading this article I realize Ive been experiencing starvation symptoms, and Im concerned about causing damage to my system both that will tax my body now and that Ill have to repair later.

    Could you recommend me some literature? Preferably free?

    Thank you

      • I did. Had 4 brain surgeries 06-09, so perfect storm for it to happen. Had everything starting with a gluten allergy. Had oral thrush for as long as I can remember but didnt know what it was til I self diagnosed.since the surgeries, constant muscle and joint soreness. Up until doagnosis the recent stuff was exzemma patches on my skin, uncontrollable uti and jock itch, and hemroids outa the blue.

        Ive always been regularly physically active and had a clean diet and been really hygenic so it didnt make sense.

        Symptoms began dissapting within weeks of diet alteration, some gone completely now. Not to mention when it dies and leaves your body you can clearly see it and I did 4 days into diet alteration. No doubt that I have it.

        Thanks for the site Ill check it out!

  3. Or, they went raw, did a ton of juice fasts to keep getting that rapid weight loss rush from the beginning of going raw, kept doing juice fasts, then did 80/10/10, then started having major problems from anything they ate, so juicing only again, then did Paleo-ish for a while, then strict Paleo, then something like Paleo, but super low-carb even more than Paleo.

    Now, they’re just eating the food. And in tears on and off for the past two days because they’re just so freakin’ grateful that their energy levels are going back up.

    Eating the food goes beyond whether or not you’re going to lose or gain weight. It’s a freeing from all the mental madness all the other extremes end up creating.

    • “Eating the food goes beyond whether or not you're going to lose or gain weight. It's a freeing from all the mental madness all the other extremes end up creating.”

      Yep. I could not nourish myself back to health and try and stay “lean”. Buying bigger pants is not the worst thing to ever happen to me but getting out of diet prison was one of the best.

      • How have you all dealt with the mental aspects of gaining weight and having to buy bigger clothes while going through this transition? It has only been two weeks for me and I gained 15 lbs and clothes not fitting…had a complete breakdown about it! Please HELP~

        • 15 pounds in two weeks is almost certainly primarily water! Things will settle down in time, in the meantime wear stretchy, comfortable clothes, take baths or swim if possible, and go easy on yourself.

  4. “There is a better way. Consistently and dependably giving your body the nutrition and energy it needs to be healthy and active will allow it to emerge from the starvation response and heal from the damage the diets have done. But it takes time. Be patient! The long-term benefits are worth it.”

    Thank you for posting this. I’m a twin and my sister and I are about 118lbs and 5’3. We have recently decided (do to extreme fatigue) to follow what you are saying and stop starving ourselves. We were regionally eating 800-1200 calories a day and running 3 miles 3x a week. It’s been about two months almost three. We are both up about 10lbs. We are not as tired, but the weight gain has been hard to deal with emotionally. We are focusing on getting stronger….but it’s so hard to fight the emotional tie to numbers!!
    Just today we were wondering if we should go back to the 1200 diet….thank you for posting this!

    Any clue how long it takes “normal” people to regulate and stop gaining

    • It sounds like you guys are at a healthy weight, so I wouldn’t obsess about the number. As your metabolic health improves, you’ll see composition improvements. Are you getting regular periods? How is your appetite and libido? These are great indicators of the state of your metabolism.

      • All fine, periods, libido and appetite. They were all fine when we were 118 too. We were just TIRED. I mean going to sleep at 7:30pm tired!! So we knew we needed to change something. We are just both worried that our weights will continue to increase and then we don’t want to restrict to lose again. We don’t want to get stuck in the yoyo. we had been restricting calories since college. Taking a break when we were pregnant. But restricting again once we were do breast feeding kids. So I guess on and ff for about 11 years. Thanks for the help, it’s nice to get response especially when we are stuck at a rough time right now!!!

        • We are currently eating 1300-1800 calories a day plus eating back calories when we work out.

  5. I did HCG, found no lasting success for overall (gained back about 10 lbs.) metabolic function and then tried to do the re-feed a la 180 diet and I gained 20 more pounds, at this point my sleep was terrible, my mood was worse, I was an emotional wreck and I was eating what I wanted, adding carbs back and it wrecked me.
    Now I am working on a low carb primal diet and feeling much better, sleeping amazingly well, mood is better every day and anxiety is almost gone and when it’s there I can calm myself much easier. The weight is coming off slowly and I even play with IF and carb re-feeding once and perhaps twice a week every once in a while.
    Tell me if I’m doing this all wrong?! I would love to know that I’m doing good for my metabolism but the info that I get from this site tells me I’m not doing it right.

    This world is confusing and it seems you have found some answers. I just don’t know what do to anymore or how to do it?!

    • It sounds like what you’re doing is better than what you were doing before. I am very uncomfortable with protocols that involve fasting and ‘re-feeding’, women, in my experience, do best when their diet is consistent. If the primal template is working for you, I’d stick with it but consider leaving the IF and refeeding behind and spreading those carbs out so you’re getting some every day. Be aware ofyour calorie intake to make sure you’re getting enough.

      • Thanks for the quick reply! I’m considering taking a more moderate approach to the IF and using it when traveling and when I’m really, very NOT-hungry. Lately, I just couldn’t hold down a breakfast if I wanted.

        I’ll also take a look at my cals to make sure I’m getting 1200 to 1500 a day. It’s a lot harder when doing only two meals without feeling like a walrus.

        • 1200-1500 is likely not enough. I don’t know your weight and activity level, but very few women need to be under 2000 a day for maintenance.

          • Wow, I’m probably nowhere near 2000 a day. I’m 5’6 about 155 lbs. Trying to get to a lean 135. I’m sure you’ve heard this but how do I get to 2,000 cals a day w/o blowing up!? I’ve had overeating tendencies in the past that would have gotten me to around 2,500 a day and that ballooned my weight.

            • I’m also interested in the answer to this question. AMber, you say you are not a fan of re-feedings? I just started reading Diet Recovery 2… i’m trying to recover my adrenals and metabolism. Should i be more careful about my eating? Also, when eating, i’ve been keeping to good saturated fats, beef and chicken, and tons of veggies and starchy veggies.

              • I’m not a fan of any protocol that defines eating and not eating periods. I think Matt’s ‘refeeding’ concept is different from the cyclical feeding and fasting protocol we’re talking about here. Matt’s protocol is more like ‘JUST FREAKING EAT!”

          • Even on my heavy eating days I don’t think I eat close to 2,000. How do I go that high w/o really gaining fat? I’ve never found eating that much food was good for my fat/muscle levels in the past.

            • Yes, these were both me. If anyone has any suggestions to pass on how to increase the cals and keep lean.

              • If you have been undereating, you will bloat five to ten l s, there’s no getting around it. But it will come off and you will be able to eat and be in better health. In the end.

    • Ann, how are you doing now? My background is SO similar to yours (same height, same current weight, did HCG twice!) And am currently back on Paleo after doing a 6 month long 180 degree health refeed (which got my period back, but also made me gain a whopping 40lbs and my symptoms got worse). I have about 20lbs to lose and want to do it the right way, and clear up the last of my lingering symptoms. So curious to know how are you feeling now and if you have any advice for me!

      • Hey Kate

        I’m working on really upping my calories. I’m TRYING to get in food during the day (constantly) and honestly it’s really tough. I’m moving up to a higher carb ratio and I’ve seen very little weight fluctuation. I haven’t lost the weight I want to lose yet but I’m working even harder on not focusing on that.

        I really do think I’ve been starving myself for a loooooong time now and some weight gain might have to come from slowly upping my cals. The problem is that my mind is sooo focused on low calorie (still) that I have a real problem getting it up there. I have noticed my performance on the water (I’m a rower) and in the gym have gotten better and I feel great most of the time. Mood is good, sleep is good and stress is fairly low.

        So long story short. The re-feed didn’t work for me because I didn’t work it the right way. I’m still scared of food but getting better.

        • thanks for your quick reply. If its any help, I wouldnt focus on the number of calories so much, as your satiation and not ignoring hunger cues. I gained so much weight doing the 180 degree refeed ala youreatopia methods (which says 2500 calories a day minimum) which I think was good at first to gain some initial weight but after a few months I was forcing myself to eat that much and feeling so sick. I stuck withit because these were supposed to be “normal” refeeding symptoms, but after 6 months, I knew something was not right. It also proved to me without a doubt I am gluten intolerant. Back on Paleo, I am now working on eating to satiety, taking long walks and moderate weight training for exercise, and I am losing weight this way (I am going by measurements and how my clothes fit). I wish I could seek a doctor who knows more about healing a damaged metabolism, but I am kind of just combining a lot of the research I read online and most importantly, listening to my own body because there is no truly accurate calorie calculator or timeline or guide of how to do this properly since everyone’s situation and body is so different. But, I am still scared of getting back down to my normal weight of 130 and still feeling crappy, despite losing the weight slowly. Best of luck to you– and I bet you look great, don’t be so hard on yourself (easier said than done, I know– I am working on that myself =)

  6. This is great. I see myself in this post for sure. My issue is that I’m not sure now if I am still not eating enough or if I’m just stuck from under eating or going low carb for a few months. I only experimented a little while with low carb but I definitely went into ketosis for a bit. Now that I’ve stopped, I still have very bad insomnia lately. Just laying there until 3am some times (and with 4 kids — that’s not a fun thing to be doing to myself!). I’m still breastfeeding and exercising about 1 hour a day fairly intensely (MMA and strength) which I do because I love it. I have no idea what I should do next. The scale wont budge. I probably should lose around 15-20lbs of fat still (147lbs, 5″4′, 25% BF). So hard to tell where to go from here!

    • Rachel: determine your energy needs, and make sure to get that many calories consistently, every day. Put your weight loss goals aside for the moment and focus on stabilizing your diet and your weight. It’s MUCH easier to lose body fat when your body isn’t stressed by inconsistent and/or inadequate nutrient intake. Let your body recover, and THEN worry about your weight…which isn’t unhealthy, so shouldn’t be a huge concern anyway.

      • Thank you. You’re right. I need to figure out my calorie needs and start tracking what I eat and how I feel. I’m hopeful that I haven’t done too much damage and things will stabilize for me soon. I don’t mind losing fat slowly because I know my muscle has been increasing and that is key. :)

    • Hi Rachel,
      Along with making sure you’re getting adequate calories, have you thought that you might “love” exercising that intensely for that long every day because you’re addicted to the adrenaline rush? Would you consider going for a gentle, hour-long walk instead for a couple of weeks, to see if your adrenals needs a break? Just a thought :)

  7. wow, this really hits home. i had an ED for 20 years (all of them, really) and have been in recovery for 2 years. i’m still trying to figure out “food” and spent the first 3 months of recovery doing low carb/paleo, then ruined my body further with IF. i finally surrendered and just let myself have what my body was craving, and it’s been months. i still don’t feel “right” but much better after incorporating sugars and carbs. it does take time, i realize i destroyed my body for decades. feeding it good food is the LEAST i can do. thank you for this post, it is very encouraging. you are a great inspiration.

  8. I read a LOT from a lot of different people but rarely comment but feel that this is an important post to briefly share my own story in order to give others hope. I had always been on and off diets. At the beginning of 2007 I did a “12 week challenge” dropping 12 kilos bringing me to me lowest weight ever (58.4 kgs at 173 cm tall). Sure enough gained it all back within weeks. Then decided to compete in figure (bodybuilding) competitions to get the weight off again. Did 2 shows in 2008 and another in 2009. By this time I was classified an eating disorder. Mid 2009, just after my last show, again having gained all the weight back plus some I was ready to kill myself. Something stopped me and from that moment on I said, “fuck it” and ate whatever I wanted promising myself to never go on a diet again and to recover. I must have eaten everything under the sun over the following months that I had felt I had missed out on including forbidden foods such as icecream and chocolate. In July 2010 we left Australia to travel the world for 8 months. I was still healing my mind and body. Towards the end of our travels I was feeling mostly “normal” again and stepped on the scales. At 80 kgs I was the biggest I had ever been. Over the next few months I released what I called my healing weight with only a minor deficit and started training again (my love for weights returned). I’ve maintained around 70 kgs for the past 3 years eating whatever I want. My moods are stable, I have a regular period 28 days on the dot each month. Libido sky high '? and all the other positives that come from eating enough food to support activity. Pretty sure this must be my set point because it’s where I started before the 12 week challenge and my body came back here every time. It does take time. Learning to love myself no matter what my weight was a huge learning curve. It was the BEST thing I’ve ever done. My advice is not to give up, as hard as it gets, don’t succumb to another diet. Stick with it knowing there will be many ups and downs but believe that in the end your life will be wildly better than ever. Hope this helps just one person out there.

    • Just a stranger on the internet, but just shed a few tears of empathy and admiration at reading your story.

  9. In your client pile do you have women dealing with the metabolic downregulation symptoms that have never been fat or even plump? Many of the recovery stories I see involve a starting point of at least 25 BMI or one or more intermediate phases when weight shot way up.

    Mine really hasn’t, ever. BMI has been 19-23 whole adult life (and the 19-20 was very short lived), and bodyfat has been 16-25. Nothing outlandish. Just lots of LOW level exercise and dieting, often at the same time.

    Thoughts for this ‘special and unique snowflake’? :-)

  10. Are you seeing this even in people with more moderate fasting windows? Like a 10pm to 12pm window? Because I’ve always disliked eating breakfast so I generally do not eat until lunch, sometimes a 10am snack if I’m hungry, and I think I fall pretty well into the category you are describing (other than increased fat and lack of muscle gain, I’ve added muscle and I’ve always had belly fat). I’m going to be unhappy if I have to start eating breakfast. Urgh.

      • Not anymore. It HAD been fine (for about a year?) but once I got down to around 165-170 (5’6″) nothing seemed to work. Every time I try to eat a deficit I do ok for a little while and then I start feeling tired, see significant strength impacts while lifting , and I start waking up at 3-4 hours early and not being able to fall back asleep. This last time I attempted I lasted 10 days, averaging 2050 calories, and then started being able to lift weights I’d lifted for reps literally the week before. I did better in January, lasted about 5-6 weeks before that happened, but it was coming off a 2 month diet (but not exercise) break over the holidays.

  11. I posted about this today on the FB page…really struggling after a shopping experience yesterday where my weight/size smacked me in the face. I started with South Beach, then Atkins when SB stopped working, then HCG (x2) when Atkins stopped working, then Primal after I gained back all the HCG weight, then Paleo when Primal didn’t work. I destroyed myself. I have been eating the food for around 5 months now, and I FEEL good, I’m much less stressed and I’m enjoying eating (mostly) healthy, fresh foods. But I had a cupcake yesterday, and it was fabulous, and I didn’t feel guilty about it.

    But I think I will be one of the people who take a year to heal. I am not losing weight, even eating at a small deficit, running a few times a week and strength training a few times a week. This morning I was struggling with wanting to do one more crash diet just to lose the weight and then work on healing. I was trying to convince myself it didn’t work before and it won’t work now.

    And then I read this, and it gives me hope. I destroyed my body for years – its going to take more than a few weeks to heal it.

    Thank you Amber!!!!!

  12. I have been struggling as well. I have gone about 10 years of either eating whatever I want or eating 1200-1300 calories (except when pregnant-3 kids). I realized when my hair started falling out last year that I needed to change and then I found your page. I’ve been ‘eating the food’ for about 2 or 3 months now…but my numbers aren’t changing (not just the scale, size as well). I’m not “overweight”, per se, in fact, we weigh the same and are the same height. But I am a size 11 and you are a 4…I just don’t feel good at this size.:..but I don’t want my hair to fall out either…lol. I lift and do HIIT type cardio. I’m just frustrated right now.

  13. Thank you, this is a really good observation. Those are all super restricted diets and it would make sense that the more restricted your diet the longer it takes to heal. And btw I would rather hear about real experience any day than read studies '?

  14. I felt that this article was very interesting, as I am a current beneficiary of IF (currently following Leangains protocol). Personally, I’ve NEVER had a better eating strategy than IF for maintenance, lean muscle gain, or fat loss. However, I am fascinated by the very different effects this is seeming to have on women. My wife currently is using the same protocol, and I’m going to be seriously watching her for the next few days/weeks. She’s had pretty decent results with it thus far with no irregular outcomes. I think IF can be a positive tool for both genders, but there may be some tweaking that needs to be looked at. I do agree with the article you posted that more female specific studies need to be conducted. I think other vitally important aspects to look at coupled with IF’s affect on women’s metabolisms are caloric volume, quality, overall fat/lean mass, and exercise regimens. Without looking at these (and a myriad of other factors) I think it’s inappropriate to come to black and white conclusions. I’ll be following this site closely for further investigation on the issue.

    • Yes, I suspect there are several factors that contribute to IF’s safety and effectiveness. :) My current opinion is that the risks outweigh the potential benefits (and those benefits can be achieved through more moderate means), especially for women, but I’m open to the potential that it can work under certain circumstances.

      • Didn’t you just say above that a 16/8 eating window is not IF then you say here that you suspect the risks of LG outweighs the benefits. Ummm do you know what LeanGains is?!!

          • One thing I will say about leangains (and nope, Amber never mentioned the site or Mark) is that when he eats he eats enough.
            I used to eat dinner only–I did it for a whole winter with no problems at all–maintained normal weight–had energy–no fluctuations, but I didn’t have any history of dieting and I took in probably 2500 or more calories every night.

  15. I don’t get what the big deal is with intermittent fasting. If I stop eating at midnight and start eating at 2 pm, how is that any different from stopping eating after dinner at 6 o’clock and then eating breakfast at 8 am? It’s still 14 hours. Yet traditional diet dogma says no snacking at night.

      • Okay Amber please define fasting then. Maybe we can find common ground after all.

        • I consider any regimented protocol that defines strict eating and not-eating periods to be fasting. If you’ve decided that there is a time that you’re not allowed to eat, there’s a problem.

          • For years conventional wisdom said don’t eat after dinner! No nightime snacking! Is that fasting?

            • If you’re hungry, but not allowing yourself to eat because you’re not in your feeding window, yes, it’s fasting.

              • Most of us who are successful with intermittent fasting do not feel the need to eat outside of our feeding window. If you are constantly hungry during your fasting window, then IF would not work for you. Otherwise, its quite sustainable.

              • So, are you of the opinion we should never go hungry? Because my appetite freaks me out sometimes. I have a gallon of OJ in the fridge and literally feel like I could drink it all at once. This is after a month or so of “rrarf”ing starting in February (after a month of low calorie ketosis *sigh* and since then eating about 2750 calories per day. I’m totally going over that today, but I did work in the garden. I guess I’m wondering if my body will quit being so hungry so I don’t have to eat “maintenance”. Because as far back as I can remember my appetite has always been strong.

      • So, now I’m curious. :)
        How do you define “Intermittent Fasting”? When does it start, after how much hours?

  16. As many women have commented…this post couldn’t have come at a better time. I’ve been very frustrated lately and patience has been wearing thin. I’ve been ETF for about 6 months but recently had an unexpected weight gain of 20 pounds in the span of 2 months and it won’t budge. I experimented with IF for a few months after low carb failed me a few years ago. I think my metabolism finally had enough. I feel liberated that I will never again be on a diet, but it’s very deflating having to buy stretchy pants because jeans just don’t fit right now. I think it’s time to stop obsessing over the why’s and give my body the time it needs to heal. It knows what to do.

  17. I would also advice people to stop running in the hamster wheel of dieting! No that I’ve made it “to the other side” I am so glad I did. I was on a paleo diet for several years and did intermittant fasting for about a year. My body looked pretty good at some point because of the heavy training I did, but I now realize I was starving the entire time. All my thoughts revolved around food: what I was allowed to eat, how long was it since my last meal, when would I be allowed to eat again, what would I eat then, how many calories, how much protein, nothing with an inkling of sugar allowed… Paleo was a diet that didn’t suit me, but for years I didn’t listen to myself. I had bought into a myth that it’s the only way to be. I thought that eating more than two or three times a day would mean that I had failed some test of being a tough sexy strong cavewoman. And that all those cravings my body had for food would disappear with discipline…

    Right.

    Then I stopped. It’s taken me nine months, but I finally got my period back. I have ENERGY to do things, I no longer have brainfog, I no longer feel constanly cold, I no longer think about food 24/7. I have gained some weight, yes, but at this weight my body is healthy. I am able to run and lift and most importantly, to have babies if I want to.

  18. For about 4 months, I have been on what I call a clean-eating diet… mostly Paleo with the exception of cheese and dairy. Usually, the only carbs I ate came from vegetables, and would opt out of eating a sweet potato or other starchy carb, even after I worked out. I was doing 2-a-days of HIIT and CrossFit, and certainly saw some gains. I lost inches, and my muscle became more defined. But by the beginning of the month, I seem to have stalled, and I’m wondering if I was putting my body into near-ketosis. I am nervous to eat more, as I still want fat loss, and hate to see the scale go up to where I’m not comfortable with what it says. Does it sound like I have a long recovery time considering how I was eating before?

      • I believe so – 5’6, 135lbs. I forgot to mention, although I’m not sure if it has to do with diet, but I went off birth control pills mid January (NOT to become pregnant, but to rid my body of synthetic hormones), and while I know it could take some time before my period returns, it hasn’t yet.

  19. I am so grateful for your encouragement, Amber. I’m doing the strategy of “pick a caloric intake that will support you at a reasonable weight and activity, and let your weight drift down if it wants to.” I lost five or six pounds in the first six weeks, and then my weight stabilized, and I started feeling tired, and not sleeping very well, and I was tempted to cut my intake more — and then I bitch-slapped myself and said, this is the way you screw it up. And I looked carefully and thought, actually it’s time to *up* my intake, not to lower it. A 500 calorie deficit is probably a bit radical to keep up for weeks at a time. I could run myself into the ground — or I could eat an extra buttered yam or two and enjoy the fact that my body is stronger and leaner than it was a few weeks ago, and let it consolidate its gains. The weight will go or not, whatever. My goal was just to exercise and eat reasonable amounts of good food, not to kiss up to the numbers on the bathroom scale, or even to the ones on the measuring tape. But it’s so hard not to stay reasonable when you’re getting tired and the numbers stop cheering you on! Which is where you come in. Thank you & thank you.

  20. Wow. I rarely ever comment on blogs, but this one hit home. Sinse I was 15 I had a pretty bad eating disorder where I restricted both calories and carbohydrates, and I started doing IF a few years later. I kept this up for maybe a year or so, at one point my weight was as low as 49 kg at 176 cm. IF lead me into bulimia, and that’s when I realised I needed to stop and find my way back to normal when it comes to eating and body image. I found 801010 in 2011, and they advocated unlimited calories, so I started eating. A LOT of food, mostly fruits. It was terrible at first, I puffed out from edema and was constantly hungry. My caloric intake was around 5000 calories most days. I also gained a lot of fat, especially around my belly. The pressure on my chest made it hard to sleep at night, I was constantly out of breath, real bad acne which I had never previously had and just feeling awful. I kept going because I knew the only way out was forward, months went by until I finally stabalized at quite a high weight, probably around 90 kg (i had stopped weighing myself). From there it was painfully slow, but symtoms of improvement started showing. Body fat started redistributing itself from the belly and more evenly around the body. My skin got a lite better and I had more energy. Only for the past few months have I been able to start training again and I found this blog and ETF only a few weeks ago. I am now working on increasing fat and proteins in my diet and gaining strength. I am so grateful for having gone through this, it’s been an emotional roller coaster but you definately come out stronger on the other side. It gets better! I am now 21 years old probably around 75 kg and eating around 3000 calories per day. What seems like your greatest falldown can actually become your greatest strength, you just need to be consistent and patient and work on your inner self much as your outer. It’s worth it!!

    • Oh yeah, and I have my periods now! Haven’t had them sinse I was 14, and I’m actually loving them! Love my healthy, functioning body and I’m so sorry for all the stress I caused it over the years.

      • Very inspiring story Clarissa – thank you so much for sharing! I am so happy you’re healthy and happy now!

    • Thank you for your story! Wonderful that you came out of that. That is scary underweight.

  21. Hi GK! I just want to say thank you for saving me! I’ve been on diets for what seems like forever. I’m 26 and finally feel like I have a life to look forward to – a life of normality and free of diets!
    I’ve read most of your articles. I am eating the right number of calories (according to the calorie calculators you linked to in another post). However I am hungry for what seems like ALL the time. I was wondering if this is another symptom of recovering from IF? I’m only a few weeks into my diet recovery, so I’m thinking my body is repairing from the diet/binge cycle I’ve been on for the last 8 years!
    Keep up the awesome work!

  22. gokaleo: when you say “stabilize quickly”, what time frame does that translate into? i’m 23 and just began eating over 2,000 calories (trying to increase to my TEE) a few weeks ago, and I’ve already gained five or more pounds, and see no end in sight (digestion/bowels still functioning poorly and body seems to holding on to everything still). of course, i am terrified, but persisting, somehow. i have a ten year history of clinical (3 years) and subclinical (7 years) starving, but never delved into the three downregulators you mentioned. can you elaborate a little on how long it takes most of your clients? and how strictly they had to eat exactly their TEE?

    • Amber mentions it could be 6 months or a year in her article – is that what you are referring to? I empathize with you though. I feel like I’m in the same boat, but I’m trying to eat more calories, eat when I’m hungry, and relax about it a bit more than when I was restricting. And I’ve pretty much been restricting my entire life.
      So far the scale has gone up a little but I don’t feel heavier, if that makes sense. Measurements are about the same. I’m making an effort to lift more and wonder if my muscles are holding on to glycogen/water for repair, but I don’t know. I am though sleeping like a rock star for the first time in weeks, so maybe it is working. But I’m scared, I won’t lie.

      • Yeah, I’m scared too. So scared that I can’t go near a scale. I don’t feel “right” in my body, and don’t feel like certain things are picking up at all (ie, digestion). I am also lifting much more than I ever have (I never lifted anything heavier than a 12 lb dumbbell before this) so I’m hoping that my muscles are holding fluid for repair, but I’m skeptical. I know that probably many people feel like “oh, eating 2,000 + calories might work for others, but it just wont work for me”, but I think that’s bullshit and don’t want to foster that in myself. Mostly I’m afraid of having to face the scale eventually and just being like “okay, this is just what my body looks like, and I have to deal”. Still haven’t let go of the dream that I am magically destined to be thin.

  23. I know I am a guy and I know I don’t have some of these experiences to speak of that some of you do, but I read every post, and it seems like it’s real easy to confuse not eating enough with the IF when you are doing both.
    I see where Ambr is basically saying there is no need to mess with it (at least that’s kind-of what I hear her saying), but I don’t see where it can do harm if you are eating enough.
    Tell me to get out of here of you’d like.
    Take care.

    • Hey Barry!

      I can only share my experience. I did the Fast Five diet for a spell and very quickly, I was freezing all the time. I didn’t worry, though, because the author treated it as no big deal and even said, hey, you’ll feel more comfortable in the summer! I didn’t know that being cold on a hot summer day was actually indicative of my metabolism getting really low. (And I ate quite a bit.)

      I did try IF again a couple years later, and this time instead of starting to eat at noon, I started in the morning (I think my window was six hours). That was better. Not sure if it’s because I ate more, or the timing. It wasn’t sustainable for me, and all my losses reversed.

      Just my experience!

      • Do you believe you took in enough calories while doing the fAST fIVE?
        I have done fine (as far as I know) before on one huge meal a day and I have been cold like you describe, and have undereaten before while eating numerous times a day.
        Did you eat 2000-3000+ calories in that five hour window.
        PS I ‘d never heard of Fast Five until now.

  24. Hi! I found your website and book through Matt Stone’s site and I am so thankful and hopeful that I am on the road to healing. Before having my two living children, I was a yo-yo dieter. I tried everything, WW, low carb Atkin’s style, veganism, fasting, etc. I would lose weight like mad and gain back a little but never really had a lot of trouble until after trying the pill when I first got married and then especially after having children. I started really gaining weight during my postpartum depression after having my first premature at 35 weeks. The adrenal fatigue from that entire situation sent me up to around 200 lbs. I thought this was the highest I would ever allow myself to climb and started to do WW again along with rigorous exercise. I kept bouncing down to 160 and then back up but could never go lower. Then, fast forward a few years, and I am pregnant with my second child. I had contractions through this entire pregnancy and wound up on bedrest for 16 weeks and gained to about 240 during pregnancy. After I had her, I ate what I wanted and breastfed to my babe’s heart’s content. At my six week checkup, I weighed in at 180. I should have been ecstatic but my OB just immediately recommended WW again. I started to work out and diet, lost 15 lbs. quickly but then started to stall and became ravenous. My weight climbed steadily until I was in the 190s again a year later. My first child was then diagnosed with type 1 diabetes. Adjusting to my son’s type 1 diagnosis meant gaining another 25 lbs., landing me at 215, my highest weight to this point. The following year (last year) as we were trying for #3 and I wound up having 4 miscarriages in 13 months. At my 1st miscarriage, weighing in at 215, my OB told me to start WW and to diet while trying to get pregnant and then while pregnant! I foolishly followed her advice, had my 2nd mc and quit the madness. Nevertheless, by February of this year, just a few weeks after my last (4th) mc, I gained the courage to start Matt Stone’s methods and look for healing–on every level.

    Here’s the rub–since starting to eat enough calories to nourish my body, I have gained and was up in the 230s at my last weigh (probably mid-March.) This panicked me. I had to start eating GF in the process–and I’ve seen a little improvement since then, but I am just wondering–given my level of adrenal fatigue from all the trauma and my history with dieting–how long this might go on? I have been tempted to start dieting again but I keep visiting Matt’s site and then find your blog today–just in time to read what I needed.

    I do eat a clean, Weston Price style diet–lots of pastured meats and raw dairy (available in plenty here in KY), potatoes, gluten free grains, fruits and veggies. I do eat sugar per Matt’s metabolism suggestions (and was surprised to actually feel better eating sugar again,) but these usually come with home cooked goodies like fruit crumbles and other treats. I’ve even seen my type 1 son A1C benefit from Matt’s metabolism suggestions combined with the removal of gluten. Gluten had to go. It’s long been a suspect in my family with my mother’s Celiac diagnosis and at least my gut feels better. I am also moderately active–no formal exercise but I am constantly busy with housework, chasing the children, schooling at home, etc. so I’m not sedentary–just not formally exercising again yet.

    So I purchased your book, Taking Up Space, and will begin reading it tonight. Any suggestions for this 36 year old mama who wants to feel light on her feet again and be at my best for my family? I guess I feel like I still need to tweak how I’m eating a bit and hope your book might help me figure that out.

    Thanks for this post and for wanting to share what you have learned with other women.

    • Kim,

      Thank you for sharing your story. I am sorry for all of the loss you have experienced in your personal life. And I wish you well in your journey of healing and health.

  25. While this site has many posts/comments that apply to either sex, and while I will continue to read stuff on here, I am wondering if you, Amber, or anyone else know of any male-oriented sites that are along this vein?

  26. Amber — I’m a big fan of your blog but I’ve been wondering how the mantra “Eat the Food” works for someone who struggles with compulsive and/or mindless eating. Putting reasonable boundaries on food seems necessary for me. By those I mean only eating at planned meal/snack times, while sitting, etc. If not, “a few bites” quickly becomes a handful and “one glass” becomes three. I am working to stop food obsession and body hate and find that I actually do better when I eat within (not too strict structures). If I just eat whatever I want, I feel terrible about myself. Or maybe I’m just crazy…

    • Maggie, I agree with Barry’s advice about the Your Eatopia site.

      I would add that you might like to take a look at intuitive eating books – currently I recommend The Overfed Head – which propose that when we eat exactly what we crave when we are hungry (no judgement), and stop when the hunger is gone, food cravings go away in time (because we are eating what we crave) and weight loss is achieved in time (if appropriate).

      I have also struggled with compulsive eating, since I was a small child, and I am giving this approach a go. It certainly makes sense in theory.

      You’re not at all crazy, so many folks struggle with food compulsions.

    • Sorry for the delay. It sounds like you have some deeper problems that just weight, but also like you are on the right track with focusing on the body hate. The body hate is the root of the problem. If having some structure is helping you with the symptoms of that body-hate, I can see its value, and I encourage you to stay focused on the real issue…overcoming that root problem will free you up from the obsessions.

  27. I did 2 of the 3.. IF and many years of low carb. HGC sounded good until I saw it was 500 cals. I feel like I need guidance. Been upping cals to healthy level 4 me first time in m life, three months ago. Up 25 lbs. and scared 2death. I started at Bmi 28/29. So it isn’t pretty. I’ve been not exercising because I felt I needed repairs done first. Where do I go from here? Been excercising all my life. Now I need to get fit. I just want to be healthy. My body temps are back up 98/99 my digestion and sleeep are so much better. What can I do now that won’t throw me back into restriction? Help.

    • Are you eating at maintenance for your current weight and has weight gain stopped? If so, try eating for maintenance for your goal weight.

      • Wont that cause my metabolism to start shutting. Down again if I reduce calories once again?

    • Once your weight is stable for a while, then you can start very gradually reducing your calorie intake. Please allow your body to stabilize before you refocus on weight loss. And when you do begin to focus on weight loss, take a VERY moderate approach, maintain a very modest calorie deficit, get regular physical activity and adequate sleep, and be patient. Extreme diets produce extreme, but temporary, results. Moderation produces slower, but permanenet results.

  28. Amber, I am a new reader and love your blog. Your adrenal fatigue and above posts are creating an aha moment for me. For the past 2 weeks I’ve made an effort to switch out of restriction and consume more calories, eat when hungry, etc versus adhering to no more than 1800 a day. (I’m 5′ 9”, 154ish and workout out running and strength training about 7 hours a week and walking my dogs 45 min each day). I’ve also increased my strength training. I don’t expect my body to make the stabilization switch overnight, but it seems like I have gained a couple of pounds over the last couple of weeks. I’m not freaking out yet, because I am starting to feel better in general, but I’m wondering if this is a normal part of the process?

    • Yes it is. Your body is in a lower metabolic state but getting more calories. Kinda like if you are poor and you get a better paying job. Suddenly you can put into savings. But say your house needs repairs and you’ve been living on ramen noodles. Once you get a little money stashed back you will start eating better and fix your house. And inthe case of your body, “savings” are both a liability and an asset, so if it feels safe about plenty of “money” coming in, it will get rid of excess savings but that may take some time. Also, some gain is water with increased glycogen stores.

      • Thanks for the affirmation, Ashley. Your explanation does make sense. It would also probably explain why I know feel ravenous all the time; my body is grabbing those calories and demanding more while the takin’ is good, I guess. I just had no idea that I was not eating enough for so long… 1800 calories seemed like plenty for my activity level, especially according to all of the “advice” out there.

    • Very, very normal. And probably a necessary part of the recovery process. That weight will help your body heal and make maintaining a healthy weight much easier in the long run.

  29. I have done multiple rounds of HCG. The first round being the most successful of 25 pounds lost. And then over the course of a year or so, I did several rounds just trying to keep off 10 of the pounds I had lost. I ended up losing a total of about 50 pounds, and have kept about 30 of it off. The reason I kept it off though is because I completely changed what I’m eating. All whole, natural foods. Absolutely no processed foods (well, the occasional, but it’s rare.)

    Have I lost any more? Nope. Not at all. And, it’s extremely frustrating. I tried the IF, but that didn’t work. I was hungry all the time. That makes for one very cranky woman. :-)

    I’ve been eating real foods with no grains or legumes consistently for 3 months now. I’m also eating fermented foods and drinking Kombucha Tea daily. And now with those changes, I’m really paying attention to when I’m eating. Before I was eating because “it’s time to eat.” Now, I’m eating when I’m hungry and stopping when I’m full.

    Am I frustrated that I haven’t lost? Yes. But, I’m also extremely excited about other changes that I have seen. More energy. Less aches and pain (I used to take at least 4 Ibuprofen every single day.) I can’t remember the last time I took something for pain, because I have very little now. I used to have headaches every day. I haven’t had a headache in 2 months (at least). My acne is clearing, cuts heal faster, hair and nails are stronger. Diegestion is better and reflux is pretty much gone. Most nights I sleep better, too.

    It’s a journey. I’ve had a life-long struggle with my weight and I’m at a place where I’m working on being healthy and trying not to worry so much about what I weigh (I threw away my scales a few weeks ago and it freaked me out!)

    I’ve put my body through a lot during my 40 years on Earth, so I have to give it some time to heal. I know my body is healing and I feel like it will eventually get to a place where it will be able to burn the excess fat I have as well. So, the journey continues.

    • Thanks for your input! You are wise to finally be putting your health first!

  30. Pingback: HCG, IF and Ketosis - the Unholy Trinity of Metabolic Downregulation | Mark's Daily Apple Health and Fitness Forum page

  31. I can only comment on ketosis and do not practice HCG no intermittent fasting, unless I am not hungry which is different.

    Studies down, even clinical trials done, on people in ketosis eating sufficient calories show an increase in metabolism. There was one last year that all of paleo came out against claiming the results were not “signifigant”. Well a 5% increase in base metabolism is actually 10x greater that what is considered signifigant in clinical trials.

    The sad thing is most ketogenic trials are combined with 1200 calorie diets (starvation levels). Trials where people are told to eat ad lib (as keto practitioners do in the real world) do not have people slowing their metabolism but rather increasing it. Do not have people losing hair, do not have people with blown out thyroids. You cannot find a clinical trial where these things appeared more often in the control group than the intervention group EXCEPT in the presence of severe caloric restriction and in those cases it occured in ALL GROUPS. This is a myth that needs to do. Severe alorie restriction combined with very low carb is a bad idea WHICH IS WHY NOBODY DOES IT except as part of clinical trials trying to prove in advance low carb is teh sux.

    Ive asked Jaminet, and others to produce a single trial that backs this claim that does not include severe calorie restriction, they were unable to do so despite 50+ years of clinical trials on ketogenic diets. I am not surprised to see no citation on point here regarding that because it does not exist.

    As far as the starvation response. The typical end point of starvation is death. The typical end point of ketosis is extended life span, improved health, improved cardiac and blood sugar markers. These are two very different typical outcomes. Saying ketosis is like starvation is extremely poor reductionism. It is only “like” starvation in that it obligates us to burn body fat. It does not “burn muscle” or lean tissue like starvation does and that is a huge distinction. In fact ketogenic diets are considered protein sparring because they prevent the use of lean tissue for amino acid needs, obligating the body to use dietary aminos. This is a prime reason body builders will go deep keto running up to a contest and cutting weight. Because they know cutting calories cuts muscles, but going keto preserves it.

    • Thanks for you input. I’ve seen the exact opposite in my clients, even when not combined with calorie deprivation I have women presenting with full-blown symptoms of starvation after ketosis. Some of these women were eating 3000+ calories a day.

      When I’ve taken a look at the science on keto, generally the study doesn’t support the claim of the keto proponent using it to bolster their claim. This causes me to question the motives and credibility of the person promoting keto.

      In the end, there are better supported, more moderate approaches to weight loss that produce superior real-world results.

  32. I have been reading your blog for a while but have never commented before.
    I am the same age as you but unlike you, i have been involved in some kind of sport or activity from the age of 6. I did it almost all, starting as a gymnast going over to track and field, then the millions of varieties of group fitness, body building, kettle bell, try, you name it, I tried and loved them all.

    I never really had a weight issue although of course my weight fluctuated up and down a bit but nothing to the extreme. Even after my twins I got back to pre pregnancy shape in a few months.

    My diet was fairly clean but never obsessive. None of that calorie counting or omitting whole food groups nonsense. I relied on eating small meals through the day, veggies, fruits, meat, eggs, nuts mainly, but when I felt like having a slice of pizza or pasta or a sub, I didn’t beat myself up over it. And I enjoyed small amounts of chocolate or red wine a couple of times a week.

    Then about a year and a half ago I started packing up pounds. I’d have a little binge and swing up 3 pounds. This normally had been normalized before in 2-3 days since it is mostly water retention. I just had to return to my normal sensible eating. Except that the 2-3 pounds started to stay with me. Right now I’m about 20 pounds over my ideal weight and oh boy, have I tried them all. I tried paleo and the scale would still creep upward direction. I tried keto and the scale would still creep up. Intermittent fasting. Detto.

    Except, at least, with IF i have learned that my strength training is much more effective in a fasted state. I’m not saying thats the norm but for me that’s how it proved to work.

    All this time, I had been working as a trainer, group fitness instructor so my workouts were there, along with the rest of my work days (tidiing up the mess in the gym, carrying dumbbells and plates etc). In fact, I had to resign because at one point I had to teach so many classes that I was in a constant state of overtraining, fatigue and micro injuries.
    However, I did not stop moving around, I walk -jog my dog 3 times a day, I finally can focus on strength training and I do my home kettle bell-sandbag-yoga routine which I love.

    My doctor checked me out for thyroid and iron but everything seems normal. I complained to him about irregular periods and hot flushes but he simply said I was too young to be gaining weight because of menopause.

    At this point I feel like I’m stuck. I am almost to the point that I’m ready to sign up with some bullshit diet program, some pills or shakes, which I have always spoken against when my clients asked me about them.

    I don’t think that IF or leto “ruined” my metabolism since the weight gain has started before I turned to them. Of course, they might have played a part.
    I’m wondering if you have ever met a client with similar story and found a solution. Thanks for giving it a thought. And of course, I’m buying your books :)

    • Have you tried eating more, Rowena? You’re describing a tremendous amount of physical activity! A lot of your symptoms sound reminiscent of undereating. Have you tried tracking your calories for a few days to make sure you’re getting what you need?

  33. i love and admire this blog so much but am struggling to walk the walk. i’ve struggled with anorexia for years. during one brief ‘recovery’ period involving inpatient care, i gained too much weight from 2400+ calories a day/no exercise, and maintained that weight on 2100 calories and light activity. my period never came back even after some time. after a period of restricting and then working again on recovery, i lost (a lot) and maintained at 1700-1750 calories a day. took forever to get there. now i’ve bumped it up to 1800-1850 and my weight is fluctuating a lot. i’m only a week or so into that calorie load, but i’m still so scared and triggered. i’m being monitored closely since i have comorbidities that make food complicated enough as it is…i don’t want to freak anyone out that i’ll begin to cut back again…but i have this feeling that i am eating too much and the weight is piling on like it did the first time. i’m so anxious. any reassurance? will my weight settle out? i know most people wouldn’t gain on that amount but i can’t help but feel like the freak who will…i need reassurance… :-/

    • You may gain weight. Your body may NEED to gain weight to heal. Without healing, you will never be able to have a healthy relationship with food, or a stable weight. Are you familiar with http://www.youreatopia.com/? There is lots of support and info there about the recovery process that may help you come to peace with this process. What you are going through is very normal! You may also find my Eating the Food facebook group helpful, there are many women there who’ve been through this and can help guide you, and assure you that there is an end in sight.
      https://www.facebook.com/groups/108315962672267/

      • i will def read up on it! thank you for the link. 1850 you think will cause weight gain? i know i will have to up it to a more reasonable amount but i am so scared of ballooning again like i did the first time (on higher amounts).

  34. Thank you so much for this post!! I came across it at the perfect time while I am trying to find answers for myself. I have done HCG so many times it’s not funny. First round, followed the vlcd protocol (maybe added in a little bit of extra protein) to the tune of about 650 calories. At the time I was very committed to it, and I lost 40lbs in 55 days, but I also noticed a bigger swing in binges (super-binges!) when I cheated on the diet. Subsequently gained it all back and then some. I tried to get back on the diet and it has been horrible, to say the least. I was all over the place. Started experimenting with calories and realized that I can actually take in a good amount more calories than the vlcd while still losing (provided it’s clean, good food, not too high in fat, and low carb). Most recently (since the beginning of the year) I have added in a good amount of exercise, which I love, but it also made the vlcd absolutely impossible to follow. I lose a lot better on lower carbs and high protein/high fat, and I feel a lot more satiated during the day as well.

    My issue now is trying to figure it all out! Typically if I am not losing I am gaining, and that’s what scares me about going off the HCG diet train. Instead I modified it quite a bit- 1500 cals/day, no more than 40 grams carbs, lots of protein, and I am finding it a lot more sustainable than the vlcd. The thing I like about the HCG is that it seems to come off from where I want it to, and not from my muscle (or my boobs), and it really does seem to keep my appetite somewhat in check. I also think that I have many hormone issues at play which make fat loss very difficult for me, and the HCG seems to aleviate some of those symptoms. I’m just worried that I’m going to screw myself up even worse from the HCG. I’ve been looking at a lot of info online and haven’t been able to find it, about what happens with HCG and a moderate calorie diet. Recently I’ve started shifting my exercise goals away from cardio and into heavy lifting, which I seriously LOVE, but it’s nervewracking right now. Anyway, I know you’re not an HCG expert but I’d love to hear your opinion. Lots of respect for the work you do :-)

    • I encourage you to shift your focus away from weight loss. Stabilizing your metabolism and hormones needs to be your first priority. Once you’re stable, weight loss will be much easier. You can’t create stability with restrictive diets. Bouncing between losing and gaining weight, restricing and binging, will only worsen the metabolic issues you’re facing. Your body needs moderation and consistency, for moderation and consistency improve metabolic function. Keep up the exercise, eat more (yes more!), and more carbs, to give you the energy to really make the most of your workouts. Back burner weight loss right now, and focus on stability, consistency and moderation. You can do this! You just need to shift your thinking a little! :)

      • Thanks so much for your reply! I think you’re right, I’ve been bouncing up and down for too long. Not gonna lie though, it’s a scary thought to me. I’m already quite a big girl (about 300lbs, 5’6″, size 20 pants/16 tops) and what makes me really afraid is gaining even past what I’m at now, although truth be told I care less about the scale and more about losing inches. Do you reccomend that I eat at maintenance level? Funny to say, but that makes me a little nervous too, at my size it’s a lot of food! Anyway, thanks so much for your insight :-)

  35. I’m slow.

    Are you saying IF is no good? I can’t tell.

    I think you are saying that people that do IF with Paleo and reach ketosis will be damaged.

    I found a link to your blog on a pro-IF Paleo site, so now I’m confused. But, that’s easy to do since my reading comprehension is extremely low.

    • I’m saying that I’m seeing more and more clients suffering with very real metabolic issues after engaging in extreme restriction, and that those who’ve used HCG, IF and Keto seem to be the hardest hit. Will a person necessarily be ‘damaged’ if they engage in these dietary protocols? That I don’t know. There are certainly many anecdotal success stories. I only know what I’m seeing in my clients, but it’s enough to make me very cautious with these diets.

      • Amber, by saying you don’t know wen you don’t know you show humility and common sense, and I appreciate it.

  36. My doctor was quite alarmed when she asked me what types of foods I crave and rather than saying “cookies” or “pizza”, I said “fatty fish, nuts, avocados, dried daikon, and grapefruit.” For so long, even foods like these were no-nos (or they were ok but only in tiny amounts), even though they are all whole foods! Even though I’m eating much more than I used t and after gaining 15 pounds I am now in the normal BMI (rather than being underweight), my pituitary and thyroid have not recovered (they are still literally almost shut off) because of years of restricting, ketogenic/paleo dieting, and self-blame.

    Now I’m kicking myself because it’s going to take me much much longer to recover than if I hadn’t done all that shit to myself before.

  37. Great article. I related to this post not as a woman but a young man. I have tried various dieting “strategies” ranging from “primal-diet”, zero carb to eating 1700-1800 cals a day, in an effort to find an optimal way to go about things. What I got in return was a nice heavy fatigued feeling in my body, irritable mood, worsened anxiety, muscle loss, strength numbers plummet and devastated libido and erection strength as a 20 year old man.

    Fast-forward, I’ve reversed all of the symptoms except my libido is still fried. I’m hoping that changes. I’m eating upwards of 800-1000g of carbs, yet still maintaining weight easily. Currently trying to eat even more to match my energy demands as I am very active. Anyway, maybe my story can relate or help others out there.

  38. This post was a welcome read, one I really needed before despairing again.

    I have successfully slowly lost weight in the past but this past winter I wanted to do it fast, as I decided to participate in a “body transformation” contest. I lost a lot of weight in the beginning and then suddenly my weight shot up and I couldn’t lose, no matter how little I ate and how much I exercised. I was eating low carb and I was doing 2-3 hours of cardio a day (swimming, biking, and/or running) and my weight wouldn’t budge. I lost some inches in the beginning but then that stopped too. It was horrid and I felt like a failure of a human being. People tried to convince me I was counting wrong, or eating too much. I knew it wasn’t true.

    My husband finally had to take the scale battery away because I was having daily mini breakdowns every time I looked. I decided to stop with all the cardio except swimming, because I love swimming and I compete, and it’s important to me. I decided to start eating more, and just walk lots.

    Finally my weight started to drop a little, but I haven’t lost much in inches. But last weekend I had an intensive swim meet, and my weight shot up immediately by almost 2kg, and I felt unwell. It seems like my body has a lot of recovery to do, and that I’ve really messed things up. I am trying so hard to be patient but it’s hard. I want to get better at swimming and reach my goals, but I do really need to lose mass in order to achieve that. I can only move my 185lb body so fast through the water compared to someone that weighs 50 lbs less. Frustrating.

    Thank you for your post. Just hearing that others have suffered the same makes it a little easier to bear. You mentioned reduced fertility – something else my husband and I are struggling with. I hope my body heals soon.

  39. I know I’m going through this process now, as I just relapsed yet again with my restrictive EDNOS… I am eating whatever I am hungry again, no matter the kind of food (so, yes, this includes lots of “bad” foods), and frankly I’m annoyed by how hungry I am and how often I have to prepare food. It’s like… I’ve got so many things I’d rather do, but the physical hunger bothers me so badly now that I simply can’t ignore it. And I HAVE gained weight, but not nearly as much as I had thought I’d gain. I’m not back up to the pants size I had reached during my last attempt at recovery, so some of my clothes fit but most are either too big or too small. Super annoying!!

    Anyway, it’s kind of nice to know that this could take up to a year + to fix… it means I can give myself a bit of a break and just… eat what I want to eat. And not worry that a lot of it is going to my normal weight gain areas. Besides, I have those bigger pants, so I don’t, for the moment, have to worry about needing newer and bigger clothes, which was a massive worry in the past. I just hope I can keep going with it all this time.

  40. It’s good to read this because I think this is what happened to me. I went through a three month period of being very low carb and intermittent fasting and ended up feeling super tired all the time, unable to sleep, and my menstrual cycle completely stopped. I think in the end I may have lost a pound or two but it definitely wasn’t worth it. I’ve been back to normal for about four months now and all I’ve seen is weight gain and my menstrual cycle still hasn’t started again. I have trouble sleeping a lot of times but my energy level during the day has gotten a lot better. It’s encouraging to read that some women could take up to a year to recover because I was thinking that I should be back to normal by now!

    Thanks for the info.

  41. I have a question. I think I messed myself up by going on a ketosis diet. My blood glucose numbers are high even though I’ve been off the diet for 3 months. Could I have given myself diabetes by going low carb?

  42. I read this and thought: MEEEEEE (“There are a few clients, though, who have a much harder time stabilizing. Their weight won't budge, or it fluctuates wildly. They don't seem to be able to build muscle mass as effectively. They begin to store more fat around their belly than they have in the past…They deal with anxiety and insomnia and other symptoms of starvation, even when their calorie intake is adequate…This goes on for months, even when calories and macronutrients are all adequate and consistent.”). Totally me. I started doing ETP in April/May and eating 22-2400 cal a day and reintroducing carbs and gained 15 pounds FAST. And then no movement on the scale or my measurements. At All. For months. Despite doing things mostly right. I was so frustrated. I started playing around with my macros and reducing my intake sloooowly and I landed in the spot where I am now: calorie consumption between1500 (rarely) and 1700 (usually) on non-workout days and 1700-2000 on workout days. Fats and proteins staying consistent and eating more carbs on workout days and less on rest days. And now literally in the last 2 weeks my body feels like it trust me again. Things are starting to move on the scale and in my measurements are starting to reflect what I am trying to do (scale down about a pound a week which I hope if fat ande waist down about .5″ (I’m 5’6 and 189, 38% BF (118 LBM) so I’ve got some stores to use). But after literally YEARS of peeing on a strip to confirm that I was in ketosis. Who knew what I was really doing

  43. It’s so good to see someone emphasize the importance of not messing uo your metabolism with an extreme diet. Of the three you discuss here I think the HCG is the most damaging but that probbly varies from person to person. Personally, I find that varying my caloric intake (not trying to continually run a deficiet) works well. I lost about 30 lbs over 6 months and it’s continued to drift down as opposed to coming back the way it always used to. also, I found shifting to short high intensity workouts did more for me that endless time on the treadmill

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