Sunday, June 25, 2023

1 Year Body Transformation - 76lbs Lost - Protocol and Reflections

One year ago, I had completely lost my health. Overweight, burned out, and unhealthy, I set out fully resolved on a journey to completely reset my body and health. I was in a unique position to devote substantial time and resources to this endeavor, and I am writing this post to share my journey and what worked for me in the hopes that it may be useful to others.

Starting stats:

• Height: 6’4”

• Weight: 282lbs

• Bodyfat: 27-28%

• Blood Pressure: 159/92

Current stats:

• Weight: 206lbs

• Bodyfat: 13.5%

• Blood Pressure: 124/70

Background:

I (34M) founded a company seven years ago and ran it as CEO until May of 2022, when I officially retired from my day-to-day role. While this was an incredible and privileged journey, the mental, emotional, and physical costs were very high, and I was deeply burned out on every level. Most critically, I had lost my physical and mental health, and had become obese (282lbs), hypertensive, insulin resistant, and depressed.

For the next six months, I decided to make my health and fitness my full-time job, going deep down many research rabbit holes and committing consistently to a rigorous (though not unreasonable or extreme) exercise program. Once I dialed in my regimen, it took much less effort to stay the course, and I returned to work to begin the process of founding my next company. Here is what I did, and what I believe moved the needle most.

Diet

This journey taught me very clearly that weight loss happens in the kitchen, not the gym.

My spouse and I used a simple app called Lose It! to manage our diet. It allowed us to set a weight loss goal (initially 2lbs/wk), and does the math to set a daily calorie budget that meets the caloric deficit necessary to achieve that. It also syncs with our Apple Watches to feed our exercise calories back into the app and reflect in our weekly calorie budget.

We had previously tried everything – keto, paleo, mostly plant-based vegetarian, and other programs, and none of them drove the profound results we saw from simply tracking our calories and macros.

Because I wanted to both cut fat and build muscle, I optimized my diet for high protein intake (approx. 1g per lb of bodyweight) while still maintaining my necessary caloric deficit. Conventional wisdom says not to try to cut and bulk at the same time, but this diet and training approach absolutely worked for me.

It took some practice to build the reflex of logging everything we ate, but the awareness this built was invaluable, and soon became second nature.

Beyond tracking calories and protein, and eating generally clean foods, I didn’t do anything special or gimmicky. The success of this simple approach made feel a bit silly for buying into so many fad diets over the years, but I’m glad I went back to basics and found something that works.

I also reduced alcohol consumption to a maximum of four drinks per week, which was a hugely positive change that not only made it easier to lose weight, but improved my sleep and mental health in the process. My body no longer enjoys being drunk, and I now drink only lightly and occasionally at social functions.

Exercise

I worked with a personal trainer who specializes in functional mobility. Rather than take a top-down approach focused solely on weight loss and aesthetics, he worked with me to take a bottom-up approach that emphasized healthy body mechanics, restorative spinal mobilization, and a balance of hypertrophy, calisthenics, and endurance training. I saw my trainer three times per week, and did three (lighter) solo workouts on the days in between, taking one day off per week.

This slow and steady approach to building a strong foundation took some time to yield the aesthetic results I wanted, but I felt the positive change in my body and health almost immediately. My workouts were challenging but nothing crazy – crafted to push me just slightly out of my comfort zone each time. I found that this bar rose steadily and quickly with each passing week.

I have maintained this activity level, with 5-6 hours of mixed exercise per week, with an emphasis on resistance training.

We are fortunate to have a nice home gym, but almost everything I did can be done inexpensively at home with bodyweight exercises, a basic set of dumbbells, and a weight bench. I don’t think I will ever “go to the gym” again, as I’ve found the facilities just aren’t necessary. Even when traveling, I stick mostly to bodyweight exercises that I can do easily in my hotel room.

In lieu of a trainer, there are several fitness apps that will customize a routine for you using whatever equipment you have available, including bodyweight-only if you don’t have access to equipment.

Medical

My medical protocol played a huge role in my success, and was the largest focus of my research and investment. Here is what I did:

Hormone optimization: I’ve spent most of my life with testosterone levels in 300-400ng/dl range – technically within the “normal” reference range, but suboptimal. I’ve also struggled with persistently elevated estradiol (estrogen), which I suspect is the result of being a morbidly obese child who went through puberty with a lot of excess bodyfat that biased me toward high aromatization.

I worked with a functional medicine clinic to get my testosterone to an optimal level of about 1100, while getting my estradiol in the 40-50 range, and slightly boosting my suboptimal thyroid levels.

  • After some trial and error, here’s where I landed with my hormone protocol:
    • Testosterone Cypionate: 30mg daily via subcutaneous injection
    • HCG: 500iu EOD (to maintain fertility and testicle size)
    • Anastrazole (aromatase inhibitor): .25mg EOD, later replaced with an equivalent dose of Exemestane, and eventually phased out entirely as I lost bodyfat and my aromatization profile shifted toward clinically normal.
    • T3/T4 Thyroid compound: I started with a low dose of natural Armour thyroid (porcine derived), but had to stop because it was triggering an antibody response. I landed on a compound of synthetic T3/T4 at 18mcg/76mcg.

Fixing my hormones was the biggest health unlock of my life. For the first time ever, instead of fighting my body and metabolism, we finally felt in sync. With consistency, my bodyfat began to melt off while my lean mass increased, and my weight loss (when averaged) tracked almost precisely to what the caloric deficit math said it should.

This protocol also significantly boosted my energy levels and mood, making caffeine or other stimulants less necessary in my routine. My confidence skyrocketed. And while I feared at the beginning that testosterone would make me act like a jerk, the effect was quite the opposite: I’m more positive, outgoing, and kind, albeit slightly less patient and with a decidedly lower tolerance for bullshit. I really like what it did for my mindset and mental health, and love what it did for my body.

In parallel, I also stacked a robust peptide regimen that I think has been transformative for my overall health, metabolism, sleep, and post-workout recovery.

Semaglutide: 1mg/wk via subcutaneous injection. This peptide has been, for me, a miracle drug that completely shut off the background mind chatter that had always encouraged me to snack or binge eat, while allowing me to still eat sufficient calories and protein, and still fully enjoy food when I want to. The shift was that eating became a conscious choice – something I wanted and chose to do – rather than a compulsive behavior that needed to be satisfied. My glucose and A1C also improved from prediabetic to textbook perfect levels.

  • Important notes on Semaglutide: It’s critically important that you eat sufficient protein when on this drug. If you’re not, you will likely lose muscle along with fat, which will leave you in even worse metabolic shape. If you overdo your dose and aren’t paying attention to your diet, it’s very easy to effectively starve yourself on this drug and not realize it. But by tracking my protein (combined with resistance training), my lean muscle mass has steadily risen since starting this drug – as measured and tracked and by DXA scan.
  • I think the pharmaceutical dosing protocols (2.4mg/wk) for this drug are insanely high. My spouse and I titrated up from .25mg/wk (which didn’t do much) to 1mg/wk, where we’ve stayed for the last six months. I’m a 6’4”, 205lb man and this dose is strong for me. Any stronger and I’d struggle to eat enough. My advice is to start with a very small dose and work your way up to the minimum effective dose that works for you.
  • This is still a new drug without the benefit of longterm safety data. While I feel dramatically healthier on it (as confirmed by all reasonable bloodwork and biometric tracking), I think caution and careful monitoring is warranted, and encourage others to be patient in finding the smallest possible dose that works for you.
  • The only side effect I experienced from this drug was mild constipation. I was able to fully counteract this with a nightly dose of an ayurvedic herb called Triphala, which works by stimulating peristalsis (involuntary muscle movement) of the digestive tract.
  • Growth Hormone Secratagogues - Ipamorelin / CJC-1295 – These peptides stimulate growth hormone release from the pituitary gland, enhancing fat loss and muscle growth while improving sleep and recovery. While not as powerful as actual growth hormone, they are much safer and can be taken safely for longer periods. I LOVE these beautiful molecules, and consider them an essential part of my stack.
  • I played with many other peptides and still use several of them, including BPC-157, TB-500, AOD-9064, Tesamorelin, Epithalon, MT-2, PT-141, Selank, Semax, and others. While interesting and useful, I don’t think they played a pivotal role in my body transformation and am omitting detailed commentary. If anyone is interested in a follow up post on these, let me know in the comments or a DM and I’ll considering doing a detailed writeup.
  • Cardarine - 10mg/day - Not a peptide, but this one was immensely helpful. It's a PPAR receptor agonist that biases the body toward burning fat for fuel. It also dramatically enhanced my cardiovascular capacity, allowing me to hit it harder in the gym. Within 30 minutes of taking this, it feels like I have a third lung in the gym. I believe this drug was very powerful in accelerating my weight loss, but was probably not essential in the long term.
    • It is also the riskiest measure in this list due to potential cancer risk. The pharmaceutical company that developed it abandoned it because it caused cancer in test rats. But importantly, they were given large doses well in excess of equivalence to my 10mg dose for more than half of their lives. The safety of this drug is still hotly debated (which you can find ad nauseum on Reddit or Google). I personally think the risk of short term use at reasonable human doses is small, and was ultimately comfortable with the cost/benefit profile or running a few cycles of this drug. But that's my opinion and not medical advice, so please proceed with caution and do your own research to reach an informed conclusion before jumping into it.
  • I did not use any steriods or anabolic compounds beyond testosterone. I have considered doing a doctor-supervised Anavar cycle, but decided it just wasn't necessary given the results I was already seeing without it.

Other Measures

  • Hyperbaric oxygen therapy – 10 (90 minute) dives at 2.2ATA – I don’t think this did much for my body composition, but felt like a reboot for my brain function and mental health, and very notably completely restored my sense of smell, which had been severely diminished nearly two years later after an alpha-strain COVID infection.
  • Stem Cell Therapy – My spouse and I did an expensive course of full body stem cell therapy in Mexico, using placenta derived mesenchymal stem cells. I don’t think this helped much with body composition, but it did completely restore my receding hairline and bald spot, and did wonders for my skin.
  • Cold Plunge - We purchased a cold plunge pool and love it. While I suspect it's providing a slight metabolic boost and improving workout recovery, I don't think it has particularly aided with my weight loss. I LOVE what it does for my energy levels and mood.
  • Sauna -- We have a basic infrared sauna from Costco and I love it. Really helps with post-workout recovery, and I think has also improved my circulation and blood pressure.
  • Tummy tuck – I did this in 2017 to remove excess skin resulting from extreme weight loss in childhood. In fifth grade, I tipped the scales at nearly 300lbs, but lost the weight in high school. After years of maintaining that, I finally got a tummy tuck. While it’s a serious procedure with a difficult recovery, it was life changing. Unfortunately, due to years of chronic stress and anxiety after starting my company, I gained most of that weight back. But fortunately, after this round of weight loss, my skin elasticity has bounced back nicely. It did leave a permanent scar, but that’s vastly preferable to the alternative.

Spousal Alignment

My husband went on this journey with me and had my back every step of the way. His results have been similarly dramatic and transformative.

I’m very fortunate to have a spouse that went on this journey with me, followed a similar diet plan, and was a constant accountability partner (as I was to him) to keep us on track. I think it would have been much harder – and maybe impossible – to do this if my spouse and I weren’t on the same page or wasn’t at minimum, highly supportive.

Conclusion

I’m healthier, happier, and more confident today than at any time in my life. Growing up with childhood obesity leaves deep psychological scars that fundamentally inform self-image. It’s a complete paradigm shift and total head-trip to be at a place – for the first time in my life – where I not only love my body, but feel confident and comfortable within it.

This feels like the end of one fitness journey and the beginning of another. I love my body today and will be perfectly happy if this is it for me, aesthetically or functionally. But now I'm hooked on fitness, and am embarking on a new journey of exploration to learn what is possible with my body, and how far I can go. But this journey feels fundamentally different those past because I'm doing it from a foundation of health, confidence, and self love with my current body (which feels very sustainable to me now that I've cracked my metabolic code). If further progress becomes unsustainable or the cost/risks are too high, I can always come back to where I am how, healthy and confident in my own skin.

I have many other thoughts I wanted to share, and went down a lot of rabbit holes and dead ends before finding the mix that worked for me. While I omitted these thoughts for length, I'm happy to answer questions or expound on request as my schedule allows.

I’m not a medical professional and this post is not medical advice. I’m sharing what worked for me in the hopes that it may be useful for others, but your path and toolset may vary.

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