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Features of a successful therapeutic fast of 382 days' duration (1973) [pdf]
- floatingatoll 7y agoReaders, please be very cautious when trying these things. There is research into "never hungry" eating disorders hinting that you can trigger a permanent (erroneous) negative feedback loop with fasting. If it works for you, hooray, but if you or your blood relatives have a history with anorexia etc., be very careful experimenting with fasting diets. EDIT: The final page of the (1973) medical study about this patient has some rather specific warnings about testing certain blood and urine metrics to minimize risk of e.g. death. https://pmj.bmj.com/content/postgradmedj/49/569/203.full.pdf https://pmj.bmj.com/content/postgradmedj/49/569/203.full.pdf
- judge2020 7y agoThe article does dedicate about 25% of its content to the "don't try this at home" section, but I understand not everyone will read it all the way before going to HN comments.
- milesvp 7y agoThis. The dieter was on a multi vitamin. I saw reference some years ago to an eating disorder (anorexia I believe) being directly linked to low levels of some common trace mineral. Some proper dosing brought back an appropriate appetite. Which made it easier to deal with the remaining psychological aspect.
- ianai 7y agoYou can count me in the camp of believing in the power of vitamins, minerals, and getting the right requirements met. And matcha tea (just a little). The positive effects on my energy levels since just picking out a good B complex impress me every day. Plus other stuff, too. It’s enough that I think it should be a common basic societal good like indoor plumbing and AC/power.
- floatingatoll 7y agoThat approach did not work out perfectly for fluoridated water and mandatory vaccinations.
- ijiiijji1 7y agoThis is how many grandfather intentionally killed himself after my grandmother died.. he got down to 110 lbs. / 50 kg at 6'2" / 1.88 m and died from complications. Risks from extreme starvation /complete fasting include: - Death - Stroke - Heart attack - Lost bone and muscle mass permanently - Organ dysfunction, especially heart absent electrolytes - Gallstones - Absence of appetite (as mentioned)
- joak 7y ago1. by eating less you are going to lose weight 2. It's no going to be easy
- cairo_x 7y agoNot at all. If you've eaten a high sugar/carb diet, it doesn't matter if you eat less because your body's still not going to burn off the fat unless you actually starve yourself. Eating less is completely different to starvation, and starvation is not a good long term strategy. 1. Cut out sugar and most other carbs (potato,bread,pasta,biscuits,fruit, etc), not counting fiber as a carb). Have a modest amount of protein and as much fat as you want. There are multiple diets such as Keto and Paleo that play with ratio of fats protein and carbs, but they all amount to pretty much the same thing--cutting out sugars and carbs as much as possible. 2. Eat as much as fills you up of everything else. 3. Body learns it needs to use fat for its energy. 4. Get to target weight, reintroduce yourself to carbs in moderation and leave sugar for special occasions. The hardest part is sugar withdrawls for the first couple of weeks. There's also possible problems with a lazy bile duct due to the body not being used to a high fat diet, but can be dealt with by taking a modest dose bile supplements for a period of time. Other than that, pretty damn easy. Compared to giving up cigarettes or coffee of which I've done both, it's a walk in the park.
- asveikau 7y agoI lost 100 lbs eating mostly pasta dishes. I think the anti-carb thing is overhyped. It's funny that you end your comment with "a walk in the park", because my experience suggests that walk in the park may help more than eliminating carbs.
- PretzelFisch 7y agoI guess that's why the body stores fat in the first place. Having done some intermittent fasting and a little 2-3 day fasts, I have seen the longer the fast the less urgent my hunger pains felt. This story is probably great motivation for some redit subs. https://www.reddit.com/r/fasting/ https://www.reddit.com/r/fasting/ and https://www.reddit.com/r/intermittentfasting/ https://www.reddit.com/r/intermittentfasting/
- hyperdunc 7y agoI did a nine day fast and the first three days were difficult. From day four I was not hungry at all but also felt noticeably weaker and couldn't do anything strenuous. After nine days I lost 10kg and six months later had only gained back 3kg. But the best thing about the whole experience was redefining my relationship with food. I appreciate and enjoy it a lot more now.
- arkitaip 7y agoAre you saying you didn't eat or drink anything during 9 days? What was your initial and final weight?
- AmericanChopper 7y agoThe fasting discussion in this thread seems to be about caloric fasting, rather than religious fasting. The latter tending to prohibit drinking, while the former doesn’t.
- Someone1234 7y agoThey said nothing about drinking. It is pretty common parlance to use "fast" to mean "without food/calories" (i.e. water is completely kosher, and some argue "black" tea/coffee/diet soda is too as it is 0 calories/negative calories).
- copperx 7y agoOne warning - tea isn't necessarily kosher, because some artificial flavors are made from non-kosher ingredients.
- fyp 7y agoI wonder if it's the same process that bears go through when they hibernate?
- rpmisms 7y agoIIRC, that's a specific metabolic state that's seasonal. Maybe this guy was able to replicate it? I'm not seeing any special considerations he took.
- not_a_moth 7y agoEven if you're not obese, fasting appears to be one of the most healthy things you can do for your body. Low insulin variability, autophagy, clear out visceral fat on organs, yields extended longevity in lab mice, etc.
- rpmisms 7y agoUnless you have low body fat, which is less common than it used to be. I maintain body fat under 7%, and I have to eat regularly or I will become very ill very quickly. If I'm to fast, I have to cut something from my diet, not cut my diet.
- loeg 7y agoYou are an extreme outlier. Even for men, bf% under 7 is in or getting into the unhealthily low range. Fasting is not for you.
- not_a_moth 7y agoThe feeling ill part is a n=1. As mentioned from fasting you still get major benefits from autophay, sirtuin activation, longevity, low insulin variability. Some of the top fitness and health practitioners who are big on fasting are very low body fat, incredible shape.
- jniedrauer 7y agoIf you are highly active and have a low bodyfat percent, then you are just catabolizing your own muscle by fasting, and you become very injury prone. There's no upside.
- not_a_moth 7y agoYou seem out of touch with the scientific literature, and have hand-waved all the real health benefits I've listed. Leading figures like Peter Attia, Tim Ferriss, Ben Greenfield, David Sinclair, Kevin Rose to name a few, all pro fasting, all in top shape/low body fat. > and you become very injury prone No, you become temporarily weaker, and that's only if you're fasting multiple days. It's recommended you work out during fasts... your body remains anabolic to muscle (barring other variables like elevated stress).
- crazygringo 7y agoI mean, sure. I've done keto, I've fasted for several days, it's fine. I personally would have eaten some cruciferous vegetables since I don't trust multivitamins to provide everything, but sounds like he did fine. My only curiosity as a strategy for months or over a year is if the lack of any protein whatsoever has harmful effects. I was under the impression that some level of protein intake was necessary to maintain muscles -- something that burning fat doesn't provide. I'm wondering if he had any muscle loss problems? Or if his leg and back muscles were already so extremely overdeveloped to support his original weight (as is normal), that as they naturally decreased, their protein was made available for normal baseline muscular maintenance?
- detaro 7y agoThe article mentions him being given vitamins and yeast, and "nutritional yeast" is a protein source.
- heymijo 7y agoWe are firmly in conjecture-only territory here, especially discussing a 382 day fast. Having said that, Dr. Peter Attia has some reasonable hypotheses/extrapolations on how one may maintain muscle on a prolonged fast. > "I don’t think it’s out of the realm of possibility that you can “eat” a meal of protein that contains all of the essential amino acids during a fast. This may be one of the benefits of autophagy, which literally translates to “self-eating.” Your muscle cells may be dining off your skin cells, so to speak. > "Obviously, the longer you fast, the more you drain your internal sources of food, and the more likely MPB will exceed MPS over time. (This may also suggest that the fatter you are to begin with, the longer you can eat yourself, and presumably maintain muscle mass for longer.)" https://peterattiamd.com/can-you-maintain-muscle-during-fasting/ https://peterattiamd.com/can-you-maintain-muscle-during-fast...
- crazygringo 7y agoFascinating article, addresses my question exactly. Thanks.
- technotony 7y ago
- DATACOMMANDER 7y agoBullshit. He would have died after no more than two months.
- romaaeterna 7y agohttps://www.findagrave.com/memorial/117717047/angus-barbieri https://www.findagrave.com/memorial/117717047/angus-barbieri Died age 51.
- point78 7y ago25 years later, trying to find cause of death...
- cududa 7y agoDude weighed 450+ pounds at the start. Gonna say the weight loss isn’t what killed him 25 years after the fact
- quaquaqua1 7y agoWe have a discord server where we studied Angus' life. A very good friend of mine in the UK officially requested his death certificate. The causes of death, if I remember correctly, were: Stomach bleeding, something else (sorry), and obesity. We were trying to understand if they put obesity on there just because he was obese decades before, or if he was obese again at that time. But we're pretty sure he put the weight back on. He died in Warwick
- newnewpdro 7y agoIt's likely he put the weight back on. Fasting for 382 days as a medical intervention isn't learning how to actually live with a stable healthy relationship to your food environment. The behavioral patterns leading to the intervention initially will very likely resume afterwards. This reminds of a personal experience, story time: <anecdata> An obese friend of mine visited the ER for a persistent respiratory issue. Through negligence of the hospital staff, he found himself in an emergency abdominal surgery with a perforated colon. What started as a relatively casual ER visit turned into an extended many-month ordeal under hospital care, mostly bedridden. As the months ticked by his weight dropped to fairly close to normal. He was still a bit overweight, but easily over a hundred pounds lighter with only hospital food in controlled portions to live off of. I clearly recall visiting him in the hospital in the days approaching his release, and how proud he was for the weight loss. He was so ignorant about his relationship with food and how significant a factor it was for the hospital's control being responsible for his weight loss vs. his own chosen lifestyle. I didn't say anything at the time, but was already a bit nervous about what would happen when he left the hospital's care, with a severely compromised abdomen still recovering. Fast-forward to a year later, and he had become more obese than before starting this ordeal. No doubt his eating problems were exacerbated by the depression of his life situation. The last I heard he needed abdominal reconstructive surgery, and had developed an intestinal hernia from the substantial size increase while still recovering. Apparently he couldn't have the procedure done until he lost the weight again. </anecdata>
- openureye51j 7y agoLol. The number of times I've been downvoted for suggesting dry fasting. Those who deny it are living in the stone age of health.
- geocrasher 7y agoComment deleted by author. Shouldn't have hit submit.
- tapland 7y agoThis guy was under (some) medical supervision with some supplements and with regular testing. Your situation sucks, but this man is not doing what is happening to your wife and you shouldn't be offended by a story about the worlds most extreme outlier case of dieting.
- loeg 7y agoNot to mention, OP's wife is completely not the norm. There's a growing majority of overweight, obese and morbidly obese people in the developed world who do not have any medical problem with absorbing food through their GI and for whom losing some fat stores would be a health boon. It is unclear why OP associates this man's anecdote with his wife — the man of the article was not reported to lose GI function because of his fast. He was just morbidly obese, and stopped eating until he was at a relatively healthy weight.
- moltar 7y agoI fasted for 3 days and it wasn’t that horrible. Once you are passed a day mark it gets easier. I was doing all my normal activities and working.
- macspoofing 7y agoI believe you. I also believe OP and the horrendous experience his wife is going through. I don't think your and his wife's experiences are analogous.
- anaisbetts 7y agoI'm so sorry for your wife. Please focus on the time you have with her.
- crazygringo 7y ago
- tus88 7y ago> His body began to adapt to the lack of food by burning its own fat stores for energy. Yeah that's called metabolism and happens whenever anyone loses weight.
- samatman 7y agoThis process, while a part of metabolism, is specifically catabolism.
- paulcole 7y agoThis guy’s blood glucose being at 36mg/dL (2mmol/L) for months at a time is insane to me. I’ve had an ambulance called when mine was around 45 and I was so loopy I couldn’t form a sentence or stand up without falling right back down. I’ve heard that long term low BG can lead to heart muscle damage which may have been what eventually did this guy in?
- virtuallynathan 7y agoKetones! When you are metabolizing fat, your need for glucose drops substantially. Only a few cell types require glucose. Ketones also spare muscle.
- smallstepforman 7y agoI’ve gone through 2 iterations of nothing but carrot juice for 28 days (detox) and 2 iterations of 14 days carrot juice only. After the first week which you go through a healing crisis, where toxins are released and your immune system goes into overdrive, aftrr that you dont feel hungry or lethargic at all. I could have easily gone 60 days.
- caymanjim 7y ago"Detox" diets are pure nonsense with no basis in medical science.
- noobermin 7y agoPerhaps the detox means less than just in-taking calorie low food for a few days.
- sxg 7y agoThat sounds like a great way to develop several kinds of vitamin deficiencies (look up Wernicke’s encephalopathy—vitamin B1 deficiency and vitamin B9 and B12 deficiency). Do you supplement any kinds of vitamins with your detox?
- noobermin 7y ago"It works" doesn't appear in the article, it might be editorializing.
- scarejunba 7y agoHow did he avoid stomach ulcers?
- floatingatoll 7y agoSomeone above points out that his death certificate included "stomach bleeding", so the answer may simply be "he didn't": https://news.ycombinator.com/item?id=21673521 https://news.ycombinator.com/item?id=21673521
- dreamer_soul 7y agoA guy did this 6 years ago [1]. He doesn't recommend it since he got into heart issues later on. [1] https://www.reddit.com/r/IAmA/comments/1o5ndh/iama_guy_who_went_from_430_pounds_to_170_pounds/ccozvkv?utm_medium=android_app&utm_source=share https://www.reddit.com/r/IAmA/comments/1o5ndh/iama_guy_who_w...
- classics2 7y agoThis is a load of shit, but I can see how people would want to believe.
- xanth 7y agoHaving switched to eating once a day four days of the week with great results and no adverse effects I cant help but feel like there was a concerted misinformation campaign, to have us eat three times a day every day.
- ianai 7y agoTotally sounds like a 1950s post war thing. The stereotype Americana decade.
- ngngngng 7y agoI don't get y'all. I have to remind myself to eat and stuff myself at least 3 times a day just to maintain weight. If I want to gain, I have to set an alarm to eat a meal every 3 hours (minus when I'm sleeping, that's sacred time)
- qzx_pierri 7y agoThat sounds like hyperthyroidism - You should get your blood checked.
- chmod775 7y agoNo it doesn't. First off, people with hyperthyroidism generally have increased appetite because of an accelerated metabolism, not reduced appetite. So half his symptoms already don't match. Secondly, don't try to diagnose people over the internet based on half a symptom and today's weather. Suggest them to see a doctor and leave it at that. Just because you happened recently read of one random disease out of millions doesn't mean everyone has that now. You'll cause more harm than anything.
- tigershark 7y agoHe only suggested him to have is blood checked. In what way is this ever harmful? From my point of view you are doing far more damage implying that he is fine and he doesn’t need a blood test.
- siliconc0w 7y agoI used to be a much larger mammal and lost a lot of weight (100+) through fasting and diet change. Longest I did was a 14 day fast with zero-calorie electrolytes, black coffee, and sparkling water. You get pretty low energy but the hunger just kinda subsides into background noise. I still try to do a 5 day 'reset' fast every quarter or if I hit 200. Diet change is really the most important factor but fasting is a nice tool to have because at least for me it's relatively easy and provides quick results compared to trying to maintain a sustained calorie deficit for multiple weeks. IF is, of course, likely safer so definitely start there if you're new to the game.
- lostmsu 7y agoDuring these 5 day resets, are you as productive (important: not 'focused') as usual?
- cable2600 7y agoIt reminds me of when the Buddha fasted for a long time, sitting in the same place all day. Everyone worried that he might die.
- Cougher 7y agoSpoiler alert: He's dead.
- tomhoward 7y ago"without eating" != "without sustenance"... > To compensate for his lack of nutrients, he was prescribed multivitamins to take regularly, including potassium and sodium, as well as yeast.
- fortran77 7y agoThis man was under medical supervision. Many obese people believe the body will enter a "starvation mode" and make it impossible to lose weight under a certain amount of calories. This is simply untrue. Cutting calories to less than your body burns each day always leads to weight loss. He needed vitamin and mineral supplements (potassium, etc) because not everything is produced when your body burns fat. But if an obese person eats, say, 1,000 calories a day of a balanced diet, he can probably continue this indefinitely until all the extra weight is off without any ill effects. (Of course, don't go below, say, 1800 kcal/day without talking to a doctor if you're obese or overweight.)
- deleted 7y ago[deleted]
- dang 7y agoA user emailed to ask that we change the article from https://www.diabetes.co.uk/blog/2018/02/story-angus-barbieri-went-382-days-without-eating/ https://www.diabetes.co.uk/blog/2018/02/story-angus-barbieri... to the paper, which is famous enough on its own. We've done so. A thread about this from 2018: https://news.ycombinator.com/item?id=16941097 https://news.ycombinator.com/item?id=16941097
- olingern 7y agoI find not eating to be a nice way to implement calorie control and also work on executive control. In my case, I've done it for the greater part of of the past three years. A typical fasting cycle would be 2 months of 20/4 intermittent fasting and 1 week of "normal" eating. I have an unfounded theory that re-sensitization helps sustain the benefits. Initially, I did find great benefit in the cognitive benefits [1] of fasting but found it came at a price. This price was mostly strength at the gym later in the day and some added stress during the workday (_not eating is sort of a stress of its own_). It also led to me yo-yo'ing (5-7 lb fluctuations [2] ) a bit with weight because I would be so hungry that I would overeat. I should mention that I paired my fasting with ketosis as type II diabetes runs in my family. I saw a lot of improvement with how I deal with insulin (shakiness, irritability, skin issues, bonking[3]). If anyone is thinking about fasting, here are my beginner recommendations: - Contrary to what this link suggests, I think the key is to start slow. There's no need to even do a 24 hour fast, in the beginning. Your body is not going to change over night. Build up to daily 10 - 12 hour fasts and build confidence that you can accomplish the fast. There are a lot of benefits to prolonged fasts, but I would suggest building up to them and learning how your body reacts instead of getting to a place where you feel faint-ish and don't know what that means for your body. - Fasting on keto feels like cheating, so I think it's a great tool for facilitating more frequent, longer fasts. For me, it seems that ghrelin is highly suppressed by being in a keto induced state. I don't feel well after 72 hours and noticed abnormal heart rhythms, most likely sodium or potassium imbalance. - Practice saying 'no' or at least make note of social obligations where you have to eat or knock yourself out of your fast / ketosis. 1 day here and there doesn't make a big difference, but how your overall diet quarter to quarter and year to year is what really matters. - Don't listen to the popular IF / keto sentiments of, "I don't have to track anything! It's magic," if you're below ~18% body fat. This is what I listened to and it led to overeating and reaching 10-12% body fat and quickly jumping back to 15-18%. No matter what your diet is, you should know your caloric intake and ( in general ) what keeps your body at maintenance. - Not sleeping makes fasting so much harder[4]. If I sleep less than six hours it's definitely an uphill fight. ____ None of this is "fun" per say but it's a process of getting to know yourself and observing how time, age, and environment affect your body. 1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670843/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670843/ 2 - I know salt and water retention play a big role here, but these changes were more than just looking / feeling bloated. 3 - https://en.wikipedia.org/wiki/Hitting_the_wall https://en.wikipedia.org/wiki/Hitting_the_wall 4 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763921/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763921/
- Cougher 7y agoIt's funny that everywhere we see the discussion of weight loss, there's so much insistence that this "one way is the only valid way" because of "this irrefutable process that science proves is real". Yet millions of people have used any number of ways to lose weight. I've used three ways successfully and they all have one thing in common: I consumed fewer calories than I burn. And the one weight-loss method that actually prepared me for the long-term weight maintenance that must come after we reach our goal is the method that wasn't some form of dietary ostracization: eating fewer calories than the number that made me fat.