c/o Lyle McDonald This week, several people have brought a recent case-study to my attention and asked me for comment. In it, a 51 year old female began marathon training along with a (self-reported) low calorie diet and either appears to have gained weight or not lost weight (she also showed a very depressed metabolic rate, nearly 30% below predicted). By raising her calories gradually, her body fat (as measured by BIA) came down and her metabolic rate increased. Now, without more details, it’s hard to really comment on this and the link to the case study is the total amount of information available. But we’ve got an older (either post-menopausal or peri-menopausal) woman, undisclosed anti-depressant medication, self-reported food intake and a method of body fat measurement that is, at best, problematic (read Methods of Body Composition Measurement Part 2 for more details). Odd things happen metabolically around menopause, some medications can cause issues, food reporting is notoriously inaccurate and BIA isn’t ideal to track changes. Then again, the measured metabolic rate change is pretty interesting; something was going on. That said, I’ve mentioned in previous articles that one oddity that I’ve seen (and personally experienced) over the years is one where the combination of very large caloric deficits and very large amounts of activity (especially higher-intensity activity) can cause problems for people either stalling or slowing fat loss. Like my previous article on The LTDFLE, or Long-term Delayed Fat Loss Effect, this is one of those oddities that seems to crop up more often than you’d expect. It’s also one where there’s not a ton of research but I will happily provide a good bit of speculation on what I think may be going on. I’d also note that the combination of big caloric deficits and large amounts of activity clearly isn’t detrimental to everyone. Some folks can get away with it but, for many, it tends to backfire more than anything else. First, Some Background Back in my early 20’s, I remember a very specific client I had. She was a little bit, well, to be honest nuts. She was older, I think she had gone through menopause but I wouldn’t swear to that. In any case, she started working with me, determined to lose weight and immediately jumped into something like 2 hours of cardio per day and cut calories massively. She claimed 600 calories per day and I won’t even try to describe her diet; it was insane (breakfast was supposedly one-half an egg and to this day I’m not entirely sure how you eat half an egg). Now, I didn’t know much at that point but I had this general idea that too much activity and too few calories was a bad thing. For weeks on end I entreated her to either cut her activity or raise her calories. She adamantly refused; how could that possibly work? I tried to point out that what she was doing wasn’t working either and she could hardly do worse by trying something different but that line of logic went nowhere. In any event, at one point she went on a cruise or a vacation or something. And what do you think she did? Exercised less and ate more like everybody does on vacation. And she came back something like 5 pounds lighter (some of which may very well have been The LTDFLE mind you). “See, see.” I told her, “You ate more and exercised less and good things happened.” And she immediately went back to a massive caloric deficit and over-exercising. But that’s how it goes sometimes. Later in my 20’s, mind you, I’d do the same thing during the now infamous Bodyopus experience (probably the singular experience that taught me what NOT to do during a fat loss diet). Frustrated by stalled fat loss (I had dieted far too long at that point in the first place), I worked even harder, cutting calories further and adding more activity. That coupled with some genuinely awful ‘carb-loads’ took fat loss to a standstill. In addition to those case studies, this is a phenomenon that I’ve seen elsewhere including the support forum, I imagine readers run into it constantly: people (frequently but not always women) who try to combine excessive caloric deficits with massive amounts of activity (often with a lot of that activity being high-intensity activity) and nothing is happening. And if you can get them to reduce activity (or just cut back the intensity to reasonable level) or increase calories, things invariably start to work better. What’s Going On: Let’s Talk About Cortisol Cortisol is one of those hormones that I imagine everyone reading this has heard about and about which a lot of misinformation exists. Simply cortisol is a stress hormone, released by the body in response to nearly all kinds of stress. In the fitness/bodybuilding world, cortisol has gotten an almost exclusively negative reputation (cortisol is ‘bad’ in the way that testosterone and thyroid are ‘good’) although this is simplistically incorrect. Rather, whether cortisol does good things or bad things in the body depends on how it’s released. Simply (and I’d simply, ha ha, refer folks to Robert Sapolsky’s amazing book Why Zebras Don’t Get Ulcers for a detailed look at this; I also talk about cortisol in The Stubborn Fat Solution), acute pulses of cortisol tend to do good things and be adaptive and chronic elevations in cortisol tend to be bad and be maladaptive. For example, the morning cortisol pulse helps to promote fat mobilization. In contrast, a chronic elevation of cortisol (especially in the face of high insulin levels) tend to promote visceral fat accumulation. As a non-fitness related topic, acute pulses of cortisol tend to be good for memory (why we often remember stressful situations in such detail) while chronic elevations (as often seen in depression) make memory go down the toilet. And there are endless other examples of where acute cortisol pulses are good and chronic elevations are bad; again see Sapolsky’s book for details. In any case, dieting in general is a stress. And of course training is a stress. And the more extreme you do of each, the more of a stress occurs. And I suspect that a lot of what is going on when folks try to combine excessive caloric deficits with massive amounts of activity is that cortisol just goes through the roof (there’s another issue I’ll come back to at the end that relates to this). Simply, you get these massive chronic elevations in cortisol levels. Tangentially, this is also one reason I suspect that various types of cyclical dieting help with some of this issue. For at least brief periods, when calories are raised to maintenance or above, you break the diet/training induced elevations in cortisol. This of course assumes that the person isn’t mentally stressed to the nines by raising calories like that but I’m getting ahead of myself. So Why is This Bad? As noted above, chronic elevations in cortisol can cause a lot of bad things to happen. One of them is simply water retention and I’ve mentioned in previous articles that water retention can mask fat loss, sometimes for extremely extended periods. I talked about this in some detail in The LTDFLE and suspect that some of the ‘fat loss’ is actually just water loss when calories are raised and cortisol mediated water retention dissipates. Reducing total training (volume, frequency, intensity or some combination) does the same thing. But that’s probably not all of what’s going on. Another effect of chronically elevated cortisol levels is leptin resistance in the brain. I’m not going to talk about leptin endlessly here again, you can read the Bodyweight Regulation Series for more information. When the normal leptin signal to the brain is blocked, a lot of things can go wrong metabolically and I suspect that this is part of the problem. In this vein, although not necessarily related to cortisol per se, at least one study found that the addition of 6 hours per week of aerobic activity to a very low calorie diet (in this case a protein sparing modified fast) caused a larger decrement in metabolic rate than the diet alone. The body appears to monitor caloric availability (simplistically caloric intake minus output) and if it gets too low, bad things can happen. This is why I so strongly suggested AGAINST the inclusion of much cardio in The Rapid Fat Loss Handbook; it causes more harm than good. Invariably, the biggest source of failure on that plan is when people ignore my advice and try to do a bunch of cardio. And fat loss stops. In any case, there are several different plausible mechanisms by which the combination of excessive caloric deficits an large amounts of activity can cause problems. Whether it’s simply cortisol related water retention, a drop in metabolic rate due to leptin resistance or something else, something is going on. From a more practical standpoint, for a lot of people, the combination simply doesn’t work. Mind you, some seem to get away with it but not all.