Metabolic Maladaptation and Relative Energy Deficiency

And so in that case, a lot of those people need to understand like being in a long-term calorie deficit like that is eventually going to lead to something called REDS, which is relative energy deficiency syndrome, where if I don't have enough calories to support everything my body needs biologically, it's going to get rid of the things that it doesn't actually need to survive like what do you need to survive my brain my heart my kidneys my liver like all those vital organs still need to be able to operate your ovaries don't need to operate well your balls don't need to operate well right like yeah so like I like to talk about it like like a car right if you're driving your car and you're you're running out of gas and you're five kilometers away from the nearest petrol station what's the fit in it's hot outside it's 40 degrees Celsius outside what's the first thing you're gonna turn off to try to save gas you don't have to push your car maybe the air con you can turn off the air con you're gonna roll the windows down and suffer you're probably gonna turn the radio off too like you're gonna turn off anything that you don't need because you don't want to have to push that car the rest of the way so that's kind of what your body does as well if it's running low on energy, it's just going to turn off the air conditioner, it's going to turn off the radio, it's going to turn off anything it doesn't need so it can actually make it to the next meal. So you can get into situations where people have been chronically dieting for a long time and or they're not eating enough for the activity that they're doing. And so they get this metabolic maladaptation where things start to slow down or they're just eliminate things for a small period of time, kind of puts them in hibernation until you actually make that deficit back up. And you see it a lot like people, people when they when January comes around, what's everybody do? I'm going to go to the gym. This is my year. 20 years in a row. 20th time. This is my year to get in shape and lose all this flab. They jump into the gym and they start thrashing themselves and they go on like a 12 to 1500 calorie diet. And they don't realize that that calories in calories out model their calories out is so high that they really when you do the math they don't have enough energy coming in to support basic life systems so their body starts shutting things down in order to just get by right so in a lot of cases those chronic dieters need to massively increase their calories at least close to maintenance so typically what we'll do is when we have somebody that's been chronically dieting like that, we'll take them to almost maintenance less, maybe 10% calories. And that's usually a lot more, 800, 900, sometimes 1,200 calories more than they've been eating. Now, all of a sudden, thermogenesis gets upregulated. They're not freezing cold all the time. All of a sudden, they get the period back. They can get a solid boner, and now they want to have sex. So that's great. They're sleeping better. Their guts aren't dysfunctional. But it's a really hard sell to someone who's been chronically dieting that listen you're going to have to eat more for a small amount of time and you're probably going to have to gain a little weight initially before we can start dieting again right um i i don't have a problem with long-term dieting or long continuous dieting as long as the deficit that is only small enough to chip away at body fat right but that's not what people do people will they'll they'll write a diet and they'll be eating you know 60 of what they need to be eating um and then they do that for months and months and months and months whereas they might they might only need to just pull 15 of their calories out and they could do that for a long period of time if they're going to pull a lot of calories out then it's probably going to be beneficial to throw in some refeeds right and so one of the tools we'll use for that is um basically We'll have them take their, we'll have them track their, um, their afternoon temperature. And if that really low then we overfeed them until we get the temperature higher and then we start a deficit um if they if they cruising along we see a trend in their body temperature going down it's time for a refeed or it's time for a diet break what are you so what would you say is the significant drop in body temperature so typically what we see is we see girls in the high 34s low 35s and that's when and then then you know it's the typical symptoms like i'm cold all the time cold hands and feet they usually have super low blood pressure they have no energy to do anything they're just surviving on sheer willpower that's something we see what we like to do is let's try to get you around you know 36 4 to 36 8 and then then we'll start chipping some calories away but if we see that that that temperature starts to tank we're going to need to do a diet break or a refeed