"Is Fasting for Weight Loss Safe?"
Although fasting for a week or two can actually interfere
with the loss of body fat, eventually, after the third week of fasting,
fat loss starts to overtake the loss of lean body mass in obese individuals.
But is it safe to go that long without food?
Proponents speak of fasting as a cleansing process,
but some of what you're purging from your body
are essential vitamins and minerals.
Heavy-enough people can go up to 382 days without calories,
but no one can go even a fraction of that long without vitamins.
Scurvy, for example, is diagnosable within as few as four weeks
without any vitamin C.
Beriberi (thiamine or vitamin B1 deficiency) may start out even earlier
in fasting patients, and once manifests can result in brain damage
within days, which can eventually become irreversible.
Even though fasting patients report problems such as nausea
and indigestion taking supplements,
all of the months-long fasting cases I've mentioned in the last few videos
were given daily multivitamins and mineral supplementation as necessary.
Without supplementation, hunger strikers and those undergoing prolonged fasts
for therapeutic or religious purposes— like the Baptist pastor hoping
to "enhance his spiritual powers for exorcism"—
have ended up paralyzed, comatose, or worse.
Nutrient deficiencies aren't the only risk.
Reading about all the successful reports of massive weight loss
from prolonged fasting in the medical literature,
one doctor decided to give it a try with his patients.
Of the first dozen he tried it on, though, two died.
Now, in retrospect, both the two patients that died
started out with heart failure and were on diuretics.
Fasting itself produces a pronounced diuresis,
meaning loss of water and electrolytes through the urine,
and so it was the combination of fasting on top of the water pills
that likely depleted their potassium and triggered their fatal heart rhythms.
The doctor went out of his way to point out that both of those who died
started out in severe heart-failure,
and both had improved greatly while undergoing starvation therapy.
Small consolation since they were both dead within a matter of weeks.
Not all therapeutic fasting fatalities were complicated
by concurrent medication use. At first, he did very well
and experienced the usual euphoria.
His electrolytes remained fine,
but in the middle of the third week he suddenly collapsed and died.
This line of treatment is certainly tempting because it does produce
weight-loss, and the patient feels so much better,
but the whole killing people thing
must make it a very suspect line of management.
Contrary to the popular notion that the heart muscle is specially spared
during fasting, the heart appears to experience similar muscle wasting.
This was noted in the victims of the Warsaw ghetto during World War II
in a remarkable series of detailed studies carried out
by the ghetto physicians themselves before they themselves succumbed.
In a case entitled "Gross Fragmentation
Of Cardiac Fiber After Therapeutic Starvation For Obesity,"
a 20-year-old woman successfully achieved her ideal body weight
after losing 128 pounds, fasting for 30 weeks.
After a breakfast of one egg, she had a heart attack and died.
On autopsy, the muscle fibers in her heart
showed evidence of widespread disintegration.
The pathologists suggested that fasting regimens should no longer
be recommended as a safe means of weight reduction.
Breaking the fast appears to be the most dangerous part.
After World War II, as many as one out of five starved Japanese
prisoners of war tragically died following liberation.
Now known as"refeeding syndrome," multi-organ system failure
can result from resuming a regular diet too quickly.
See, there are critical nutrients such as thiamine and phosphorus
that are used to metabolize food.
So in the critical refeeding window, if too much food is taken before
these nutrients can be replenished, demand may exceed supply.
And whatever residual stores you still carry can be driven down even further,
with potentially fatal consequences. That's why rescue workers are taught
to always give thiamine before food to victims who had been trapped
or otherwise unable to eat.
Thiamine is responsible for the yellow color of "banana bags,"
a term you might have heard used on medical dramas,
used to describe an IV fluid concoction often given
to malnourished alcoholics to prevent a similar reaction.
Anyone with negligible food intake for more than five days
may be at risk for developing refeeding problems.
Medically-supervised fasting has gotten much safer
now that there are proper refeeding protocols;
we know what warning signs to look for, and we now know
who shouldn't be fasting in the first place, such as those
with advanced liver or kidney failure, porphyria,
uncontrolled hyperthyroidism, and pregnant and breastfeeding women.
The most comprehensive safety analysis of medically-supervised,
water-only fasting was recently published
out of the TrueNorth Health Center in California.
Out of 768 visits to their facility for fasts up to 41 days,
were there any adverse events? Yes, 5,961 of them!
But most were mild known reactions to fasting such as fatigue, nausea,
insomnia, headache, dizziness, upset stomach, back pain.
They report only two serious events, and no fatalities.
Fasting longer than 24 hours, and particularly three or more days,
should only be done under the supervision of a physician
and preferably in a live-in clinic. In other words, don't try this at home.
This is not just legalistic mumbo-jumbo.
For example, normally your kidneys dive into sodium conservation mode
during fasting, but should that response break down
you could rapidly develop an electrolyte abnormality that may only manifest
with non-specific symptoms like fatigue or dizziness,
which could easily be dismissed until it's too late.
The risks of any therapy must be premised on the severity of the disease.
The consequences of obesity are considered so serious
that effective therapies could have "considerable acceptable toxicity."
For example, many consider major surgery
for obesity to be a justifiable risk. But the key word is effective.
Therapeutic fasting for obesity
has been largely abandoned by the medical community,
not only because of its uncertain safety profile,
but it's questionable short-term and long-term efficacy.
Remember, for a fast that only lasts a week or two,
you might be able to lose as much body fat or even more
on a low-calorie diet than a no-calorie diet.