Questions for Jason Fung and Megan Ramos

(What The Fast?!) #81

Thank you @N1coleS!! I love hearing other people’s stories. I’ll try that! I went off coffee for awhile and had good results.

Today I’m down 2 lbs to 147.7 but still not my lowest fasting weight from a few weeks ago (147.0). I’m sure I’ll get there tomorrow, but would love to get there and STAY there! I have a friend coming in town this weekend, so I’ll be feasting. I’d love to hear about your feasts - do you do mainly OMAD or are you eating multiple meals? How many days do you feast before fasting again?

SORRY - just now realizing I should have posted this in a different thread!

(Nicole Sawchuk) #82

I am all over the map. I fast every week Monday - Friday. Some weeks they are straight 5 day fasts. Other weeks I go 3 days with IF the rest of the week. Thed OMAD is not uncommon for me because I don’t have time for more food because of my schedule. Weekends I refuel and try to eat only twice a day on those days. But its the weekend and I do just go with the flow.
In other words, my fasting schedule is all over the map.

Alternate Day Fasting turned ZC...back to fasting
(WanderinJack) #84

Hello all,
I’m new and have some questions about Fat Fasting and rather than start a new thread I figure I’d jump in here.

Question: What should the macro profile look like to do an effective Fat Fast? My first one was ~88% fat, 7% carb, 5% protien in an OMAD with~1200 calories. The problem is that when I look online at various fat fast menus they are more like 75%-80% fat. Seems a little light on fat and the likely culprits are the carbs in the avocados and the protein in the bacon, ugh…my two favs. I’ve attached a copy of what I ate. Thanks for any input.

Background: I’ve been keto since 2014 at about 65%-75% fat and around 70g of protien, the rest veggie carbs (no grain, fruit or sugar)). I’ve started 18/6 IF over the summer, moved to 20/4 and now at OMAD in about a 2 hour window and feel great and weight is starting to drop weight.

Although I’ve overcome fatty liver, leaky gut, candida, a rash all over my body and probably a bunch of stuff I wasn’t aware of I have been stuck at 10# above my goal weight (lost about 75#) and still have a little pot belly. I’m thinking fasting is the final solution. Thanks.

(Jeff Widener) #85

I have the same issue with the 2017 ketonix. Keto since March. Fasting most weeks since June. I fast 4 days a week on the 3rd and 4th days my PPM is 3.0-6.5. When I break my fast I go up to 10-15. I have just stopped testing while fasting. I know that I’m in ketosis but it is frustrating seeing the meter going so low. I want a blood tester just not the highest priority right now. I thought it was my ketonix. Thanks for posting.

(Jaelith Webster) #86

Dr. Fung’s books recommend medical monitoring for fasts over 7 days. What things need to be monitored? I understand that if someone has a medical condition, that some conditions need different tests (like diabetics concerning glucose numbers). I would like to take a list of things to my doctor so I can do an over 7 day fast, but I have no idea what to ask to be monitored. I am 40 and 100 pounds overweight and only take thyroid medicine (I have no thyroid). I have no other medical conditions.

(Nicole Sawchuk) #87

You are taking medication and fasting can have an impact on the medication you take. Not to mention, some times fasting can make some conditions that you weren’t even aware you had appear!
Its just good practice to be kept under a watchful eye of a physician during those longer fasts.

(Jaelith Webster) #88

I understand the importance of medical supervision. This thread is for asking questions to Dr. Fung/Megan Ramos. My request to Dr. Fung is what he recommends to ask for when I go to my primary doctor. My primary doctor (and probably a lot of doctors) would not have the experience that Dr. Fung has as to what conditions to watch out for. If I am armed with knowledge of what to ask my doctor to monitor, then he would be more likely to agree to it compared to asking my doctor, who knows nothing about EF, what he would recommend. Especially since most doctors don’t recommend EF for anything in the first place. My doctor still thinks that low fat diets are the best diets to follow. :roll_eyes:
My medicine is supposed to taken while fasting and it takes 6 weeks before a change to the amount will show up in blood tests. I also know the signs to look for when an adjustment is needed.
The recommendation I’m asking for from Dr. Fung would not be specific for any medical condition, as each medical condition would have it’s own things to look for.

(Nicole Sawchuk) #89

My bad! I jumped the gun on the response - sorry!

(Bobbie) #90

I think it is important to have an episode regarding some of the potential complications coming breaking a fast/keto and how to avoid them if possible. I consider myself someone who likes to research before starting something and I never crossed a particular topic. Refeeding edema. I fell off the wagon and resumed my previous habits of eating after Fasting over 1 week. I attempted a 2 week fast, but made it only 8 days of fasting. I resumed my usual carb loaded diet and did not continue to weight myself as I knew I would have a little bit of weight gain resuming carbohydrates. Within the 6th day after my fast break, for whatever reason I decided to add lots of salt (because you need it with low carb/fasting) to a few meals I had had that day. By the evening I was edematous. I was so swollen my feet and lower legs were huge, full of fluid. I’m talking about 4+ pitting edema! I weighed myself after that and I had gained 16 pounds of fluid. I could have went into pulmonary edema, but I did not. I had a BNP drawn and there was not any stress to the heart. But, I feel this is important to discuss on how to avoid it! I now know I probably should have avoided placing that extra salt on that 6th day. I also should have continued to weigh myself. I do not know if I gained 16 pounds in 1 day or 6 days, but either way that was 16 pounds of fluid in 6 days and definitely way too much in such a short time. It has been months since that episode and I continue to get dependent edema 1+.

I wholeheartedly believe in low carb and I love following Dr Fung. I have been skittish to do another fast because of the potential fo refeeding edema. I do wish it could be discussed in further detail in a podcast or blog post.


Hi Carl

I don’t know, if you are still collecting questions because you already did the ‚Questions for IDM Part #1‘ episode a few weeks back but looking at the title I am hopeful that you will release another episode where Dr. Fung and Megan will answer more questions from the community.

I understand that Dr. Fung and Megan are primarily dealing with patients who are obese, are dealing with T2D or have kidney disease. I am wondering, if they also treat patients with different conditions and can advise on how to implement fasting and/or ketogenic dieting.

Specifically, I would like to know, if they have any experience in dealing with migraines. I have a friend who has to deal with frequently occurring migraines. She is not overweight and recently tried a 5 day fast which really seemed to help. She stopped fasting after dropping below 50 kg (~110 pounds) and feeling tired but the fasting seemed to have helped with her condition.

I assume that with her not having too much body fat to play around with, frequent extended fasts are not advisable. My first thought was to recommend a ketogenic diet to her because it would be the closest thing to fasting. However, with her being a vegetarian and cutting out other migraine triggers from her diet, I don’t know, if this sort of diet would be feasible in the long run.

What would be their advice in a case like this? If this case is too specific: What are other conditions they have seen improved during a fasting / ketogenic diet regiment? How do they deal with people who do not need to lose any weight but may benefit from fasting? What would be their guidelines for a ketogenic diet when dealing with a vegetarian or a vegan?

Best regards

(What The Fast?!) #92

Question!! If you have low fasting insulin (per a blood test), normal blood sugars, and are likely NOT insulin resistant…is there any other reason that the pounds will not shed maintaining a ketogenic diet, IF, and some EF? (Yes, there is definitely excess weight!)

(This is my situation and I’m sure there are others.)

(Nicole Sawchuk) #93

I am experiencing this too right now and I am starting to get frustrated!

(carl) #94

I’ve been keto for 2 years. Weight stalled for 1.5 years. I still feel great and I’m still losing inches. It happens to many people who go keto, especially if you are trying to undo years (50 in my case) of insulin resistance. Be patient and let your body heal. Your body will shed pounds when it’s ready to.


(Philippa ) #95

I would like to ask if it is correct that a ‘fat fast’ gives exactly the same benefit to insulin levels as a ‘water fast’?

The reason is after reading Dr Fung’s blog posts about incretin and protein intake I went hunting for incretin response to pure fat intake and found this study:

This study found that there is a insulin response to a pure fat meal, of low magnitude but prolonged duration, significantly different to the control group which just drank water.

I would really like to hear Dr Fung’s views on this study. Is the rise in insulin low enough to be irrelevant? Or should we be concerned that pure fat intake (a ‘fat fast’) will be less effective in the reversal of insulin resistance than a water fast?

Many thanks for the great podcast,

(What The Fast?!) #96

Thanks Carl! I understand that stalls are to be expected, especially with IR. I’d love to hear from Megan and Jason on people who don’t show signs of IR (via blood test results) but still struggle to lose on keto. I’ve been keto for 10 months and am now doing lots of IF and EF, but in the entirety of my keto life, I’ve only lost about 4lbs (and DEXA says BF of 33%) and even that comes back on and off. I test for ketosis and I know it’s working because my allergies have become virtually non-existent…but I’d love to hear their thoughts/advice from people in this situation.

(carl) #97

What are you eating, and how often, if you don’t mind me asking?

(Adam Kirby) #98

Hmm. Why would you have lost your initial weight, then, presuming your insulin and IR was higher when you started keto? Also out of curiosity, how many inches have you lost while being weight stable?

(carl) #99

Wish I knew. I only know that it’s a pattern we see over and over again.

I have gone down 2 pants sizes and 2 shirt sizes. Don’t know how many inches, but I continue to shrink. :slight_smile:

(Adam Kirby) #100

That’s awesome. Do you think you’re putting on lean mass while losing fat, or the fat cells are somehow shrinking? I’m fascinated by people who shrink while weight stable.


@carl, have you really been stalled 1 1/2 years? You were T2D, right? I’m asking because I’m also T2D (won’t use the past tense until I know that it’s well and truly healed) and have maintained since the first part of October (still have about 30 lbs to go) but not gained anything back, for which I credit keto. It makes me curious, when we T2Ds stall, if our stalls tend to be longer and harder to break. Thanks, Carl! (Would love for Dr. Fung and Megan to chime in on this as well if they know.)