May 13, 2025 • 20 mins
Episode #204
In this Fasting Q&A episode, Megan Ramos answers some of your fasting questions:
1. On eating days I almost always feel very full. I try to make my meal portions smaller but I still feel full. I don't seem to feel hunger cues on eating days nor fasting days. Have 20 years of dieting broken my body? My usual fasting protocol is three 36s, lately, two 42s. (Ewelina) [01:34]
2. I’ve read on some of the PCOS blogs that you shouldn’t skip breakfast because it balances your blood sugar, but I find it harder to meet my fasting goals when I eat breakfast. Is this a reference to early, time-restricted eating? Is it better to meet the fasting goal of longer fasts or to consume the meals earlier in the day? [04:45]
3. How do I not lose much more weight with extended fasts for autophagy? I am 71 and have lost 44 pounds over an 8-month period (1 pound on most weeks, never more). I have loose skin on my arms, belly, and legs, and I am looking older than I ever have! I will be doing 24-hour fasts to maintain my weight loss. (Anne) [09:47]
4. I started doing the 42-hour extended fasts (sometimes three a week, sometimes two) to switch it up. I’m not losing weight or inches. What am I doing wrong? (Sylvia from California) [13:10]
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Summary Timestamps
00:00 Intro
01:34 Lack of hunger on eating days
04:45 Is breakfast necessary with PCOS?
09:47 Fasting for autophagy and loose skin reduction
13:10 Doing EF but still not losing weight or inches
Disclaimer
This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. You should always speak with your physician or other healthcare professional before doing any fasting, changing your diet, taking or adjusting any medication or supplements, or adopting any treatment for a health problem. The use of any other products or services purchased by you as a result of this podcast does not create a healthcare provider-patient relationship between you and any of the experts affiliated with this podcast. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
The reason why you're not feeling
hungry on your eating days after a
36 or 42-hour fast is
because your body's actually burning a lot
of fat.
Yes, you are a fat-burning
machine! It's doing exactly what
you want it to do.
(00:23):
[music]
Hi everyone, it's Megan Ramos here
with another episode of The Fasting Method
podcast.
Today I'm going to answer your questions.
We're going to cover topics such as how
you know when your current fasting protocol
is no longer working for you,
do you need to extend things to 48 hours,
should you skip breakfast or should it be the
(00:44):
most important meal of the day.
Now, let's dive on in.
The first question comes from Ewelina,
"On the eating days, I almost always
feel very full.
I try to make my meal portion smaller,
but I still feel full.
I don't seem to feel any hunger cues
on my eating days nor fasting days.
(01:06):
Have 20 years of dieting broken my
body? My usual fasting protocol
is three 36s or, lately, two
42s."
This is a fantastic question and, my
friend, and for all of you out there who I
have no doubt are in the same boat
as our good friend here, you are not
broken from your history of dieting.
(01:27):
The reason why you're not feeling
hungry on your eating days after a
36 or 42-hour fast is
because your body's actually burning a lot
of fat.
Yes, you are a fat-burning
machine! It's doing exactly what
you want it to do.
But because your body is burning so much
(01:47):
fat and providing it with so much of the
fuel that it needs, the hunger just
isn't there, it's not there at all, and it
can feel really difficult to try
to push through and eat multiple
meals on those eating days.
This is when it's time to graduate
into doing that 48-hour fast
twice a week.
(02:08):
You don't have to force yourself to
eat that lunch.
You don't have to try to get creative with
jam-packing a lot of fat calories and protein
into a small meal,
not unless you have certain nutrient
deficiencies that you're tackling.
So if you do have certain nutrients
deficiencies that are becoming
serious issues, then, yes, you
(02:30):
might need to eat a little bit more and fast
a little bit less.
But if that's not the issue, then extend
those two 42s that you're doing to two
48s. So that would look like - on
Sundays you have lunch, you have dinner,
you begin your fast, and you fast until
Tuesday dinner.
Then you eat Wednesday lunch and dinner,
you fast from Wednesday dinner until Friday
(02:52):
dinner. And then you eat Saturday and
Sunday. Again, on repeat,
two 48s.
It's okay. If you've got the body fat to
burn, and you're burning it and you are not
feeling hungry, then it's time to graduate
to two 48s.
Again, if you're doing those three 36s and
you found those three meals to be too small,
(03:13):
then you go to the 42s and try to do two
meals. That's what you've done.
Still can't get that meal in just
quite right, then you go two 48s.
The 48s are often really effective.
They keep your metabolism running high and
they'll keep you burning fat.
They'll keep you working towards your goals.
Where a lot of people struggle here
(03:33):
is they end up falling into a one-meal-a-day
situation.
You know, they can't necessarily do the 42s
because they're not necessarily hungry all
the time.
The diet then gets kind of messy on
the eating days. They end up struggling a bit
with the fasting.
Then they end up going to 24s and just think,
"Oh, I'm going to do daily 24s
(03:53):
and that will be so much better." It is
not better, my friend.
It is not better at all.
It's better to go back to the 48s
twice a week.
The next question says, "I read on some of
the polycystic ovary syndrome (or
PCOS) blogs that you shouldn't skip
breakfast because it balances your blood
sugar, but I find it harder to
(04:14):
meet my fasting goals when I eat breakfast.
Is this referenced to early, time-restricted
eating or is it better to meet the
daily fasting goal, or longer
fasts, or to consume the
meals earlier in the day?"
All right, my friend, there are only a couple
of instances where I say we should really
have breakfast in the morning.
(04:35):
Number one, your morning cortisol levels are
quite high, they're on the higher side
of things.
Sometimes just having a higher morning
glucose will tip you off on this.
You can do a saliva test or you could do
a urine test that measures your saliva
or urine over the period of 24 hours
so you can see your cortisol curve.
(04:56):
If our cortisol levels are elevated
in the morning, then we do want
to eat breakfast. We do want eat a protein
rich breakfast, usually within
that first 30 to 60 minutes of
waking to blunt the cortisol levels.
We can have dysregulated cortisol
levels for a whole variety of reasons.
I'm experiencing it personally right now
(05:18):
because my son is going through a lot of
teething and he's up all night.
I don't remember the last time I slept.
I know it was sometime in 2024.
I dont think I've slept yet in 2025.
I'm sure I probably won't have slept by the
time this episode comes out.
So my circadian rhythm's all off, my
cortisol's all off as a result of
(05:39):
that.
So we have these disturbances,
we could have stress going on,
or, again, just sort of your regular,
circadian-rhythm stuff being a bit off.
PCOS individuals tend to struggle
with sleep quite a bit because of their
lower progesterone levels.
So it's always good to know where that
cortisol is.
(05:59):
Our cortisol levels are going to be the
highest they are throughout the day in the
morning, but are they a healthy high or
are they an abnormally healthy high?
This is where doing that 24-hour
urine or saliva test can be really
helpful.
Morning-cortisol blood tests are virtually
useless, so you want to look at
it over 24 hours with a saliva test
(06:21):
or a urine test.
The urine one is called the DUTCH Test [Dried
Urine Test for Comprehensive Hormones] byPrecision Analytical.
They also do a saliva test.
That one I believe, in most states, you can
order yourself.
I'm not so sure about ordering saliva tests
independently.
Many labs do them, like Genova.
Any healthcare naturopath or
integrative functional doctor will
(06:42):
be able to order those particular tests
for you as well.
And I do believe you can use FSA or
HSA in the United States to
purchase the DUTCH Test from Precision
Analytical.
That's the one I used recently to learn
my cortisol was so high.
So that's usually what we're looking to
tackle.
This can further be an issue
(07:03):
in individuals who are struggling with
HPA axis dysfunction or
adrenal insufficiency.
If someone's struggling with adrenal
insufficiency (meaning they sort of
have these chronically lower levels of
cortisol, even if their level is
still okay in the morning but it's too low
throughout the rest of the day), we do want
to maintain some cortisol reserves.
(07:25):
So if you have adrenal insoufficiency,
then we include breakfast in the morning.
So those are two instances.
A third one would be if you have reverse T3
hypothyroidism.
That's also largely connected to cortisol
patterns.
But if you had reverse T3 hypothyroidism,
then we would want you to make sure that
you're having breakfast within that first
(07:46):
hour of waking.
So those are really the three big ones.
If someone is actively trying to
conceive, during the second
half of the cycle, I do like to introduce
breakfast, especially that last
week of the cycle.
But, outside of that and those scenarios
there, then you don't necessarily need
(08:08):
to skip breakfast.
What the people who are saying this-- the
rule of thought is that, if you
eat, you'll lower your cortisol levels,
which will then lower glucose levels.
But if you have PCOS and you have a lot of
insulin resistance, we do want to treat that
insulin resistance first and then work
on optimizing the rest of the levels
(08:29):
side of that.
And if there are things that are driving your
elevated cortisol, taking some
supportive herbs or supplements to help
with that, as well as addressing lifestyle
factors can go a long way.
So we would do that simultaneously with
treating the insulin resistance.
Once we start having regular cycles and the
symptoms of PCOS are gone, we're
(08:50):
getting normal blood work, imaging looks
well (like an abdominal ultrasound or CT
scan), then we would move into
doing something a little bit more optimized
where we would include breakfast during
certain parts of our cycle.
The next question says, "How do I not lose
more weight with extended fasting for
autophagy?
(09:10):
I am 71 and I've lost 44 pounds
over an eight-month period - one
pound most weeks, never more."
Congratulations. That's a really cool amount
of weight loss over an eight-month period, my
friend.
They then go on to say, "I have loose
skin on my arms, belly, and legs.
I'm looking older than I ever have.
I will be doing 24-hour fasts to maintain
(09:33):
my weight loss."
We see skin start to tighten
on fasts that are 36 hours or
longer, but it sort of
depends on how that weight was lost.
Now, from Anne's question, it does sound like
she lost that 44 pounds over
eight months doing fasting.
So congratulations, Anne.
(09:54):
When we do have loose skin, we would
then start to cycle in some of these longer
fasts, so 36 hours or longer,
which is why Anne is asking and
saying that she wants to do some extended
fasts for autophagy, but not
lose weight.
So, Anne, one of the things I would do first
is go get a DEXA body composition scan,
(10:14):
or get one of those body composition scales
at home. There's the Omron, there's
the Renpho, there's an InBody one that
you can buy for your home.
I have the InBODY and I have a Omron.
A bunch of coaches on my team have the Renpho
and really like it.
They're all good.
Let's see where your body composition is
so we know just how much weight that
(10:35):
there is to lose.
And if the body composition ends up
surprising you a little bit, then we might
not necessarily have to worry so much
about modifying things on our eating days.
We can carry on with extended fasting
and we can introduce some strength training
to help you put on some lean and
healthy mass.
The weight on the scale just tells us the
(10:56):
total number.
We want to know what that total number means
- how much fat mass, how much bone mass,
how much muscle mass is there?
Are there any areas for improvement in
any of these categories.
If there ends up being a surprising amount of
fat mass, then we don't have to necessarily
worry about losing that fat
mass. We would focus on gaining some healthy
(11:16):
weight by optimizing our bone-mass density
and our muscle mass.
And the best way to do that (two birds with
one stone) is through strength training or
body weight training.
Now, if you are to do that body composition
analysis and you don't very much body
fat at all, and you want to do some of these
therapeutic fasts for autophagy,
then what we would do is we would add in
(11:38):
anywhere from 15 to 30 extra grams
of protein on your eating days, as
well as fat.
Usually, for most people, we start off with
15 grams of proteins, 15 grams
of dietary fat.
We just kind of see how their weight-loss
efforts shift and then we increase it upwards
to about 30 grams, so adding
in healthy building blocks.
(11:59):
So when you're doing that strength training
to help you put on healthy weight,
you do have the building blocks there that
you need in order to do so once
the muscle starts to repair.
So we do add in the extra protein, we do
add in that extra fat.
The goal is to gain healthy weight.
So that's the approach that we've taken when
we worked with professional athletes in the
(12:19):
past who have very little body fat
and are looking
to do therapeutic fasting for various
reasons.
And our last question of the day comes from
Sylvia in California.
Sylvia says, "I started doing 42-hour
fasts, sometimes three a week, sometimes
two to switch it up.
(12:40):
I'm not losing weight or inches.
What am I doing wrong?"
Well, I love to hear that Cynthia is checking
both weight and inches because sometimes
that scale can be deceiving.
So it's really about how are your clothes
fitting, how are those inches moving?
If you're not losing inches, then there's
a bit of a plateau going.
(13:00):
It's best to do three therapeutic fasts
a week. So on those weeks that you can only
do two 42s, I would still
throw in at least a 24 to get
three of them in a week.
There are things that we do a
quick scan on eating days and then fasting
days before we dive into some more of
the labs.
The first thing we do is look at eating days.
(13:22):
This is usually where we can make the most
progress and get the weight coming off.
So on our eating days, are we snacking
and grazing or are we just having meals?
A lot of people will do something like 16
or 18 hours of fasting on their
eating days, and then they'll have this
6 to 8-hour eating window in which they
eat often and frequently through
(13:44):
those 6 to 8 hours.
That's bad news.
That's grazing. We don't wanna graze, we
don't wanna snack, even if it's on healthy,
low-carb or ketogenic foods, even if
it's just meat. We don't want to do it
because even having our insulin levels
go up a little bit, micro amounts,
constantly, non-stop, that constant stimulus
of insulin for hours causes insulin
(14:05):
resistance.
Everybody thinks they need to eat a loaf of
bread, or a bowl of pasta, or something
that's going to cause their blood sugar
levels to skyrocket.
That's not the case.
Even producing a little of insulin
consistently over hours
can cause insulin resistance itself.
It's not always about the volume of insulin
of food that you that causes you to produce,
(14:26):
it is the frequency at which
you eat throughout the day.
So are there opportunities to
tidy up the time-restricted eating on
those 16, 18-hour fast days?
Are we having lunch?
Are we have dinner?
Are we not having anything in between?
So that's number one.
Number two - are we getting in enough
(14:47):
protein?
Now, protein needs are going to vary greatly,
depending on the individual and their
activities, and, for women too, where
they are in the hormonal stages of their
journey. But are we getting in enough
protein?
I'll tell you, when I usually ask people to
keep a food diary and track their macros,
it's because I want to see this.
More often than not, people are eating
(15:09):
one meal's worth of protein over the
span of two meals.
So then we adjust the protein.
Most of us want to be sort of
targeting around 80 grams of
protein a day on a two meal day when we're
looking to lose weight.
Of course, that changes as we approach
maintenance. We might need upwards to about
100 and sometimes 120
(15:30):
grams, but, usually, it's around 80g
over a two-meal day, so 40 and 40 grams.
We don't want to eat much more than 40-50
grams per meal because the excess
will get converted to glucose at that
particular time and cause gluconeogenesis,
but we do want to make sure that we are
getting in adequate protein on
our eating days.
(15:50):
So, making sure we're not snacking and
grazing, making sure we're getting in
adequate protein.
A lot of people, too, when they switch to a
low-carb or ketogenic diet, is they
remove starches, they remove grains,
and they're not quite sure what to fill them
up on. So they end up filling up on
cheese and nuts and seeds.
Now, cheese and nuts and seeds are fine to
have if they agree with your system, but you
(16:11):
need to think about having them in
garnish-size amounts.
You've got to think, you know, about one
third of your plate, if you're an omnivore,
which most people are omnivores.
One third of your plate needs to be
animal protein, two thirds of your plates
need to be fibrous vegetables, and
then you can use some cheese, you can
some nuts and seed as garnishes
(16:32):
on those things that are on the plate.
So you think of them as like a seasoning
ingredient. They're not a side dish on their
own. Sometimes people do keep the volume
of cheese and nuts down very much, but they
don't fill up on anything else, and then
they're kind of constantly looking to eat,
never really feeling quite satiated,
and that ends up throwing them off.
So are there things that we can fix on
(16:54):
the eating days?
For carnivores, we usually like them to have
a couple of different sources of fat, a
couple of different sources protein at a meal
to make sure we're getting in adequate food.
For plant-based individuals, you know, we
really hunker down, make sure there's
adequate protein and fat at each particular
meal, and that we're covering all of our
amino-acid bases with the plant-based
(17:15):
individuals. So those are some of the
alternate diets that we often work a lot with
and some of the hiccups and fixes for
those.
Now, on your fasting days,
how much heavy cream are you having, if
you're even having any?
Are you measuring it?
A lot of people think they can ballpark it
just by pouring, and that never goes well.
(17:35):
We had one share in our
community recently that, when they measured
it, they were having almost a cup's worth
throughout the day in their tea.
So, you know, this is something that we
want to scale back down.
I know Jason and I, for years, have said
three tablespoons, three tablespoons.
Honestly, it should be more like three
teaspoons.
(17:56):
So we really wanna cut back on the amount of
fat that we're having throughout the day.
We need to take a look at the use of fasting
training wheels.
Are you using them because you can have them
and you want them on your fasting days
or are you using because you need to
use them?
So we've looked to see what improvements that
we can make - if we can adjust anything,
(18:16):
scale it down, if we need something
versus if we just want to have something,
and trying to remove the wants
as much as possible from our fasting days.
If those things are not working, then we
start to look at the labs.
We start to look to see if there's any
deficiencies that we need to tackle, if there
are any additional hormonal imbalances
(18:37):
that we need to handle.
A common period in a woman's life
is during perimenopause, when sometimes
we do need to be very mindful
about nutrient stores, especially
iron stores, and making sure that those
are all up to level.
And with women who are going through
perimenopause, in general, we
cap it at about 36 hours just to make
(18:58):
sure that they are getting in protein because
this particular demographic usually needs
about 100 grams of protein, even if they have
quite a bit of weight loss to lose, and we
try to get about 35 grams per meal,
or the span of three meals, to
help balance the hormones.
We do eat breakfast in the morning a
lot in perimenopause just to sort
(19:18):
of help support thyroid function,
to support adrenal function, to get some of
those hormones in balance.
Perimenopause is one of the most disruptive
times in a woman's life so
we do focus a lot on 36-hour
fasts three times a week so we can
get in those three meals and spread that
protein out over the course of the day.
(19:39):
We go through those strategies, we take a
look at the labs, we try to point you
in the direction, too, from the labs, of
what practitioners you might need to see, if
any, or if there's anything nutritional-wise
that stands out to us that we can help you
adjust. But taking a look at those particular
things can often really help get the
fat loss going.
(19:59):
Alright, everyone, thank you so much for
joining us for another episode of The
Fasting Method podcast. We'll be back next
week. Bye for now and happy fasting!
The reason why you're not feeling
hungry on your eating days after a
36 or 42-hour fast is
because your body's actually burning a lot
of fat.
Yes, you are a fat-burning
machine! It's doing exactly what
you want it to do.
(00:23):
[music]
Hi everyone, it's Megan Ramos here
with another episode of The Fasting Method
podcast.
Today I'm going to answer your questions.
We're going to cover topics such as how
you know when your current fasting protocol
is no longer working for you,
do you need to extend things to 48 hours,
should you skip breakfast or should it be the
(00:44):
most important meal of the day.
Now, let's dive on in.
The first question comes from Ewelina,
"On the eating days, I almost always
feel very full.
I try to make my meal portion smaller,
but I still feel full.
I don't seem to feel any hunger cues
on my eating days nor fasting days.
(01:06):
Have 20 years of dieting broken my
body? My usual fasting protocol
is three 36s or, lately, two
42s."
This is a fantastic question and, my
friend, and for all of you out there who I
have no doubt are in the same boat
as our good friend here, you are not
broken from your history of dieting.
(01:27):
The reason why you're not feeling
hungry on your eating days after a
36 or 42-hour fast is
because your body's actually burning a lot
of fat.
Yes, you are a fat-burning
machine! It's doing exactly what
you want it to do.
But because your body is burning so much
(01:47):
fat and providing it with so much of the
fuel that it needs, the hunger just
isn't there, it's not there at all, and it
can feel really difficult to try
to push through and eat multiple
meals on those eating days.
This is when it's time to graduate
into doing that 48-hour fast
twice a week.
(02:08):
You don't have to force yourself to
eat that lunch.
You don't have to try to get creative with
jam-packing a lot of fat calories and protein
into a small meal,
not unless you have certain nutrient
deficiencies that you're tackling.
So if you do have certain nutrients
deficiencies that are becoming
serious issues, then, yes, you
(02:30):
might need to eat a little bit more and fast
a little bit less.
But if that's not the issue, then extend
those two 42s that you're doing to two
48s. So that would look like - on
Sundays you have lunch, you have dinner,
you begin your fast, and you fast until
Tuesday dinner.
Then you eat Wednesday lunch and dinner,
you fast from Wednesday dinner until Friday
(02:52):
dinner. And then you eat Saturday and
Sunday. Again, on repeat,
two 48s.
It's okay. If you've got the body fat to
burn, and you're burning it and you are not
feeling hungry, then it's time to graduate
to two 48s.
Again, if you're doing those three 36s and
you found those three meals to be too small,
(03:13):
then you go to the 42s and try to do two
meals. That's what you've done.
Still can't get that meal in just
quite right, then you go two 48s.
The 48s are often really effective.
They keep your metabolism running high and
they'll keep you burning fat.
They'll keep you working towards your goals.
Where a lot of people struggle here
(03:33):
is they end up falling into a one-meal-a-day
situation.
You know, they can't necessarily do the 42s
because they're not necessarily hungry all
the time.
The diet then gets kind of messy on
the eating days. They end up struggling a bit
with the fasting.
Then they end up going to 24s and just think,
"Oh, I'm going to do daily 24s
(03:53):
and that will be so much better." It is
not better, my friend.
It is not better at all.
It's better to go back to the 48s
twice a week.
The next question says, "I read on some of
the polycystic ovary syndrome (or
PCOS) blogs that you shouldn't skip
breakfast because it balances your blood
sugar, but I find it harder to
(04:14):
meet my fasting goals when I eat breakfast.
Is this referenced to early, time-restricted
eating or is it better to meet the
daily fasting goal, or longer
fasts, or to consume the
meals earlier in the day?"
All right, my friend, there are only a couple
of instances where I say we should really
have breakfast in the morning.
(04:35):
Number one, your morning cortisol levels are
quite high, they're on the higher side
of things.
Sometimes just having a higher morning
glucose will tip you off on this.
You can do a saliva test or you could do
a urine test that measures your saliva
or urine over the period of 24 hours
so you can see your cortisol curve.
(04:56):
If our cortisol levels are elevated
in the morning, then we do want
to eat breakfast. We do want eat a protein
rich breakfast, usually within
that first 30 to 60 minutes of
waking to blunt the cortisol levels.
We can have dysregulated cortisol
levels for a whole variety of reasons.
I'm experiencing it personally right now
(05:18):
because my son is going through a lot of
teething and he's up all night.
I don't remember the last time I slept.
I know it was sometime in 2024.
I dont think I've slept yet in 2025.
I'm sure I probably won't have slept by the
time this episode comes out.
So my circadian rhythm's all off, my
cortisol's all off as a result of
(05:39):
that.
So we have these disturbances,
we could have stress going on,
or, again, just sort of your regular,
circadian-rhythm stuff being a bit off.
PCOS individuals tend to struggle
with sleep quite a bit because of their
lower progesterone levels.
So it's always good to know where that
cortisol is.
(05:59):
Our cortisol levels are going to be the
highest they are throughout the day in the
morning, but are they a healthy high or
are they an abnormally healthy high?
This is where doing that 24-hour
urine or saliva test can be really
helpful.
Morning-cortisol blood tests are virtually
useless, so you want to look at
it over 24 hours with a saliva test
(06:21):
or a urine test.
The urine one is called the DUTCH Test [Dried
Urine Test for Comprehensive Hormones] byPrecision Analytical.
They also do a saliva test.
That one I believe, in most states, you can
order yourself.
I'm not so sure about ordering saliva tests
independently.
Many labs do them, like Genova.
Any healthcare naturopath or
integrative functional doctor will
(06:42):
be able to order those particular tests
for you as well.
And I do believe you can use FSA or
HSA in the United States to
purchase the DUTCH Test from Precision
Analytical.
That's the one I used recently to learn
my cortisol was so high.
So that's usually what we're looking to
tackle.
This can further be an issue
(07:03):
in individuals who are struggling with
HPA axis dysfunction or
adrenal insufficiency.
If someone's struggling with adrenal
insufficiency (meaning they sort of
have these chronically lower levels of
cortisol, even if their level is
still okay in the morning but it's too low
throughout the rest of the day), we do want
to maintain some cortisol reserves.
(07:25):
So if you have adrenal insoufficiency,
then we include breakfast in the morning.
So those are two instances.
A third one would be if you have reverse T3
hypothyroidism.
That's also largely connected to cortisol
patterns.
But if you had reverse T3 hypothyroidism,
then we would want you to make sure that
you're having breakfast within that first
(07:46):
hour of waking.
So those are really the three big ones.
If someone is actively trying to
conceive, during the second
half of the cycle, I do like to introduce
breakfast, especially that last
week of the cycle.
But, outside of that and those scenarios
there, then you don't necessarily need
(08:08):
to skip breakfast.
What the people who are saying this-- the
rule of thought is that, if you
eat, you'll lower your cortisol levels,
which will then lower glucose levels.
But if you have PCOS and you have a lot of
insulin resistance, we do want to treat that
insulin resistance first and then work
on optimizing the rest of the levels
(08:29):
side of that.
And if there are things that are driving your
elevated cortisol, taking some
supportive herbs or supplements to help
with that, as well as addressing lifestyle
factors can go a long way.
So we would do that simultaneously with
treating the insulin resistance.
Once we start having regular cycles and the
symptoms of PCOS are gone, we're
(08:50):
getting normal blood work, imaging looks
well (like an abdominal ultrasound or CT
scan), then we would move into
doing something a little bit more optimized
where we would include breakfast during
certain parts of our cycle.
The next question says, "How do I not lose
more weight with extended fasting for
autophagy?
(09:10):
I am 71 and I've lost 44 pounds
over an eight-month period - one
pound most weeks, never more."
Congratulations. That's a really cool amount
of weight loss over an eight-month period, my
friend.
They then go on to say, "I have loose
skin on my arms, belly, and legs.
I'm looking older than I ever have.
I will be doing 24-hour fasts to maintain
(09:33):
my weight loss."
We see skin start to tighten
on fasts that are 36 hours or
longer, but it sort of
depends on how that weight was lost.
Now, from Anne's question, it does sound like
she lost that 44 pounds over
eight months doing fasting.
So congratulations, Anne.
(09:54):
When we do have loose skin, we would
then start to cycle in some of these longer
fasts, so 36 hours or longer,
which is why Anne is asking and
saying that she wants to do some extended
fasts for autophagy, but not
lose weight.
So, Anne, one of the things I would do first
is go get a DEXA body composition scan,
(10:14):
or get one of those body composition scales
at home. There's the Omron, there's
the Renpho, there's an InBody one that
you can buy for your home.
I have the InBODY and I have a Omron.
A bunch of coaches on my team have the Renpho
and really like it.
They're all good.
Let's see where your body composition is
so we know just how much weight that
(10:35):
there is to lose.
And if the body composition ends up
surprising you a little bit, then we might
not necessarily have to worry so much
about modifying things on our eating days.
We can carry on with extended fasting
and we can introduce some strength training
to help you put on some lean and
healthy mass.
The weight on the scale just tells us the
(10:56):
total number.
We want to know what that total number means
- how much fat mass, how much bone mass,
how much muscle mass is there?
Are there any areas for improvement in
any of these categories.
If there ends up being a surprising amount of
fat mass, then we don't have to necessarily
worry about losing that fat
mass. We would focus on gaining some healthy
(11:16):
weight by optimizing our bone-mass density
and our muscle mass.
And the best way to do that (two birds with
one stone) is through strength training or
body weight training.
Now, if you are to do that body composition
analysis and you don't very much body
fat at all, and you want to do some of these
therapeutic fasts for autophagy,
then what we would do is we would add in
(11:38):
anywhere from 15 to 30 extra grams
of protein on your eating days, as
well as fat.
Usually, for most people, we start off with
15 grams of proteins, 15 grams
of dietary fat.
We just kind of see how their weight-loss
efforts shift and then we increase it upwards
to about 30 grams, so adding
in healthy building blocks.
(11:59):
So when you're doing that strength training
to help you put on healthy weight,
you do have the building blocks there that
you need in order to do so once
the muscle starts to repair.
So we do add in the extra protein, we do
add in that extra fat.
The goal is to gain healthy weight.
So that's the approach that we've taken when
we worked with professional athletes in the
(12:19):
past who have very little body fat
and are looking
to do therapeutic fasting for various
reasons.
And our last question of the day comes from
Sylvia in California.
Sylvia says, "I started doing 42-hour
fasts, sometimes three a week, sometimes
two to switch it up.
(12:40):
I'm not losing weight or inches.
What am I doing wrong?"
Well, I love to hear that Cynthia is checking
both weight and inches because sometimes
that scale can be deceiving.
So it's really about how are your clothes
fitting, how are those inches moving?
If you're not losing inches, then there's
a bit of a plateau going.
(13:00):
It's best to do three therapeutic fasts
a week. So on those weeks that you can only
do two 42s, I would still
throw in at least a 24 to get
three of them in a week.
There are things that we do a
quick scan on eating days and then fasting
days before we dive into some more of
the labs.
The first thing we do is look at eating days.
(13:22):
This is usually where we can make the most
progress and get the weight coming off.
So on our eating days, are we snacking
and grazing or are we just having meals?
A lot of people will do something like 16
or 18 hours of fasting on their
eating days, and then they'll have this
6 to 8-hour eating window in which they
eat often and frequently through
(13:44):
those 6 to 8 hours.
That's bad news.
That's grazing. We don't wanna graze, we
don't wanna snack, even if it's on healthy,
low-carb or ketogenic foods, even if
it's just meat. We don't want to do it
because even having our insulin levels
go up a little bit, micro amounts,
constantly, non-stop, that constant stimulus
of insulin for hours causes insulin
(14:05):
resistance.
Everybody thinks they need to eat a loaf of
bread, or a bowl of pasta, or something
that's going to cause their blood sugar
levels to skyrocket.
That's not the case.
Even producing a little of insulin
consistently over hours
can cause insulin resistance itself.
It's not always about the volume of insulin
of food that you that causes you to produce,
(14:26):
it is the frequency at which
you eat throughout the day.
So are there opportunities to
tidy up the time-restricted eating on
those 16, 18-hour fast days?
Are we having lunch?
Are we have dinner?
Are we not having anything in between?
So that's number one.
Number two - are we getting in enough
(14:47):
protein?
Now, protein needs are going to vary greatly,
depending on the individual and their
activities, and, for women too, where
they are in the hormonal stages of their
journey. But are we getting in enough
protein?
I'll tell you, when I usually ask people to
keep a food diary and track their macros,
it's because I want to see this.
More often than not, people are eating
(15:09):
one meal's worth of protein over the
span of two meals.
So then we adjust the protein.
Most of us want to be sort of
targeting around 80 grams of
protein a day on a two meal day when we're
looking to lose weight.
Of course, that changes as we approach
maintenance. We might need upwards to about
100 and sometimes 120
(15:30):
grams, but, usually, it's around 80g
over a two-meal day, so 40 and 40 grams.
We don't want to eat much more than 40-50
grams per meal because the excess
will get converted to glucose at that
particular time and cause gluconeogenesis,
but we do want to make sure that we are
getting in adequate protein on
our eating days.
(15:50):
So, making sure we're not snacking and
grazing, making sure we're getting in
adequate protein.
A lot of people, too, when they switch to a
low-carb or ketogenic diet, is they
remove starches, they remove grains,
and they're not quite sure what to fill them
up on. So they end up filling up on
cheese and nuts and seeds.
Now, cheese and nuts and seeds are fine to
have if they agree with your system, but you
(16:11):
need to think about having them in
garnish-size amounts.
You've got to think, you know, about one
third of your plate, if you're an omnivore,
which most people are omnivores.
One third of your plate needs to be
animal protein, two thirds of your plates
need to be fibrous vegetables, and
then you can use some cheese, you can
some nuts and seed as garnishes
(16:32):
on those things that are on the plate.
So you think of them as like a seasoning
ingredient. They're not a side dish on their
own. Sometimes people do keep the volume
of cheese and nuts down very much, but they
don't fill up on anything else, and then
they're kind of constantly looking to eat,
never really feeling quite satiated,
and that ends up throwing them off.
So are there things that we can fix on
(16:54):
the eating days?
For carnivores, we usually like them to have
a couple of different sources of fat, a
couple of different sources protein at a meal
to make sure we're getting in adequate food.
For plant-based individuals, you know, we
really hunker down, make sure there's
adequate protein and fat at each particular
meal, and that we're covering all of our
amino-acid bases with the plant-based
(17:15):
individuals. So those are some of the
alternate diets that we often work a lot with
and some of the hiccups and fixes for
those.
Now, on your fasting days,
how much heavy cream are you having, if
you're even having any?
Are you measuring it?
A lot of people think they can ballpark it
just by pouring, and that never goes well.
(17:35):
We had one share in our
community recently that, when they measured
it, they were having almost a cup's worth
throughout the day in their tea.
So, you know, this is something that we
want to scale back down.
I know Jason and I, for years, have said
three tablespoons, three tablespoons.
Honestly, it should be more like three
teaspoons.
(17:56):
So we really wanna cut back on the amount of
fat that we're having throughout the day.
We need to take a look at the use of fasting
training wheels.
Are you using them because you can have them
and you want them on your fasting days
or are you using because you need to
use them?
So we've looked to see what improvements that
we can make - if we can adjust anything,
(18:16):
scale it down, if we need something
versus if we just want to have something,
and trying to remove the wants
as much as possible from our fasting days.
If those things are not working, then we
start to look at the labs.
We start to look to see if there's any
deficiencies that we need to tackle, if there
are any additional hormonal imbalances
(18:37):
that we need to handle.
A common period in a woman's life
is during perimenopause, when sometimes
we do need to be very mindful
about nutrient stores, especially
iron stores, and making sure that those
are all up to level.
And with women who are going through
perimenopause, in general, we
cap it at about 36 hours just to make
(18:58):
sure that they are getting in protein because
this particular demographic usually needs
about 100 grams of protein, even if they have
quite a bit of weight loss to lose, and we
try to get about 35 grams per meal,
or the span of three meals, to
help balance the hormones.
We do eat breakfast in the morning a
lot in perimenopause just to sort
(19:18):
of help support thyroid function,
to support adrenal function, to get some of
those hormones in balance.
Perimenopause is one of the most disruptive
times in a woman's life so
we do focus a lot on 36-hour
fasts three times a week so we can
get in those three meals and spread that
protein out over the course of the day.
(19:39):
We go through those strategies, we take a
look at the labs, we try to point you
in the direction, too, from the labs, of
what practitioners you might need to see, if
any, or if there's anything nutritional-wise
that stands out to us that we can help you
adjust. But taking a look at those particular
things can often really help get the
fat loss going.
(19:59):
Alright, everyone, thank you so much for
joining us for another episode of The
Fasting Method podcast. We'll be back next
week. Bye for now and happy fasting!
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