1

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IF for 19 year old obese female?

Answered on August 19, 2014
Created March 19, 2012 at 9:07 PM

Hi all,

I am working with a female who needs to lose 59 lbs by next September. She is currently at ~214, 5'6".

The goal weight is 155, which is the maximum allowable weight according to Air Force standards for her age, height, and gender. Even at 155, she's probably going to struggle to pass the physical fitness test and so getting below that number as much as possible would be good.

I've put her on a paleo diet but allowed her dairy (which she doesn't take too much advantage of, so I'm not too worried about it) and she's shown reasonably good compliance in the last 40 days or so, and has lost about 8 lbs as of the 8th of March (we will do another weigh-in this Friday). She's also lost several inches off the waist. In short, she's making good progress.

She also working out at a fairly good rate, usually with calisthenics or some form of weight training. My difficulty with her physical training has been trying to keep her from injuring herself in her enthusiasm. She repeatedly ignores my instructions for physical training and has injured her knee several times, though I believe it is runners knee and not terribly serious.

Given the short time constraints we are under, and her continual insistence that she is not hungry, I was considering starting her on an intermittent fasting program. I'm concerned that I don't know what intervals to suggest, and I don't want her to crash and burn if she tries it because I really have zero room for error with this girl's self esteem, and if she fails, she may binge eat. I don't want to trigger any sort of disordered eating issue, either. I am encouraging her to seek counseling for the issues I can't handle, but in short:

Would you suggest an intermittent fasting protocol with a client who presents with this history? If so, what sort of protocol? I can post her food log if that would be helpful.

Thanks all!

77877f762c40637911396daa19b53094

(78467)

on March 20, 2012
at 09:17 PM

IF = Massive adrenaline spikes, anxiety, jittery, grumpy, insomnia. VLC = Tired, dry skin that hung like an elephant, I did lose weight, and did sleep ok but just couldn't wake up and was just never very peppy. Everything felt like a chore, but it was more of a semi-tired slog and couldn't really get the energy up to hate it.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on March 20, 2012
at 03:33 PM

I appreciate your willingness to exchange ideas and your obviously sincere desire to help. I'm definitely rooting for a positive outcome!

2a00b9a42e4cb6e489a0e69d20714576

(3043)

on March 20, 2012
at 11:32 AM

Screwed you up how?

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 03:58 AM

They do a BMI analysis if you're over the weight limit, so if you are quite muscular you'd be fine, I think.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 03:55 AM

Even if she loses only 30 (or less) lbs by next September, she has options. Those options include repeating a year of ROTC, which she can do since she is not contracted, or OTS after college, as mentioned, or even enlisting. If it looks like we're not going to make the cut-off, or get close to the cut-off, then I can explore those options with her then--when she has established a track record of some success with losing weight, and has the potential to be less discouraged by additional obstacles to her eventual goal. I can investigate further options with her cadre, as well.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 03:51 AM

I am not being paid for this, nor do I have any professional credentials to speak of-and she is under no illusion that I know anything; this is why I am encouraging her to seek counseling and why I'm looking for information (this includes asking a med school friend for info-and she gave me permission to ask). I explained to her once-briefly-that she would need to lose more than 2 lbs a week to reach her goal in time. I haven't brought it up since and I haven't made it a point to do the numbers out in front of her. I fail to see how that would help, I think it would merely discourage.

518bce04b12cd77741237e1f61075194

(11577)

on March 20, 2012
at 02:47 AM

Seriously, that's the weight cut off?? I am 1 inch shorter than her, and I used to stay at 150 for training seasons in varsity sport...but apparently wouldn't be allowed in the air force...Man, that seems a little wrong, there's such thing as weighing more but being strong.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on March 20, 2012
at 02:38 AM

@Laura, feel totally free to ignore me but your comment makes me uncomfortable. If you're counseling her gratis, that's one thing. If she's paying you, my 2-cents says it's your professional responsibility to level with her. Show her the math and advise her on the sensible options, such as using the next year to REALLY get ready. If she winds up furious or feeling like a failure and feels you deceived her through your silence, how have you helped her?

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 02:07 AM

I'm inviting her to work out with me on Thursday; we will run through the test then.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 01:44 AM

I agree with you, and have done the math numerous times hoping that the numbers come out differently. I haven't, however, shown her that math--and she hasn't done it herself (which should tell you something about her initiative). Frankly, I don't think she's going to make the weight and I'm not trying induce a dangerous amount of weight loss--because coming out of this process with a healthier relationship to food and a reduced risk of heart disease is far more important for her future (IMO) than becoming a 2d Lt. Still, that is her goal and my role is to facilitate it and explore options.

D290734f36a9ae03e3f60e0fa088d7ed

(1304)

on March 20, 2012
at 01:24 AM

60 pounds in 5 months seems downright unhealthy. As an Army officer myself I can say the military doesn't joke around with height/weight for officers. Officers can't be obese because it sets a bad example for the soldiers and airmen serving under them. This sounds like a crash diet, and if I were the professor of military science I would not reauthorize her waiver unless there was a more long-term track record of good habits. Someone that loses 60 pounds in 5 months can probably gain it back in 3 months. She should consider OCS after college in order to lose weight in a more healthy manner.

22fcea5ec4415ff2238c663324aca40f

(556)

on March 19, 2012
at 10:50 PM

Have her fast for full days, so she has no option, but to not eat. That may help her binges. If she wants to join the Air Force she will need mental strength, this is no different. I do not fast for weight loss, but to allow cells to cleanse and my digestive system to clear. That our stomachs can stretch to hold food, and still we are able to move is evidence that IF has always been apart of the human species.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 19, 2012
at 09:47 PM

She's enrolled in an ROTC program. Next September is when her weight waiver expires, so when it does she needs to be under the weight limit though she does not need to pass the fitness test the first go around; she has until February to pass. She won't be going to boot camp (if she gets selected) until Summer of 2013, so she has some choice in food, but she's very limited financially It's also possible--though I don't know for sure--that if she shows significant progress between now and next September, but is still over the weight limit, that the AF will reissue the waiver until February.

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8 Answers

3
96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on March 19, 2012
at 09:42 PM

Okay, we're talking 60 lbs in 5 months--averaging 3 lbs per week? To be followed by high stress and activity, with you-eat-what-we-serve food options in a military environment while the weight loss must be maintained or increased? I found in Army basic that I gained at first upon exposure to their menu.

I'm not optimistic, I have to say--this is exactly the type of goal that leads toward frantic/self-destructive behaviors, so your concern is warranted. On the positive side, I assume her motivation is very high but I have to ask, wouldn't this be a terrific goal for a YEAR from now? I'll assume you already addressed that and it "has to be" this September.

I'd actually suggest moderation of activity and let the Air Force build her musculature once she's there. Muscle is heavy! IF is relatively neutral re: weight loss. The eating window doesn't determine low/full/excess energy intake. Again, with high motivation the discipline of IF can be reinforcing if she likes it.

With such a short total time and the likelihood that weight loss is likely to slow at some point, if she's going to do this you should research and discuss/dismiss a short-term strategy for the first month that would be something like CR (extreme calorie restriction) or ADF (alternate day fasting) or even a step like a 2-week water-fast. That assumes the final 3-4 months would involve moderate, balanced nutrition and activity to reach goal--and that's when IF might make great sense.

I wish you both success no matter how you two decide to define it.

I only mentioned the above because most people won't average 3 lbs of weight loss per week over a 5 month spell of moderate diet/IF.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 19, 2012
at 09:47 PM

She's enrolled in an ROTC program. Next September is when her weight waiver expires, so when it does she needs to be under the weight limit though she does not need to pass the fitness test the first go around; she has until February to pass. She won't be going to boot camp (if she gets selected) until Summer of 2013, so she has some choice in food, but she's very limited financially It's also possible--though I don't know for sure--that if she shows significant progress between now and next September, but is still over the weight limit, that the AF will reissue the waiver until February.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 03:51 AM

I am not being paid for this, nor do I have any professional credentials to speak of-and she is under no illusion that I know anything; this is why I am encouraging her to seek counseling and why I'm looking for information (this includes asking a med school friend for info-and she gave me permission to ask). I explained to her once-briefly-that she would need to lose more than 2 lbs a week to reach her goal in time. I haven't brought it up since and I haven't made it a point to do the numbers out in front of her. I fail to see how that would help, I think it would merely discourage.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on March 20, 2012
at 02:38 AM

@Laura, feel totally free to ignore me but your comment makes me uncomfortable. If you're counseling her gratis, that's one thing. If she's paying you, my 2-cents says it's your professional responsibility to level with her. Show her the math and advise her on the sensible options, such as using the next year to REALLY get ready. If she winds up furious or feeling like a failure and feels you deceived her through your silence, how have you helped her?

D290734f36a9ae03e3f60e0fa088d7ed

(1304)

on March 20, 2012
at 01:24 AM

60 pounds in 5 months seems downright unhealthy. As an Army officer myself I can say the military doesn't joke around with height/weight for officers. Officers can't be obese because it sets a bad example for the soldiers and airmen serving under them. This sounds like a crash diet, and if I were the professor of military science I would not reauthorize her waiver unless there was a more long-term track record of good habits. Someone that loses 60 pounds in 5 months can probably gain it back in 3 months. She should consider OCS after college in order to lose weight in a more healthy manner.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 01:44 AM

I agree with you, and have done the math numerous times hoping that the numbers come out differently. I haven't, however, shown her that math--and she hasn't done it herself (which should tell you something about her initiative). Frankly, I don't think she's going to make the weight and I'm not trying induce a dangerous amount of weight loss--because coming out of this process with a healthier relationship to food and a reduced risk of heart disease is far more important for her future (IMO) than becoming a 2d Lt. Still, that is her goal and my role is to facilitate it and explore options.

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 03:55 AM

Even if she loses only 30 (or less) lbs by next September, she has options. Those options include repeating a year of ROTC, which she can do since she is not contracted, or OTS after college, as mentioned, or even enlisting. If it looks like we're not going to make the cut-off, or get close to the cut-off, then I can explore those options with her then--when she has established a track record of some success with losing weight, and has the potential to be less discouraged by additional obstacles to her eventual goal. I can investigate further options with her cadre, as well.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on March 20, 2012
at 03:33 PM

I appreciate your willingness to exchange ideas and your obviously sincere desire to help. I'm definitely rooting for a positive outcome!

2
Da3d4a6835c0f5256b2ef829b3ba3393

on March 19, 2012
at 09:12 PM

I am not in any position to suggest any sort of protocol for anyone*, but I can say that many of the smart paleo gurus, like Robb Wolf, warn people away from such fasting UNLESS everything is locked in.... meaning, diet, sleep, exercise, etc. Once everything is in order, then these smart guys say that it's okay to give IF a try.

Intermittent fasting can be tough on a person, particularly if he/she isn't squared away and ready to take on any added stress.

*I'm just some guy who reads a bunch and tries to experiment/implement things and see what works for me.

1
246ebf68e35743f62e5e187891b9cba0

(21420)

on March 20, 2012
at 05:23 AM

If you can successfully pull off intermittent fasting as an obese person, nothing works better at curbing future binges. But for a person who is a binge eater, it may not be the best solution (very high recidivism). Personally I've found very strict low-carb to be the ticket for initial weightloss, and after a month or so of that, then attempt IF.

But if you insist - To really pull it off successfully (in my experience as a recovering obese person), she needs to be keto-adapted first.

For me, this would mean having a VLC/ZC meal with no "soft" dairy (butter and hard cheese is ok - cream cheese, sour cream, milk is not ok) in the early evening (before 6pm if she beds at 9-10pm or so) before a fast. Fast until 2pm or so the next day, but keep the eating window very short compared to say, leangains - eat maybe two meals in a 4-hour window (or as I do, one fairly large meal). Perform this protocol three times in a week and in a week's time, she will be fairly keto-adapted.

However, I would like to offer another alternative...

You can't fix a broken engine by driving it faster, no matter what quality of fuel you put into it. You have to fix it first. So I suggest:

  1. Moderate Exercise (1-2 weightlifting sessions per week and increased locomotion i.e. walking/biking/swimming)
  2. Adequate Sunlight (1 hour a day minimum, 3-4 hours a day awesome)
  3. Very low carbs initially to keto-adapt and also quickly shed water weight (seeing the scale shift downward is a great initial confidence boost).

Those three things and I think she will be able to succeed at getting an initial boost of 8-10lbs in the first few weeks from decreased water retention and a repaired endocrine system.

Once that stalls, then it's time to bring out the IF, tinkering with carbs, activity level, etc... but the first thing to do is to fix the problem.

1
9063665d3cc2a23c44ff596167621cfe

on March 19, 2012
at 10:21 PM

Please test her on the AF PT test qualifications and post those numbers, waist measurement, max push-ups, max sit-up, 1.5 mile run...

While she needs to meet the weight standards - the test qualifications are super important. She needs to test in these areas at least once a week with you - in my own humble opinion... This can be counted as a workout, but must be done and tracked - no matter how poor she does. It will show how she is improving as one should treat a PT test like a sport. It is sport specific training - while other exercises are good and will help, the test needs to be done weekly for muscle memory and practice - this is an open book test...

9747ae0ff20a8f4a4a2857c66820b125

(439)

on March 20, 2012
at 02:07 AM

I'm inviting her to work out with me on Thursday; we will run through the test then.

0
77877f762c40637911396daa19b53094

(78467)

on March 20, 2012
at 05:04 AM

Trying to IF completely screwed me up. So did VLC. Try it but if it's really uncomfortable just back off and try it again some other time.

77877f762c40637911396daa19b53094

(78467)

on March 20, 2012
at 09:17 PM

IF = Massive adrenaline spikes, anxiety, jittery, grumpy, insomnia. VLC = Tired, dry skin that hung like an elephant, I did lose weight, and did sleep ok but just couldn't wake up and was just never very peppy. Everything felt like a chore, but it was more of a semi-tired slog and couldn't really get the energy up to hate it.

2a00b9a42e4cb6e489a0e69d20714576

(3043)

on March 20, 2012
at 11:32 AM

Screwed you up how?

0
0df668399c068fa6a6c78fc1318c97a6

on March 20, 2012
at 03:45 AM

Not so bad of a predicament. I am a very strcit Paleo guy, but seriously the answer is Atkins. Read his book or even Gary Taubes " What makes us Fat" Regulate insulin. Stimulate Hormone release by exercising. Heigh rep weights is my suggestion. Discipline is going to be the key. Can't see why it's not unattainable. Don't skip meals. Eat "good calories" Good luck

0
7bf306ada57db47547e9da39a415edf6

(11214)

on March 19, 2012
at 09:34 PM

When I was seriously dieting, I would weight my food. I'd eat 4oz of meat, possibly a similar amount of vegetable and then wait twenty minutes. If I was still hungry, I'd eat again. When I established this behavior appetite suppression from the Shangri-La Diet had just kicked in strongly, so I got full pretty fast. I was able to stay under 1500 calories using this approach.

IF seemed pretty exciting, but it does seem to be the sort of thing you have to have everything solid in order for it to work. I liked not having to bring food to work, but life kept getting in the way of keeping that lifestyle up. (I don't know that I ate enough during the evening either, so if I ever do it again I will aim for more calories.)

Since she's still overweight, I'd suggest a kitchen scale could be more helpful than IF. And I only suggest this because she has a deadline- otherwise I encourage her to just eat normal paleo and develop some healthy relationships to food.

0
99ac392257e444e014be6d4da6a900e4

(1036)

on March 19, 2012
at 09:14 PM

I have a good friend that went from 380 on 02/14/2011 to under 230 in about 9-10 months. He IF'd everyday, basically eating within a 1-2 hour window and virtually zero carb. I'm not sure that's the right plan for everyone but it worked for him. Also, no exercise outside of daily tasks.

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