Prolonged Fasting (stubborn client)

Nutrition Q&A [Moderated]
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Hi guys, thanks in advance for your time.

I have a coaching client who insists on using prolonged fasting in order to cut weight. He seems to have got the idea from Elliot Hulse (I know a little about him and he seems very guru’ish). The approach is basically 3 days without any food, 1 day consuming one 4000 calorie meal, repeat for 3 weeks. My client’s stats are as follows:

Height: 5 foot 9
Weight: 215 lbs
Body fat %: probably around 30%
Waist measurement: 42 inches
Training status: 5 years of on/off training. Has been training consistently for the last year.

He has tried this diet before and insists that he did not lose any muscle mass however I challenged him on this as I said there was no way for him to verify that he didn’t lose lean mass.

During the diet his training is practically non-existent and his protein intake is zero on fasting days. Because of this, I fear he is in fact losing a large amount of lean mass and when he finishes the diet he has a history of putting the weight back on quickly.

I’ve asked if he can meet me in the middle and try intermittent fasting (shorter fasting periods), with adequate protein and resistance training but he is being stubborn. He plans on losing 30lbs in a 4 week period. As he is significantly overweight and has a history of yoyo dieting and rapid weight regain, I would really like him to try a slower weight loss approach with some behavior and lifestyle modifications which he can hold onto when it comes time to maintaining a healthier body weight.

What i’m basically asking is,

  1. What is your opinion on prolonged fasting as a weight loss approach

  2. Are my concerns about lean body mass loss legit or should I chill out

  3. How should I reason with this client

Thanks

Tom

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Hey Tom,

Thanks for the post and I hope you’re well. This sounds like a tough situation given the client’s desire to use this strategy. That said, it’s clearly not something that has worked well for him, as he has ~30-45 pounds to lose and is unlikely to be carrying a large amount of muscle mass given his anthropometry.

  1. The data on fasting suggests it does not produce better weight loss than any other type of diet that is calorie matched. If this improves adherence then I’m all for it, but I’m wary of this strategy as it has not proven to be effective in this person and, additionally, is unlikely to be something he could sustain for life.

  2. The data is less clear on LBM loss, but I’d guess he’s probably not doing himself any favors by taking this approach.

  3. I think exploring why he wants to do this diet and what other sorts of behavioral interventions he’s open to try may be useful. If he’s open to doing other stuff, you can help. If not, you might just be along for the ride here, which begs the question why is he paying you for your professional advice.

-Jordan

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Thanks Jordan , Much appreciated

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@TomBabington
Just a couple of thoughts, the first thought that comes to my mind is wondering if your client struggles with some type of disordered eating/ eating disorder not interchangeable I know, however with the many different diets and the expecting to lose 30 pounds in one month with only 30-45 pounds just feels like could be something to be explored. I would be interested to know if there is guilt and shame when he does jumps from diet to diet, when he “fails” on a diet or even how often he is obsessing about food. It sounds like he is dealing with other psychological issues related to eating or at least using eating as coping that you will never be able to solve and he may not explore or even know that he could explore. I am not diagnosing him or saying he does have an issue with how he handles food, I just think this maybe an area in which your client could explore. In saying this if you had a candid conversation about this with him, he may use avoidance or become angry and leave you as a coach if you suggest exploring this option (this is where rapport and trust is vital). I maybe totally off the mark on this one and goodness knows I am wrong often:) motivational interviewing can be really useful for a client like this and for them to determine how ready they are and assess this throughout the coaching process as readiness can ebb and flow with many.

@Jordan_Feigenbaum Nice, when using only data when it comes to how much this person has to lose, I like it ( I mean not that it matters what I like, it’s just nice to see:)