Semaglutide questions

[Oenomaus]

Have been reading various threads over several weeks & figured time to put my big boy pants on and ask my own. Long time lifter, but have slowed down with family life. Resistance training 4-5 days a week with active rest/cardio on any not lifting. Have been considering semaglutide to help diminish appetite. Had a Thyroidectomy this year (Non service connected love from Uncle Sam) and hormones and appetite have been difficult to control. Down 25 lbs but weight tends to fluctuate up and down 5 from there, without going any lower. Currently intermittent fasting and trying to maintain 40/30/30 macros, and successful most of the time. But after prolonged IM will encounter some days where hunger is nearly insatiable. Have my labs done normally & TSH & T4 are good, but can’t seem to break past this plateau. Know a lot of the gym bros are against the ozempic for various, and often justifiable reasons, but can’t help wondering if it may be my missing piece of the puzzle. Wife had success with the compounded and was recently able to find someone that has the meds at a price that’s affordable. Any advice, dos or don’ts would be appreciated. Also thought about running a recomp cycle, have been successful in the past. Without the control of appetite, even over eating the healthy things, it seems it would be a waste of time & resources. Sorry for word salad. Again, any help guidance is appreciated. You’re not going to hurt my feelings but, please be constructive if you’re offering help. More than “you’re just doing it wrong”
Currently 5’8” about 215-220 depending on the day. Would like to get down 185-195 without losing too much muscle

 

[SweetLou321]

I am not against semaglutide personally, but based on your post, it sounds more like a plan issue overall. There are many ways to structure a diet for adherence to lose weight sustainability. Intermittent fasting works for some, but not others, and that is okay. This right here stands out to me: "Currently intermittent fasting and trying to maintain 40/30/30 macros, and successful most of the time. But after prolonged IM will encounter some days where hunger is nearly insatiable."

If the goal is to lose weight and keep it off, I would avoid using semaglutide if possible in this case. The main reason is that usually, the behaviors gained while losing weight will largely need to be maintained to some degree to keep weight off. So if you NEED semaglutide to hit you goal, and the goal is sustainable (IE we are not talking about 5-6% BF), then you will likely need to stay on semaglutide to keep the weight off. I would suggest experimenting with other dietary strategies and behaviors first before going to semaglutide.

 

[Oenomaus]

I am not against semaglutide personally, but based on your post, it sounds more like a plan issue overall. There are many ways to structure a diet for adherence to lose weight sustainability. Intermittent fasting works for some, but not others, and that is okay. This right here stands out to me: "Currently intermittent fasting and trying to maintain 40/30/30 macros, and successful most of the time. But after prolonged IM will encounter some days where hunger is nearly insatiable."

If the goal is to lose weight and keep it off, I would avoid using semaglutide if possible in this case. The main reason is that usually, the behaviors gained while losing weight will largely need to be maintained to some degree to keep weight off. So if you NEED semaglutide to hit you goal, and the goal is sustainable (IE we are not talking about 5-6% BF), then you will likely need to stay on semaglutide to keep the weight off. I would suggest experimenting with other dietary strategies and behaviors first before going to semaglutide.

Thanks for reading and responding. Have tried other diet methods & much like you said, weight comes back when done. Open to hearing any that you may suggest. Have tried Mediterranean & Keto in the past, as well as a poor man’s carnivore. All help for a time and results. This is with food tracking in various apps, & using food scales. Have also tried other appetite suppressants in the past with little to no avail. Know it’s different for everyone and my situation sucks with no thyroid, but have seen some be successful with it. But like you said, don’t want to yo-yo the weight. Any recommends are appreciated.

 

[SweetLou321]

Basically, all diets help you lose weight and body fat via a caloric deficit. That is eating less calories than you burn each day, so your body makes up for the difference via the stored calories in your adipose tissue. Each diet you listed it just another way to structure things to help achieve that main goal, a caloric deficit. So in this way, I would probably stop thinking in terms of named diets, and more in terms of sustainable behaviors that help you achieve a caloric deficit. If you find these same behaviors fairly sustainable while losing weight, then they can be used with more food to help you keep the weight off once you reach your goal.

I would consider a few behaviors, that many usually find helps them.

Find low calorie and high volume foods you enjoy. Which lean proteins? Which fruits? Which vegetables? I would try to find these and use them in the diet first. These can help you get enough protein, fiber, and volume to stay full for the caloric density they provide.

From there, you can experiment with more fats or more carbs to fill in the rest of your caloric needs overall. Some people find themselves more satiated with higher fiber carbs sources, others find fats to do the trick better. Or maybe even more a balance between the two.

Pick a number of meals that you enjoy and is sustainable. 1,2,3, or 4? ect. Some people like to eat more often but less volume, others like bigger meals but less of them. Try to keep a structure here when possible, this helps regulate hunger.

Aim for a sustainable exercise program that you enjoy and fits into your lifestyle. This can help manage hunger and burn calories.

Aim to get enough sleep most nights, this helps hunger as well.

There is more that can be said for sure, but I would start thinking of terms of a healthy lifestyle and less of short term diet plans if your long term goals is to lose weight and improve your body composition and maintain it.

 

[Oenomaus]

Basically, all diets help you lose weight and body fat via a caloric deficit. That is eating less calories than you burn each day, so your body makes up for the difference via the stored calories in your adipose tissue. Each diet you listed it just another way to structure things to help achieve that main goal, a caloric deficit. So in this way, I would probably stop thinking in terms of named diets, and more in terms of sustainable behaviors that help you achieve a caloric deficit. If you find these same behaviors fairly sustainable while losing weight, then they can be used with more food to help you keep the weight off once you reach your goal.

I would consider a few behaviors, that many usually find helps them.

Find low calorie and high volume foods you enjoy. Which lean proteins? Which fruits? Which vegetables? I would try to find these and use them in the diet first. These can help you get enough protein, fiber, and volume to stay full for the caloric density they provide.

From there, you can experiment with more fats or more carbs to fill in the rest of your caloric needs overall. Some people find themselves more satiated with higher fiber carbs sources, others find fats to do the trick better. Or maybe even more a balance between the two.

Pick a number of meals that you enjoy and is sustainable. 1,2,3, or 4? ect. Some people like to eat more often but less volume, others like bigger meals but less of them. Try to keep a structure here when possible, this helps regulate hunger.

Aim for a sustainable exercise program that you enjoy and fits into your lifestyle. This can help manage hunger and burn calories.

Aim to get enough sleep most nights, this helps hunger as well.

There is more that can be said for sure, but I would start thinking of terms of a healthy lifestyle and less of short term diet plans if your long term goals is to lose weight and improve your body composition and maintain it.

Absolutely, and agree. These are all things that I consistently incorporate as well. Added the IM as a recommend from a friend to help with the cravings, but hasn’t done much. Even my over eating is mostly lean meats and veggies. Chicken & greens, asparagus, broccoli, etc. Seeing change as the clothes and uniforms are fitting more loosely, but like you said, calories in = out means no real or sustainable change on the scale. My sleep is problematic, and probably one of the biggest hindrances to my progress. I agree with what you’ve stated here though, I should have mentioned that in the original post as well.

 

[SweetLou321]

I would start to think about what is causing your cravings, if that is a big barrier.

Sleep, diet structure, stress ect can all be factors. If you find yourself with a lot of cravings that you are giving into often enough to prevent weight loss, I would try to find out why this is before semaglutide, if possible.

 

[Dustin07]

I think we have all had similar challenges with either gaining or losing weight and likely the old addage of "fail to prepare, prepare to fail" can be relatable to most. Without knowing what your lifestyle is like, I can say what my own experience has been.

You likely need groceries regularly, and I'm guessing you might have a normal "off" day from work... like traditional weekends.

My wife and I grocery shop on Sundays, come home, do our meal prep for the week. We prep all our breakfasts, lunches, snacks, and then she usually has a loose meal plan for dinners that includes veggies, fish, pork, chicken, and/or red meats.

Of course as we learn more we are learning that food I prep on Sunday may not be a 100% perfect healthy nutrition by friday, But having my breakfasts, snacks, lunches already prepped and ready to go keeps me satiated. broiling up brussels, cauliflower, garlic, broccoli etc with our tilapia, or cod, or whatever protein of the evening also works. Getting up at 4:30am every day, and trying to be on the couch winding down by 7pm with my wife usually puts me in bed by 8:15-8:30. Looks like an old mans schedule, but this routine does tend to keep my caloric consistency much much easier.

I do like intermittent fasting, I have been known to throw 20:4 into my daily routine very often especially if there is a high calorie dinner planned, however I have also experienced the insatiable hunger. so again, preparation and having a plan for what I break my fast with helps a LOT.

There are many ways to skin the cat, you just gotta figure the one out that works for your body, mind, and lifestyle, IMO.

 

[Dustin07]

Dave Asprey has an interesting tv show out called biohacking that you might enjoy to watch. A lot of what he presents is information we already know, but from his perspective. I can't say I agree with 100% of everything he says, but he does present it in an interesting way for the sake of discussion.

My wife and I have started adding some MCT and ghee into the morning coffee as an experiement, just to see how it goes.

IIRC, Dave Asprey feels this combination actually may not negate the positives of fasting, but may help curb appetite. I have no idea if that's accurate but I think it's an interesting idea and I don't see the harm in throwing some MCT into my regiment...

 

[Oenomaus]

I think we have all had similar challenges with either gaining or losing weight and likely the old addage of "fail to prepare, prepare to fail" can be relatable to most. Without knowing what your lifestyle is like, I can say what my own experience has been.

You likely need groceries regularly, and I'm guessing you might have a normal "off" day from work... like traditional weekends.

My wife and I grocery shop on Sundays, come home, do our meal prep for the week. We prep all our breakfasts, lunches, snacks, and then she usually has a loose meal plan for dinners that includes veggies, fish, pork, chicken, and/or red meats.

Of course as we learn more we are learning that food I prep on Sunday may not be a 100% perfect healthy nutrition by friday, But having my breakfasts, snacks, lunches already prepped and ready to go keeps me satiated. broiling up brussels, cauliflower, garlic, broccoli etc with our tilapia, or cod, or whatever protein of the evening also works. Getting up at 4:30am every day, and trying to be on the couch winding down by 7pm with my wife usually puts me in bed by 8:15-8:30. Looks like an old mans schedule, but this routine does tend to keep my caloric consistency much much easier.

I do like intermittent fasting, I have been known to throw 20:4 into my daily routine very often especially if there is a high calorie dinner planned, however I have also experienced the insatiable hunger. so again, preparation and having a plan for what I break my fast with helps a LOT.

There are many ways to skin the cat, you just gotta figure the one out that works for your body, mind, and lifestyle, IMO.

Thanks for the response. Very similar to my program, in that my wife & I prep meals on Sunday that we roll out through the week. Recently started splitting my routine to AM lift & PM cardio, alternating those on weeks with my son as he is recently showing interest into the lifestyle & training with him after work/school. It’s been beneficial, and definitely feel healthier than the stagnant weeks after my surgery. My work in healthcare is reasonably mobile. No heavy lifting but, on my feet most of the day. Averaging 10k steps and 15 stand hours during the work week. Weekends are not as productive/active. But still make it a point of emphasis to move my body and train cardio. Tread climber has become my favorite, but have also used elliptical & stationary bike on mid resistance. Don’t enjoy the run as much anymore, as it causes pain to my knees & flat feet. The other gentleman makes good points on the supplement in that it won’t fix bad habits & you can rebound if you’re not diligent in doing all the things. Gave up tobacco in ‘17, alcohol in ‘21 and Pot in ‘22 but have still been struggling with weight. Only way to lose is to quit though, and sincerely appreciate the added perspective and insight you guys are bringing. Would like to try longer fasting hours as you mentioned, but find my self binging even the healthy stuff like a broken levy when the eating hours are & it wrecks any progress.

 

[Oenomaus]

Dave Asprey has an interesting tv show out called biohacking that you might enjoy to watch. A lot of what he presents is information we already know, but from his perspective. I can't say I agree with 100% of everything he says, but he does present it in an interesting way for the sake of discussion.

My wife and I have started adding some MCT and ghee into the morning coffee as an experiement, just to see how it goes.

IIRC, Dave Asprey feels this combination actually may not negate the positives of fasting, but may help curb appetite. I have no idea if that's accurate but I think it's an interesting idea and I don't see the harm in throwing some MCT into my

Was just talking to the wife about adding more fitness knowledge to my day in form of a podcast or radio show. Will look this up. Thank you.

 

[Oenomaus]

I would start to think about what is causing your cravings, if that is a big barrier.

Sleep, diet structure, stress ect can all be factors. If you find yourself with a lot of cravings that you are giving into often enough to prevent weight loss, I would try to find out why this is before semaglutide, if possible.

Definitely in need of a sleep study, honestly believe this is at the core of of many of my issues. At odds with the insurance on the matter though, and they’re generally not cheap. Cortisol is checked by endo, and is within “normal” range. My test is also quite low due to lack of sleep. Should have mentioned that as well, but don’t think it contributes to the cravings.

 

[SweetLou321]

Definitely in need of a sleep study, honestly believe this is at the core of of many of my issues. At odds with the insurance on the matter though, and they’re generally not cheap. Cortisol is checked by endo, and is within “normal” range. My test is also quite low due to lack of sleep. Should have mentioned that as well, but don’t think it contributes to the cravings.

If sleep is an issue, it can definitely contribute to cravings and lack of diet adherence. There was a study, I dont have time to look for it now, that showed that people ate like 500 +/- 500 calories more when eating freely and under slept. That means some people eat like 500-1,500 more calories without thinking about it when sleep deprived. Not to mention that not getting enough sleep makes fat loss harder and muscle loss more likely.

I would explore options for why your sleep is bad in this case. Look up good sleep hygiene, then there are supplements that can help with various aspects sleep and sleep deprivation if needed as well.

 

[Dustin07]

Sometimes I think it's really a very valuable asset to grab a coach (IDK if @MrKleen73 is currently taking on clients??) because it allows that unbiased observer to make the adjustments and you just have to follow directions. It also forces you to hold some additional accountability because you're not just checking into yourself in the mirror tomorrow, but into a coach that you paid and when check-in day arrives you have to be honest about whether or not you hit your macros/calories or cheated.... plus a coach teaches you lifelong lessons that you'll hold forever.

My wife worked with 3 or 4 different nutrtional coaches. She only had success with 2 originally, me, and this new gal she worked with all summer. The problem with me is it was high output and hard on the body, but I like the abuse, lol. Her other coach was 100% about the nutrition and my petite 5'3" wife dropped like 20lbs with her at a rate of just over 1lb per week I believe. it was perfection.

 

[Resolve10]

I don't have anything against using things to help, but I think Lou has given you a lot of good advice.

A combination of finding the things that let you keep intake where it needs to be (more complicated than it may seem and the touching on sleep, etc. seems to be the right path to begin thinking with) and things that help you keep activity levels up even as you lost weight (since new lows tend to make lots of things "down shift" to keep you from staying there) should be kept in mind.

 

[Oenomaus]

If sleep is an issue, it can definitely contribute to cravings and lack of diet adherence. There was a study, I dont have time to look for it now, that showed that people ate like 500 +/- 500 calories more when eating freely and under slept. That means some people eat like 500-1,500 more calories without thinking about it when sleep deprived. Not to mention that not getting enough sleep makes fat loss harder and muscle loss more likely.

I would explore options for why your sleep is bad in this case. Look up good sleep hygiene, then there are supplements that can help with various aspects sleep and sleep deprivation if needed as well.

Sleep is definitely a factor, appears I’ve underestimated just how much. My insurance is crap and won’t fund the study. We are changing providers next year, so will bark up that tree again as well. Appears to be undiagnosed apnea, based on my CBC & elevated RBC. Wife also reports my breathing stops. Has diminished a lot since cutting the booze & such. Blood pressure dropped significantly, but still wake multiple times at night. There used to be a supplement I took, but they changed the formula & it stopped being as effective. Also possible my apnea got worse. It would help me go down quickly, but would still wake multiple times. Just found it easier to fall back asleep more quickly when taking it. May just be stuck here until able to properly treat poor sleep.

 

[Resolve10]

Dave Asprey has an interesting tv show out called biohacking that you might enjoy to watch. A lot of what he presents is information we already know, but from his perspective. I can't say I agree with 100% of everything he says, but he does present it in an interesting way for the sake of discussion.

My wife and I have started adding some MCT and ghee into the morning coffee as an experiement, just to see how it goes.

IIRC, Dave Asprey feels this combination actually may not negate the positives of fasting, but may help curb appetite. I have no idea if that's accurate but I think it's an interesting idea and I don't see the harm in throwing some MCT into my regiment...

I would look for much better people to follow than Asprey. He is one of those weird anti carb zealots that doesn't ever really back anything he says up.

Obviously adding fats may have a satiating effect, food will decrease hunger, but then you'll just have to account for taking those out later in the day as well. I don't stay updated with these people anymore, but I can't believe people like that still have followings.

 

[Oenomaus]

I don't have anything against using things to help, but I think Lou has given you a lot of good advice.

A combination of finding the things that let you keep intake where it needs to be (more complicated than it may seem and the touching on sleep, etc. seems to be the right path to begin thinking with) and things that help you keep activity levels up even as you lost weight (since new lows tend to make lots of things "down shift" to keep you from staying there) should be kept in mind.

Thank you, and agree. Lou & Dustin have been helpful. Should have made this post sooner. Seems

Sometimes I think it's really a very valuable asset to grab a coach (IDK if @MrKleen73 is currently taking on clients??) because it allows that unbiased observer to make the adjustments and you just have to follow directions. It also forces you to hold some additional accountability because you're not just checking into yourself in the mirror tomorrow, but into a coach that you paid and when check-in day arrives you have to be honest about whether or not you hit your macros/calories or cheated.... plus a coach teaches you lifelong lessons that you'll hold forever.

My wife worked with 3 or 4 different nutrtional coaches. She only had success with 2 originally, me, and this new gal she worked with all summer. The problem with me is it was high output and hard on the body, but I like the abuse, lol. Her other coach was 100% about the nutrition and my petite 5'3" wife dropped like 20lbs with her at a rate of just over 1lb per week I believe. it was perfection.

This is actually a great idea. Asked my internist for a dietitian referral. Blew me off, said they’re not very helpful. Currently looking for a new primary & someone to help in this area as well they specializes in hormonal imbalances.

 

[Dustin07]

I would look for much better people to follow than Asprey. He is one of those weird anti carb zealots that doesn't ever really back anything he says up.

oh I don't disagree, but I found his show just to be an interesting regurgitation of information we typically already know but presented from his perspective. My wife and I tend to grab things like that with the Saturday morning coffee so we watched a couple of his episodes this past weekend.

 

[akboom87]

All very good advice in here.

Looks like you are meal prepping, hitting the gym and getting steps in plus some treadmill time.

I’m assuming you are tracking calories/macros? Didn’t catch it if you mentioned it. I can say this is where the devil can be in the details on weighing out and tracking down all foood intake.

I know @Hyde and @SkRaw85 had a online sleep study and got machines fairly quick they might be able to point you in that direction.


Also how is your water intake? It’s amazing how getting water in can curb hunger.

 

[Oenomaus]

All very good advice in here.

Looks like you are meal prepping, hitting the gym and getting steps in plus some treadmill time.

I’m assuming you are tracking calories/macros? Didn’t catch it if you mentioned it. I can say this is where the devil can be in the details on weighing out and tracking down all foood intake.

I know @Hyde and @SkRaw85 had a online sleep study and got machines fairly quick they might be able to point you in that direction.


Also how is your water intake? It’s amazing how getting water in can curb hunger.

Thanks for reading. Currently using the “Lose it” app for calorie/macro tracking. Was a little better until recently, when they started charging for access to barcode scanner. Luckily, being a creature of habit, most of my meals & snacks have already been weighed/tracked. Water intake is on point. It’s literally the only thing I drink, besides black coffee. Even stopped using the zero calorie sweeteners recently in an attempt to curb cravings. Not a lot more to cut in diet, with the exception of removing all sodium in seasoning, but man, that just sounds miserable. Seems like my problems are sleep & portion control. Going to have to lay off the second helpings & MRPs when craving, or pull the trigger on weight loss supps. Lou made a very good point about the sleep. It’s been bad so long, didn’t even consider it as a main factor in my stunted growth. Could also be my dysmorphia. Wife says she can see progress but the scales not moving enough for me to be satisfied. Someone told me about the at home sleep studies, and may have to go that route. Was advised my HCP may not accept a home study, but it would still be good to know for sure and hash out a plan for cpap if needed after.

 

[SkRaw85]

All very good advice in here.

Looks like you are meal prepping, hitting the gym and getting steps in plus some treadmill time.

I’m assuming you are tracking calories/macros? Didn’t catch it if you mentioned it. I can say this is where the devil can be in the details on weighing out and tracking down all foood intake.

I know @Hyde and @SkRaw85 had a online sleep study and got machines fairly quick they might be able to point you in that direction.


Also how is your water intake? It’s amazing how getting water in can curb hunger.

Gem sleep is where I got my home sleep study from @Hyde recommendation. Can’t imagine life without it.

 

[Resolve10]

oh I don't disagree, but I found his show just to be an interesting regurgitation of information we typically already know but presented from his perspective. My wife and I tend to grab things like that with the Saturday morning coffee so we watched a couple of his episodes this past weekend.

Again, just me being annoying, but he doesn't really follow in line with much research at all so I'd question what information he is saying that we already know from a different perspective. Most of what he's ever said I've just found annoyingly wrong and unhelpful.

 

[Resolve10]

Thanks for reading. Currently using the “Lose it” app for calorie/macro tracking. Was a little better until recently, when they started charging for access to barcode scanner. Luckily, being a creature of habit, most of my meals & snacks have already been weighed/tracked. Water intake is on point. It’s literally the only thing I drink, besides black coffee. Even stopped using the zero calorie sweeteners recently in an attempt to curb cravings. Not a lot more to cut in diet, with the exception of removing all sodium in seasoning, but man, that just sounds miserable. Seems like my problems are sleep & portion control. Going to have to lay off the second helpings & MRPs when craving, or pull the trigger on weight loss supps. Lou made a very good point about the sleep. It’s been bad so long, didn’t even consider it as a main factor in my stunted growth. Could also be my dysmorphia. Wife says she can see progress but the scales not moving enough for me to be satisfied. Someone told me about the at home sleep studies, and may have to go that route. Was advised my HCP may not accept a home study, but it would still be good to know for sure and hash out a plan for cpap if needed after.

I really like Macrofactor, although it isn't free.

 

[SweetLou321]

Sleep is definitely a factor, appears I’ve underestimated just how much. My insurance is crap and won’t fund the study. We are changing providers next year, so will bark up that tree again as well. Appears to be undiagnosed apnea, based on my CBC & elevated RBC. Wife also reports my breathing stops. Has diminished a lot since cutting the booze & such. Blood pressure dropped significantly, but still wake multiple times at night. There used to be a supplement I took, but they changed the formula & it stopped being as effective. Also possible my apnea got worse. It would help me go down quickly, but would still wake multiple times. Just found it easier to fall back asleep more quickly when taking it. May just be stuck here until able to properly treat poor sleep.

There are still things you can do in this case for the time being. If you feel you may have apnea, then I would consider the following:

Add more time to sleep to your routine since your quality is worse.
If you have allergies, treat them appropriately, night time congestion can be a factor.
Avoid alcohol at night, can make apnea worse. I would also try to limit nicotine and caffeine close to bed as well.
Do not cycle until this is better treated, androgenic hormones can worsen this.
Sleep on your side.
Slightly elevate the head of your bed.
1,800 mg NAC has some data helping with apnea/snoring event during sleep and daytime energy levels as a result: https://pubmed.ncbi.nlm.nih.gov/21838198/
I would consider a melatonin formulation that is both immediate and extended release, melatonin release can be altered and delayed in those with apnea event, this can help normalize it and help to normalize sleep. I like the melatonin IR/XR by life extension personally.
You can probably find an automated CPAP on Ebay honestly.

 

[WickedWarlock]

My thoughts on this are a bit different from others. I think semaglutide is the way to go right out the gate. You will lose weight fast and potentially clear up the sleep apnea issue. Then You don’t need to have a sleep study or bother wearing a cpap.

If I was OP, I would take semaglutide and make my diet as perfect as possible while taking it. Drop 20lbs and see where you are at. Just my thoughts on the matter.

 

[MrKleen73]

Dave Asprey has an interesting tv show out called biohacking that you might enjoy to watch. A lot of what he presents is information we already know, but from his perspective. I can't say I agree with 100% of everything he says, but he does present it in an interesting way for the sake of discussion.

My wife and I have started adding some MCT and ghee into the morning coffee as an experiement, just to see how it goes.

IIRC, Dave Asprey feels this combination actually may not negate the positives of fasting, but may help curb appetite. I have no idea if that's accurate but I think it's an interesting idea and I don't see the harm in throwing some MCT into my regiment...

Dave is wrong. A calorie is a calorie, you have broken the fast when you add the fats into your morning. I am not saying this will have detrimental effects on your diet because as we have discussed many times it all comes down to Calories in VS Calories out. However for the actual benefits of fasting you have to be fasting. Many people consider fasting getting the insulin/glucagon levels and BG back to low levels but if the body has been fed it has been fed. However this does work well in the case of Carb Backloading. Which is not a fasting protocol but keeps insulin low throughout the day until training, then has all the carbs for the day post training.

Sleep is definitely a factor, appears I’ve underestimated just how much. My insurance is crap and won’t fund the study. We are changing providers next year, so will bark up that tree again as well. Appears to be undiagnosed apnea, based on my CBC & elevated RBC. Wife also reports my breathing stops. Has diminished a lot since cutting the booze & such. Blood pressure dropped significantly, but still wake multiple times at night. There used to be a supplement I took, but they changed the formula & it stopped being as effective. Also possible my apnea got worse. It would help me go down quickly, but would still wake multiple times. Just found it easier to fall back asleep more quickly when taking it. May just be stuck here until able to properly treat poor sleep.

Sleep is a factor, but I am going to be honest with you. Your decision to eat when you are hungry after you have met your calories for the day is the cause of your problem. Plain and simple. You just have to decide what you want more and what is more important. You are a grown man, and regardless of cravings, or lack of sleep or any other factor / excuse, you choose to overconsume. If you prep your meals for the week there is no excuse for you to eat more. You stop eating for the day when you finish your food you made for the day. Super simple.... Say it is 9:00PM, and you are so hungry you don't know what to do. You go to the fridge, all my meals are gone for the day... Well crap, I am going to bed hungry. Done, your problem is solved. This decision has nothing to do with how much sleep you get, or anything else other than how much more you want the results of the diet than you do the food you are craving. I just came off of prep where we got all the way down to 1250 calories a day, I was hungry at all times. I could hardly walk, every step was a decision. I wasn't getting much sleep, and would literally lie down on the floor at the gym in between my sets. What I did not do was eat more than was on my diet for the day. Obviously this was an extreme situation, but it comes down to how much you want something, and if you are willing to sacrifice what is needed to get it. Stop selling yourself short that you can not but also stop looking for a smoking gun. We know what the problem is. When you get hungry you choose to break your diet and overconsume. All of the things you and Sweetlou have been discussing are extenuating circumstances that make it harder to make the right decision, but you are still the person in control of what you do and the choices you make.

Okay now that we are done with the tough love portion of the programming. You do not sound like you are suited to IF, you are prone to binging even on healthy foods when you feel you have restricted for too long. You are probably more suited to having your food throughout the day. Some people find IF to trigger binge eating, it is actually pretty common. You may find you enjoy a 3 meal a day set up if you like larger meals like Breakfast Lunch and Dinner, or 4-5 meals depending on preference and or convenience.

Just remember that it isn't the fault of the diet you are on, or a mystery why you are not losing weight as quickly as you want, it is you choosing to eat more than your diet plan allows. Once you have that taken care of then it comes down to how big of a deficit you choose to create that will guide your rate of weight loss. You can do it, and if you need help look into a coach or something to help with accountability.

 

[MrKleen73]

My thoughts on this are a bit different from others. I think semaglutide is the way to go right out the gate. You will lose weight fast and potentially clear up the sleep apnea issue. Then You don’t need to have a sleep study or bother wearing a cpap.

If I was OP, I would take semaglutide and make my diet as perfect as possible while taking it. Drop 20lbs and see where you are at. Just my thoughts on the matter.

Could work this way too as long as he learned how to maintain his weight which means learning to practice self control. Semaglutide does not help with that at all. It basically removes the hunger hormone from the equation which does nothing to teach self control, or good eating habits. Unfortunately this means he would be very likely to end up right back where he is now if not heavier after. However used appropriately combined with learning how to eat better and making better choices he may get himself slightly ahead of the curve and do really well. It is just not what we typically see when people go off of these types of things.

 

[Dustin07]

You do not sound like you are suited to IF, you are prone to binging even on healthy foods when you feel you have restricted for too long. You are probably more suited to having your food throughout the day. Some people find IF to trigger binge eating

I don't know about other people but I have found that a 30hr+ fast is far easier than a 20:4 even though I run the 20:4 more often around big family dinners etc. Without any proof, my theory is dopamine response. In the same way that sitting down and reading a book on vacation feels like it heals a.d.d. for me, pushing a 30hr+ fast feels like it heals the dopamine addiction of food. It's like at 20hrs, your body is overly rewarded with that first bite but at 36hrs, the dopamine trigger/requirement isn't as strong and it feels much easier to make the better protein driven decision.

I don't have a better explanation or scientific backing, but that has been my experience.

 

[SweetLou321]

My thoughts on this are a bit different from others. I think semaglutide is the way to go right out the gate. You will lose weight fast and potentially clear up the sleep apnea issue. Then You don’t need to have a sleep study or bother wearing a cpap.

If I was OP, I would take semaglutide and make my diet as perfect as possible while taking it. Drop 20lbs and see where you are at. Just my thoughts on the matter.

This isnt a bad was to approach some of his issues, but I still there are major behavioral barriers that need to be considered and trialed without the drug. I could even think a middle of the road approach is to take another month to work on diet strategies and sleep, make those as seamless with his needs as possible prior to the drug, then he could go all in for quick results, at least then he would have some structure to fall back on.

I just know from my own experience that the behaviors I had to take on for sustainability evolved as I lost weight. I feel like semaglutide would mute the need for that evolution, which may make the sustaining the weight loss harder on the back end. I also feel that what one considers as a sustainable end point needs to be considered in the bigger context of life. Its not always about what one can sustain physiologically, but making sure that the lifestyle one wants to live is cohesive with the weight they are trying to maintain. Gotta live after weight loss, and that will look different for all people. Some people can maintain 10% just fine physiologically, but what it takes lifestyle wise does not match up for them, so they should probably be closer to 15%, if that makes sense.

 

[Dustin07]

Gotta live after weight loss, and that will look different for all people. Some people can maintain 10% just fine physiologically, but what it takes lifestyle wise does not match up for them, so they should probably be closer to 15%, if that makes sense.

That's true. for me at least, 10% and 15% are both very different lifestyles.

 

[MrKleen73]

This isnt a bad was to approach some of his issues, but I still there are major behavioral barriers that need to be considered and trialed without the drug. I could even think a middle of the road approach is to take another month to work on diet strategies and sleep, make those as seamless with his needs as possible prior to the drug, then he could go all in for quick results, at least then he would have some structure to fall back on.

I just know from my own experience that the behaviors I had to take on for sustainability evolved as I lost weight. I feel like semaglutide would mute the need for that evolution, which may make the sustaining the weight loss harder on the back end. I also feel that what one considers as a sustainable end point needs to be considered in the bigger context of life. Its not always about what one can sustain physiologically, but making sure that the lifestyle one wants to live is cohesive with the weight they are trying to maintain. Gotta live after weight loss, and that will look different for all people. Some people can maintain 10% just fine physiologically, but what it takes lifestyle wise does not match up for them, so they should probably be closer to 15%, if that makes sense.

Some great advice and thought processes here. Also making a plan for maintenance, there is no going "off" the diet, you simply adjust the diet to where your calories are at maintenance. That still requires all the discipline, and meal planning you did during the deficit portion of your diet, just slightly more food, or perhaps the same amount of food with a free meal each week, or however you choose to make sure you are not going into a surplus. To do that you need to understand how to do these things in the first place.

 

[Oenomaus]

Dave is wrong. A calorie is a calorie, you have broken the fast when you add the fats into your morning. I am not saying this will have detrimental effects on your diet because as we have discussed many times it all comes down to Calories in VS Calories out. However for the actual benefits of fasting you have to be fasting. Many people consider fasting getting the insulin/glucagon levels and BG back to low levels but if the body has been fed it has been fed. However this does work well in the case of Carb Backloading. Which is not a fasting protocol but keeps insulin low throughout the day until training, then has all the carbs for the day post training.

Sleep is a factor, but I am going to be honest with you. Your decision to eat when you are hungry after you have met your calories for the day is the cause of your problem. Plain and simple. You just have to decide what you want more and what is more important. You are a grown man, and regardless of cravings, or lack of sleep or any other factor / excuse, you choose to overconsume. If you prep your meals for the week there is no excuse for you to eat more. You stop eating for the day when you finish your food you made for the day. Super simple.... Say it is 9:00PM, and you are so hungry you don't know what to do. You go to the fridge, all my meals are gone for the day... Well crap, I am going to bed hungry. Done, your problem is solved. This decision has nothing to do with how much sleep you get, or anything else other than how much more you want the results of the diet than you do the food you are craving. I just came off of prep where we got all the way down to 1250 calories a day, I was hungry at all times. I could hardly walk, every step was a decision. I wasn't getting much sleep, and would literally lie down on the floor at the gym in between my sets. What I did not do was eat more than was on my diet for the day. Obviously this was an extreme situation, but it comes down to how much you want something, and if you are willing to sacrifice what is needed to get it. Stop selling yourself short that you can not but also stop looking for a smoking gun. We know what the problem is. When you get hungry you choose to break your diet and overconsume. All of the things you and Sweetlou have been discussing are extenuating circumstances that make it harder to make the right decision, but you are still the person in control of what you do and the choices you make.

Okay now that we are done with the tough love portion of the programming. You do not sound like you are suited to IF, you are prone to binging even on healthy foods when you feel you have restricted for too long. You are probably more suited to having your food throughout the day. Some people find IF to trigger binge eating, it is actually pretty common. You may find you enjoy a 3 meal a day set up if you like larger meals like Breakfast Lunch and Dinner, or 4-5 meals depending on preference and or convenience.

Just remember that it isn't the fault of the diet you are on, or a mystery why you are not losing weight as quickly as you want, it is you choosing to eat more than your diet plan allows. Once you have that taken care of then it comes down to how big of a deficit you choose to create that will guide your rate of weight loss. You can do it, and if you need help look into a coach or something to help with accountability.

Absolutely, it’s a matter of discipline as much as anything else. Making excuses for myself & saying “it’s still good stuff” isn’t helping. Ends up being a bit of a bulk instead of a cut. Most of the time, I’m fine with going hungry. It’s after prolong periods my discipline wains & I give fold. Was the huge part of wanting to try the ozempic to aid where my own will has faltered. Thanks for the pep. Need this sometimes.

 

[Oenomaus]

I don't know about other people but I have found that a 30hr+ fast is far easier than a 20:4 even though I run the 20:4 more often around big family dinners etc. Without any proof, my theory is dopamine response. In the same way that sitting down and reading a book on vacation feels like it heals a.d.d. for me, pushing a 30hr+ fast feels like it heals the dopamine addiction of food. It's like at 20hrs, your body is overly rewarded with that first bite but at 36hrs, the dopamine trigger/requirement isn't as strong and it feels much easier to make the better protein driven decision.

I don't have a better explanation or scientific backing, but that has been my experience.

Never tried a fast this long. Most was with the “ultimate cleanse”. That pepper & syrup mix. It was effective, but the weight comes right back if you’re not doing what you should, which I wasn’t. Will look more into this, thanks

 

[Oenomaus]

My thoughts on this are a bit different from others. I think semaglutide is the way to go right out the gate. You will lose weight fast and potentially clear up the sleep apnea issue. Then You don’t need to have a sleep study or bother wearing a cpap.

If I was OP, I would take semaglutide and make my diet as perfect as possible while taking it. Drop 20lbs and see where you are at. Just my thoughts on the matter.

This was my original idea but, as stated, my discipline has to improve as well. It does me no good to plan a diet & then give in whenever the cravings get rough. Haven’t tried the meds yet but, everyone says the deterrent for eating is insane. The part I was hoping for. Leaning towards this option as well though.

 

[WickedWarlock]

This was my original idea but, as stated, my discipline has to improve as well. It does me no good to plan a diet & then give in whenever the cravings get rough. Haven’t tried the meds yet but, everyone says the deterrent for eating is insane. The part I was hoping for. Leaning towards this option as well though.

My thoughts are that you lose weight fast, getter better sleep, which will in turn help with cravings after.

 

[Oenomaus]

There are still things you can do in this case for the time being. If you feel you may have apnea, then I would consider the following:

Add more time to sleep to your routine since your quality is worse.
If you have allergies, treat them appropriately, night time congestion can be a factor.
Avoid alcohol at night, can make apnea worse. I would also try to limit nicotine and caffeine close to bed as well.
Do not cycle until this is better treated, androgenic hormones can worsen this.
Sleep on your side.
Slightly elevate the head of your bed.
1,800 mg NAC has some data helping with apnea/snoring event during sleep and daytime energy levels as a result: https://pubmed.ncbi.nlm.nih.gov/21838198/
I would consider a melatonin formulation that is both immediate and extended release, melatonin release can be altered and delayed in those with apnea event, this can help normalize it and help to normalize sleep. I like the melatonin IR/XR by life extension personally.
You can probably find an automated CPAP on Ebay honestly.

Thank you for this. Gave up alcohol & nicotine years ago trying to resolve but, still having sleep trouble. Will follow this link. Melatonin unfortunately seems to have little to no effect on me. Same as caffeine. Could be my less sophisticated lizard brain. Will give it another shake with extended release.

 

[Oenomaus]

I really like Macrofactor, although it isn't free.

Always looking for new tools, will give it a whirl to see if it’s better management than the free version of the app I use currently. Thanks for the referral.

 

[Oenomaus]

My thoughts are that you lose weight fast, getter better sleep, which will in turn help with cravings after.

Hopefully, or at least that’s what it’s done for those around me. Can’t make excuses for my hormones or other disadvantages. Gotta put in the work, even with the supplemental help. Appreciate you chiming in.

 

[SweetLou321]

Thank you for this. Gave up alcohol & nicotine years ago trying to resolve but, still having sleep trouble. Will follow this link. Melatonin unfortunately seems to have little to no effect on me. Same as caffeine. Could be my less sophisticated lizard brain. Will give it another shake with extended release.

Melatonin is really a dose dependent thing, what dose have you tried in the past?

Other options are black cumin seed oil, which has been shown to support sleep duration and quality:

A proprietary black cumin oil extract (Nigella sativa) (BlaQmax®) modulates stress-sleep-immunity axis safely: Randomized double-blind placebo-controlled study - PubMed

BCO-5 significantly modulated the stress-sleep-immunity axis with no side effects and restored restful sleep.

pubmed.ncbi.nlm.nih.gov

Also, ashwagandha has been shown to support sleep duration and quality:

A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults - PubMed

Clinical Trials Registry-India (www.ctri.nic.in). Registration number: CTRI/2017/02/007801.

pubmed.ncbi.nlm.nih.gov

 

[Oenomaus]

Melatonin is really a dose dependent thing, what dose have you tried in the past?

Other options are black cumin seed oil, which has been shown to support sleep duration and quality:

A proprietary black cumin oil extract (Nigella sativa) (BlaQmax®) modulates stress-sleep-immunity axis safely: Randomized double-blind placebo-controlled study - PubMed

BCO-5 significantly modulated the stress-sleep-immunity axis with no side effects and restored restful sleep.

pubmed.ncbi.nlm.nih.gov

Also, ashwagandha has been shown to support sleep duration and quality:

A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults - PubMed

Clinical Trials Registry-India (www.ctri.nic.in). Registration number: CTRI/2017/02/007801.

pubmed.ncbi.nlm.nih.gov

Ashwagandha (1300 mg) is in my daily multivitamin pack, among others. Still feeling the consequences of over indulgence of alcohol, even a few years after quitting. When trying melatonin started off at 5 & progressed up to 40 mg before stopping. Falling asleep is easy enough, just staying asleep isn’t possible when I stop breathing. Will follow the link though and see if they’ve got more tips on improving efficacy.

 

[Dustin07]

Never tried a fast this long. Most was with the “ultimate cleanse”. That pepper & syrup mix. It was effective, but the weight comes right back if you’re not doing what you should, which I wasn’t. Will look more into this, thanks

I haven't experienced any negatives from 30hr+ fasts. They really end up being 36hr-40hr if I go from say 8pm Sunday to 8am or noon on Tuesday. Kleen opened me to the idea of ADF (alternate day fasting) a year or two ago and one month I gave it a full go. Fast 30hrs+, then eat in a surplus and lift the next day, then back to fast and rest the day after. I dropped 10lbs and PR'd deadlifts and I think bench press that month.

The hardest part can be social life, but I went as far as to meet friends at a bar and order diet coke or iced tea.

 

[MrKleen73]

I am curious, how long are you dieting before you hit the cravings wall that sends you over the edge? Like how long are you able to stay on the wagon so to speak?

 

[Oenomaus]

I am curious, how long are you dieting before you hit the cravings wall that sends you over the edge? Like how long are you able to stay on the wagon so to speak?

Usually good about 6-8 weeks no problems. After about two months the double portions become a problem. Been more mindful since starting this thread. Think it was you who helped me out. “Eat your days macros & sit down somewhere” paraphrasing, of course.

 

[Oenomaus]

I haven't experienced any negatives from 30hr+ fasts. They really end up being 36hr-40hr if I go from say 8pm Sunday to 8am or noon on Tuesday. Kleen opened me to the idea of ADF (alternate day fasting) a year or two ago and one month I gave it a full go. Fast 30hrs+, then eat in a surplus and lift the next day, then back to fast and rest the day after. I dropped 10lbs and PR'd deadlifts and I think bench press that month.

The hardest part can be social life, but I went as far as to meet friends at a bar and order diet coke or iced tea.

Wow, that is impressive. May be able to pull off the food fast easier than the training one though. It’s as much for my mental health as it is physical. Need the endorphins. I’m one of those weirdos.

 

[rixrix]

I am late to the party here, but let me give my two cents on the matter.

I have always been a big eater. You all know the sayings

"abs are made in the kitchen"
"you can't outrun a bad diet"

But food was always my problem. I come from a family of obese diabetics and in 2022 I was diagnosed with T2.

I started with the barbells.

But I discovered two things that worked great: TRT and Mounjaro.

Ozempic is freakin' great. And Mounjaro is 10x better than Ozempic.

Did it put me in the hospital for gastroparesis? Yes.

Would I do it again. even though it put me in the hospital? Yes.

Do I think it's dangerous? Maybe. probably, I don't know.

Do I think that being a fat slob is way more dangerous than Ozempic? Yes.


So yeah, weigh the pros and cons. But for me, I've dropped my bodyfat very substantially, partially fixed my health, fixed my liver, and so forth.

 

[WickedWarlock]

I am late to the party here, but let me give my two cents on the matter.

I have always been a big eater. You all know the sayings

"abs are made in the kitchen"
"you can't outrun a bad diet"

But food was always my problem. I come from a family of obese diabetics and in 2022 I was diagnosed with T2.

I started with the barbells.

But I discovered two things that worked great: TRT and Mounjaro.

Ozempic is freakin' great. And Mounjaro is 10x better than Ozempic.

Did it put me in the hospital for gastroparesis? Yes.

Would I do it again. even though it put me in the hospital? Yes.

Do I think it's dangerous? Maybe. probably, I don't know.

Do I think that being a fat slob is way more dangerous than Ozempic? Yes.


So yeah, weigh the pros and cons. But for me, I've dropped my bodyfat very substantially, partially fixed my health, fixed my liver, and so forth.

What is the going treatment for gastroperesis?

 

[MrKleen73]

What is the going treatment for gastroperesis?

@WickedWarlock - According to the AI search - There's no known cure for gastroparesis, but a medical professional can help manage the condition and improve symptoms. Treatments include dietary changes and medications. In some cases, a feeding tube or gastric venting tube may be necessary.