Permanent Metabolic Damage Followup – Q&A
About 10 days ago I posted a Q&A titled Permanent Metabolic Damage dealing with the claim that, following extreme contest diets, bodybuilders and other physique competitors have ‘damaged’ their metabolic rate so irrevocably that they are able to gain significant amounts of fat consuming only 700-900 calories per day. I’ll let you read that piece to see my answer. But in the comments sections were several questions that seemed worth addressing although they weren’t all exactly related to the specific topic I was addressing.
Question: I suppose a follow-up question to this answer is just how rare it would be to cross a true “point of no return” where you may have fouled up your internal physiology to where it may never be able to rebound. Or is it usually a case of time and reversing some of the actions that cause it in the first place? i.e. the longer and more extreme the descent, the longer it will take to recover, but recovery is entirely possible
Would clinically severe eating disorders probably be the only instances where someone could allow things to devolve to such a degree that any sort of irreparable damage may have been done to some part of the body and its normal functioning?
Answer: First let me say that I am not and do not claim to be any sort of expert on the topic of eating disorders. It’s simply not been a major area of interest of mine. I think it’s worth considering that what is going on in something like anorexia or bulimia is quite different than what is going on with the topic I was primarily addressing in the original Q&A, to wit contest diets in bodybuilders/physique athletes.
For example, if nothing else we can see massive differences in the nutritional intake of a dieting bodybuilder/physique competitor (typically based around high protein intakes and ‘healthy’ foods) as opposed to the near complete absence of food in the anorexic or the alternation of binging and purging in the bulimic.
With that said, what little literature I have looked at in terms of recovery from eating disorders doesn’t lead me to believe that there is any sort of permanent damage. So long as a ‘normal’ weight is regained (here we’re typically looking at the anorexic), things come more or less back to normal. Even in the seminal Minnesota study, metabolic rate eventually rebounded to normal; of course the subjects had regained all of the fat they had lost as well for that to occur.
But again, this is really outside of my major sphere of interest; if anyone reading this has expertise that can contribute to this question, I think we’d all love to see it.
Question: Layne Norton once said that from the day one begins to eat normally again, it can take anywhere from 3-4 months to completely restore BMR to 100% from post-dieting levels. Although he didn’t cite it, do you know of any studies roughly reflecting this extended time frame? I’m only referring to restoration of normal hormone output and, thus, adaptive thermogenesis, since if the weight loss were maintained, BMR would still be relatively lower than it was pre-diet simply by virtue of a lower final body weight.
Answer: No direct research on this comes to mind immediately although it may exist. I think the problem is that, usually in looking at post-diet ‘recovery’ there is almost always a regain in body fat which tends to color the issue. For example, in the Minnesota study that I mentioned in the question above, following the 6 months of semi-starvation, the men were allowed to eat as much as they wanted. And they went nuts, eating massive numbers of calories and regaining fat. Which normalized metabolic rate eventually but doesn’t really apply to what you seem to be describing.
Frankly, I’m not 100% sure that hormones will ever return to completely normal (see next question) assuming that the lowered body weight/body fat level is maintained. They can be improved by raising calories to maintenance for sure. This is part of the rationale behind The Full Diet Break although that’s really meant to break up periods of explicit dieting (I also suggest it at the end a diet to start normalizing things). Which is a long way of saying “I don’t know” If Layne has a reference for that, I’d love to see it.
Question: So there is evidence of metabolic derangement, but do you think it is permanent even when returning to normal caloric intake?
Answer: The studies of the post-obese (see next question) suggest that, even at weight maintenance (i.e. when calories have been returned to normal), there is still a small overall reduction in basal metabolic rate (on the order of perhaps 5%) compared to someone who is ‘naturally’ of that weight. Meaning that if you compare someone who is 180 pounds without dieting to someone who has dieted down to 180 pounds, the second person will show a slightly reduced metabolic rate compared to the predicted values. But the effect is slight when calories are brought back to maintenance.
As I discussed in the original Q&A, it looks like the main impact in terms of reducing daily energy expenditure is on spontaneous activity levels; this probably explains why exercise seems to have so much bigger of an impact on weight maintenance than weight loss (as I discussed in Exercise and Weight/Fat Loss Part 2).
I am unaware of any research examining if this is maintained in the long-term (i.e. will the post-obese continue to show decreases in spontaneous activity). However, the long-term studies of the post-obese (ranging from 2-5 years if my memory serves correctly) suggest that the effect on basal metabolic rate never goes away. So yes, it’s effectively permanent; it’s simply small.
Question: I’m also wondering about the permanence of any such metabolic adaptations. It seems likely to me that metabolism would return to normal at some point. If so, how long would it take? It seems like I read something about this in a discussion of the Minnesota study, but I’d have to go searching to see if I’m remembering correctly.
Answer: As noted in the question above, what data I’ve seen looking at the post-obese in the long-term suggest that there is a slight reduction in basal metabolic rate that doesn’t appear to ever go away. At least not in any practical time frame. Based on what we know about the issue of setpoint (discussed in Set Points, Settling Points and Bodyweight Regulation Part 1) I wouldn’t expect this to ever truly go away. I imagine someone will ask the logical followup to this in the comments which is “So what about people who get and stay lean in the long-term, how do they do it?” Maybe addressing that will get me past my writer’s block to write an actual article about it.
Question: I am a clinical nutritionist at clinic where we see a lot of people with “screwed up metabolisms”. In a different vein, there are the people who got fat from overeating and eating the wrong types of foods and became insulin resistant. Now they have to eat low calorie diets otherwise they gain weight.
One of my clients weighs 360 lbs and her BMR according to the the InBody is 2700 calories. The girl eats maybe 1200 calories a day and maintains that weight. Reversing insulin resistance by eating the proper foods and incorporating resistance training obviously helps. I am wondering if there is an approach to increasing calories systematically when working to reverse insulin resistance without gaining weight?
Answer: This is really a bit outside of what the original Q&A was discussing but I’ll address it anyhow; certainly there can be metabolic derangements that occur in obesity (what’s cause and what’s effect is often hard to determine). However, it’s highly unlikely that your client is truly maintaining her weight on 1200 calories per day if her measured BMR is that high (meaning that her total daily energy expenditure is even higher); insulin resistance or not, that’s simply a physiological impossibility.
The more likely (and exceedingly common) issue is that she’s simply consuming more food than she’s aware of or self-reporting. Because even in studies of insulin resistance, when calories are reduced (and and accurately monitored), weight/fat loss occurs. So either she’s a physiological anomaly or she’s not really eating 1200 calories per day. And my experience (along with a large body of research) suggests that it’s the latter issue that’s the cause of the problem.
Thanks for the questions folks!
“I imagine someone will ask the logical followup to this in the comments which is “So what about people who get and stay lean in the long-term, how do they do it?” Maybe addressing that will get me past my writer’s block to write an actual article about it.”
BING BING BING We have a winner!
Excellent topic Lyle, and very interesting. At 3DMuscleJourney we help many natural bodybuiders prepare for the stage, and probably the most difficult and important variable to manipulate is carb intake. Ideally, the goal is to get to stage condition 4-6 weeks before the show date, and then to slowly taper carb intake up at a pace that refills glycogen stores, upregulates thryoid output and leptin, improves exercise performance, facilitates regaining of lost muscle, and all the while not increasing caloric intake fast enough to cause any fat gain. In fact, many times we see further fat loss as the metabolism tends to overcompensate for the carbohydrate increase.
We have seen it time and time again that we can get the majority of competitors up to near offseason carb intake levels if we are given enough time and the competitor starts lean enough.
The relevance to the question should be obvious: one can maintain very low bodyfat levels and rehab the metabolism through a controlled and monitored, gradual increase in carb intake. We also taper cardio, and we keep one or two higher carb days in weekly for most clients.
The individual variability here is massive though. We see some competitors walk into shows with 350g of carbs on normal days and 2 days at 500g. While another competitor at the same weight comes into their show eating 200g of carbs on normal days and has one 400g day a week. Also with differing cardio amounts.
Metabolism can come back to near baseline levels even when someone is extremely lean. The cases I was referring too both competed with striated glutes at their shows and were eating comparitively high calories considering the norm for that level of conditioning. However, unless the person has an abnormally low setpoint, I don’t think they can return to true offseason intakes until bodyfat has reached a more normal level. It is also important to note that without fail, all of these competitors who walk around eating high carb intakes (relatively) while being 5% bodyfat have horridly low energy levels and many times no libido. So its not a walk in the park by any means.
Hope our experience helps shed some clarity on this issue.
-Eric
Hi, Lyle. I don’t have any questions to direct your way right now, I just wanted to say thank you for being a class act and always so generous with your extensive knowledge. In a world full of enough shady clowns peddling B.S., it is an honor to learn from you. I am grateful for all of the effort you routinely put into your content and could never properly repay you for all I have picked up from you.
Lyle,
I am not sure if this will end up sounding like the answer should be plainly obvious to me, but does intentionally setting out to pack on new muscle help to possibly counteract any modest residual drop in BMR that comes about as a result of contest dieting (or in situations like the ones you mentioned regarding studies on the post-obese population? I’d also wonder if this can have a larger role to play in situations that previously /still involve eating disorders (although I recognize that you mention that is not an area you focus on, so comments in that regard aren’t necessary; I also realize that dealing with the psychosocial aspect of such disorders likely makes an intent focus on muscle gain something that is mostly off of the radar).
But for post-obese folks who start embracing the fitness lifestyle and (more commonly so) the post-contest bodybuilder, I would imagine that a purposeful focus on adding muscle mass in an intelligent manner (namely not eating everything in sight while using the intent of muscle gain as an excuse for binging) would be an ally in combating any hits to the metabolic rate.
Some of your comments with respect to the Minnesota Study noted that metabolic rate returned to normal levels after the individuals had regained all of the fat they had lost, but in this case I am wondering about the relative impact of minimizing any tendency toward fat regain (as much as possible when attempting to gain muscle, that is) while seeking to add muscle.
Lyle – interesting as always. One question, if I diet down to a level, then raise my body mass back to the original weight by adding muscle will I have a metabolic rate 5% lower than my original BMR or not? I guess the question is whether this drop in BMR is related to the change in body composition or the absolute change in body mass.
Lyle, thanks for addressing our questions directly! Very much appreciated!
Great follow-up with great answers, thanks!
Lyle-
What a great topic! Having been on a weight roller coaster for 35 years, of late I’ve wondered if I’m so screwed up there’s just no point of trying to lose weight any more.
I can’t find the original topic, but I’m still looking.
Eric-
That was great info, too! I am SO glad you mentioned the low energy level in seemingly ultra-fit people! While I’m carrying around WAY too much fat, my vitals, bloodwork, and energy are all at very healthy levels. So perhaps I won’t freak out and try to lose it all in a couple of months, but keep reading this website and then take a nice middle road to a normal weight. I really appreciate your comments.
Meg, don’t worry about the lethargy associated with being at essential body fat levels. There is no reason to get this lean unless your goal is to compete in a bodybuilding show, you can look absolutely fantastic and be lean and healthy and have no feelings of lethargy. I feel great at at 190lbs morning weigh in, but once I start getting close to the 180-185 mark that’s when it gets tough. But, I am what you would consider “ripped” at 190. So don’t stress it, that really only happens at VERY lean levels that are even uncommon among bodybuilders at the amateur level.
Lyle,
First off, wonderful site/article, they answer almost every question I could ever think to ask about exercise, fitness, etc. when concerned with calories expended and such.
However, you talk about how someone reducing their weight to 180 will have a slightly less caloric “expense” than one naturally at 180.
Well, lets say that person who dieted down to 180 was originally 200, and he gains oh idk, 100% LBM/muscle and reaches 200 again. What then? Will he still have a natural deficit due to the diet?