By Doc Crossfit.
Disclaimer: This is not medical advice, this is general medical knowledge.
For those of you who have attended the Metabolic Class, I want to explain in more detail what I mean when I say that the road to Health and Fitness is like going to school from Kindergarten to 12th grade. I like to use this image to convey the fact that for motivated patients there is a well defined road of continued improvement in health parameter, and that all human beings can become quite healthy if they want to. That is the good news. The not so good news is that just like going to school, from K all the way to 12, it takes time and dedication, and there is no easy or fast shortcuts.
The patient affected with metabolic syndrome (obesity, type 2 diabetes, elevated triglycerides, cardiac and vascular disease) as a consequence of sugar toxicity, is like the 5 year old going to Kindergarten for the first time. In Kindergarten, we learn the basics of behavior to function in society. School will then take us in a well defined journey, in which every year builds on the foundation laid the previous year, until we graduate to adult life and hopefully, independent and meaningful function. In the metabolic clinic, we come in with metabolic syndrome and we learn the basics skills to reverse it at the first step and then take it one step at a time becoming healthier and fitter, as far along that road as we want or need to. It's an easy to understand analogy. So without further ado, here is the layout of metabolic class k-12:
Kindergarten: we show up afflicted with different degrees of metabolic toxicity, from obesity but metabolically healthy, to full blown metabolic syndrome with or without obesity. We may be in multiple medications and near the end of our rope. The entry level metabolic conditioning knowledge will be carbohydrate and sugar restriction. Only changing the macronutrient mix of diet. In other words, just stop eating sugar and carbohydrate and switch to meat and some greens. That is it. No calorie counting, no complicated intake schedule, and no need to workout. Patients that are in multiple medications need to do this under the supervision of their physician. As these dietary changes are made, patients will need less insulin, less hypoglycemic medications, and other medicines such as diuretics (water pills), and blood pressure medications may be decreased in dose or eliminated altogether. The deeper in the hole of metabolic syndrome patients are, the more medical supervision is required. Secondary to loss of fluid, patients may lose from 5-20 lbs in this induction phase. Kindergarten may also be called the de-prescription phase, because a lot of medications may not be needed anymore. Keto flu may be observed and can be annoying, although it does not have to be, if proper precautions are taken.
Graduation from kindergarten: at that time, patients graduate up to 20 lbs lighter, and with fewer or no metabolic prescription meds. This is a hell of a success and reason to celebrate, and for many patients, this will be satisfactory and they may decide to stop the journey here, and re introduce some carbs and see what happens (hint, nothing good usually happens…). The success rate of this first step is roughly about 50% and it is defined by those who can follow carbohydrate restriction, versus those who can't.
First Day of Day of Kindergarten:
Graduation Kindergarten:
Elementary school: For those patients that want more, we move on to elementary school 1-6th grade. After changing macronutrients and eating high quality meat and greens (or just meat lol), patients may decide they want to lose more fat and gain muscle. In other words, now that metabolic syndrome has been left behind, they want to improve body composition. Usually, people get stuck in their weight loss around here. This is where things get a little complicated, because to start modifying body composition, gain muscle and lose fat, we have to start counting calories. And this sucks. Counting calories is a drag. It adds a layer of complexity that can be impossible to navigate without extra help, like a coach or a training buddy. Besides, most of us metabolics have trouble regulating appetite, it's part and parcel of the sugar toxicity metabolic problem. And people that know argue that it may take years for down regulation of appetite in metabolic patients. But hell, we are motivated and ahead we go. Usually this is the time to step on a body composition scale, find out % of body fat, and crunch some numbers and come up with a caloric restricted, macronutrient appropriate regime. In other words, we are going to keep eating correctly, lots of meats and a little greens, and we are going to eat a little less quantity of them. We will probably start going to the gym at this time, and my advice is to gain muscle first, by either power lifting or cross fit, and then to work in pure aerobic conditioning later. But there are many ways to skin this cat, as long as you are working out, it is ok. Success in elementary school means that we can shed a good amount of body fat, and our body will start shaping nicely. Usually patients feel good and confident enough to enter a race or competition of some kind. By this stage, patients turn into athletes, and most feel no need to re introduce crap in their diet, unless is a holiday or special occasion. Success rate is a lot less than kindergarten. I wouldn't even try to quantify it because at this stage, patients/athletes develop what Mrs Crossfit calls "an eating disorder" because they become obsessed with eating well and healthy. Not many make it this far, and to be honest with you, sometimes it is a matter of who your friends are. If your friends are fit and in the same boat, it is a lot easier to make it this far. If your friends have bad habits and eat poorly, you will not go far at this stage.
Graduation from 6th grade: We may be in the low end of obese, or just overweight. We like what we see in the mirror and new clothes are in order. We sleep better, perform better, energy is abundant and life has never been better. Prescription meds from a metabolic point of view, are few to none.
First Day Elementary School:
Graduation Elementary School:
Intermediate/High school: Now that we see how far we have come, and how good we look, we decide to go all out. A positive eating disorder develops. We want to see how far low our body fat can go. We start reading body composition books and may start hanging out with body building coaches. We may hire someone to cook for us or we may become amateur chefs. We start distrusting all restaurants and start developing aversion to eating out. We start looking for cattle and pig farmers to buy farm to kitchen local organic meats. We buy a lunch box. We meal prep. We become goal oriented in our workouts. We weigh ourselves obsessively and learn by trial and error what makes us lean and what makes us fat. There is no need for further medical advice. We got this. We become outliers, people compliment us in our appearance.
First Day Intermediate School:
Graduation High School:
For those of you who want to see what graduation from metabolic college looks like, here we go:
Any leaner than that, your are a professional (or insane), and one in a million. This is as far as reasonable people should go in their quest for fitness. You can get leaner, but it will happen for a couple of weeks at a time. It is really hard, and probably impossible to be leaner than this permanently. You may do it for a body building competition once or twice in your lifetime but that is about it. There is a hard metabolic floor as to how low your body fat % may go.
If you are metabolic and think that achieving some of these pictures is not realistic, that may be correct. But do not compare yourself to other people out there. Just compare yourself to your past self. If you are type 2 diabetic, on multiple medications, why settle? Most type 2 diabetics can reverse their condition and go off meds with dietary modification. This is the best kept secret out there in medical circles. Type 2 diabetes is reversible. Your body composition can be improved. Your metabolic profile can be made healthy. Body builders prove that every day. Is about time physicians and patients reap the benefits of that body of knowledge.
May you all graduate with honors!!!
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