ex150 trial case study: 26 year old male loses 5-8lbs in 26 days, mostly water weight

Unfortunately for him, the princess is in another castle.

This is the second case study from the ex150trial. If you recall, I put out a post asking for volunteers to try the ex150 diet for 30 days. The first few have finished their trials, and this is one of them.

Previous case study: 48 year old female loses 14.6lbs in 30 days.

Subject: 26 year old male

Subject had previously done carnivore, high carb/low fat, OMAD (One Meal a Day), and fasting.

His goal was to lose 5kg (11lbs). That’s right, subject is European and uses the metric system. I’ll be showing weight in pounds, because kilograms mess with my head lol. I just don’t have a reference.

Experiment: Rocky start, brutal keto-flu

Right from the beginning, the subject experienced quite a bit of keto-flu. This lasted for about a week and was very unpleasant. In his own words:

I am not feeling great but I think it’s keto flu.
Need more salt, I have lost almost 3 kilos [6.6lbs] in water weight.

A few days later:

My pulse was a bit higher and I even had a low pressure moment where I had to sit down on day two or something, so quite extreme [keto-]flu/adaptation. Now I am feeling normal.

Apart from the keto adaptation, subject at first seemed pretty happy with the diet:

Other than that, I think this diet is easy to follow, no cravings,
most hunger related to ghrelin response so it should be passed in a couple days.

Unfortunately, over the next few weeks, the subject would find the diet quite boring and socially restrictive. He ended the experiment on day 26. Neither of us thought the remaining 4 days would’ve made a big difference.

Let’s take a look at his weight over the experiment:

Rapid water weight loss in the beginning, followed by much slower weight loss.

There’s the characteristic rapid water drop in the beginning. But then, his weight goes back up for another week or so. It ends up coming down a bit more after that, but not substantially - he never goes another kilo (2.2lbs) below his original water-weight low.

If we take the lowest weight, the subject lost about 8.5lbs in 20 days, but then went back up a bit for a final 5lbs lost.

The subject noted throughout that the diet was socially restrictive. E.g. he’d have family and social obligations where he could not adhere to the diet. Luckily, he recorded all these meals, and so we can superimpose them on the graph and take a look:

Weight graph with cheat meals.

We can see that the subject deviated from the diet a few times. Not all of them have an immediately measurable negative effect on weight loss.

1. In the beginning, subject had coffee with milk and sugar a few times, and a little bit of cheese. This doesn’t seem to have had any effect on weight loss, or maybe it was still masked by drastic water weight loss.

2. After the water weight loss was over, subject had potatoes with cheese. This seems to have increased his weight for a few days. It could just be some glycogen replenishment + the high fiber from the potatoes binding water.

3. Then, subject had a “full cheat day” that didn’t budge much. He gained a tiny bit of weight the next day, but promptly began losing it again. This could indicate that this whole middle section is just water + glycogen.

4. Subject then stayed very strict for about a week and lost all that weight again, even going below his previous low.

5. For two days, he ate very slightly higher protein and some carbs, and promptly gained a tiny bit of water weight, which came off right away.

6. Near the end, subject just went off the diet completely for 2 days, involving social functions. This involved a “brutal amount of carbs” and there’s a massive spike back up to nearly his original weight. The subject notes that he isn’t sure if maybe his scale was off that day, as the spike seems pretty extreme and comes back down quickly.

I think that last spike could actually just be water weight, not a scale error. 8lbs in 3 days is a lot, but I’ve seen it quite a bit in my own experience with temporary weight fluctuations. That said, it is a huge outlier on his graph, even compared to his previous cheat meals.

Subjective well-being: Keto-flu, bored with cream

Despite initial optimism, the subject ended up not being very happy with the diet.

• Initially, he got a really bad case of keto flu that lasted an entire week.

• He found the diet boring, and didn’t enjoy the cream much. At various times he noted that he was probably undereating, just because he didn’t like the cream.

• After a while he began adding salted butter to his coffee instead, and liked this much better.

• He craved salt. ex150 is not technically restrictive on salt, although I personally don’t add any salt to my food. After he brought this up and we clarified it, subject began adding salt liberally and this seemed to make it more palatable.

• I somewhat suspect that the salt craving is really a need for higher protein. The extreme protein limitation on ex150 is specifically designed for people with weird, messed up protein metabolism (like myself). It’s possible the subject does not have this issue and can/should eat much more protein.

• Subject has lots of social events in his life that make abstaining from food awkward. This made the diet impractical, and he deviated on various occasions. An interesting point, as I’m sure it could be modified to fit better into social settings.

Interesting quotes

Despite the heavy bout of keto flu, and the fact that the diet didn’t end up working out for him, subject kept in good spirits the entire time.

I'm quitting, 4 days short! Real weight loss has been.. around 8 pounds I think, which is fine, but I found it quite unbearable on a magnitude of factors.

I found cream to be quite.. boring, I found myself hungry but trying to avoid cream, but my life improved quite a lot when I added salted butter (in the order or 30g per coffee) to the cream.

This is great feedback. Honestly, what were the chances that EVERYBODY loves heavy cream? I should explore other substrates in the future.

Other than that, I think this has the potential to work, if the protein doesn’t have to be that low, and we found other sources of fat that can offer variability. For the keto people, I think this is a good approach. [..] I think the princess is in another castle for my metabolism.

It’s likely that the subject doesn’t need to restrict his protein as drastically as I (and some others) do.

I think of ex150 as pushing several buttons: it’s ketogenic af, very low protein, near-zero-PUFA. I ended up with all these because just going keto wasn’t working for me.

But many people probably don’t need to push all the buttons. The subject might do much better on a slightly less ketogenic, higher-protein diet. Or maybe it doesn’t even have to be ketogenic. (Blasphemy!)

If I were to prescribe this diet to somebody, I would
slowly (4-5 days) make them reduce carb intake, to avoid [keto] flu.

Another valuable piece of feedback. Sometimes I forget not everybody is doing keto. It’s become so normal for me after 7+ years, and so many of my friends do it, that it’s just become the status quo in my mind.

But many people who start keto experience severe keto flu, and I should probably build that into the trial protocol to avoid the experience this subject had. Nobody wants to be miserable for a week.

Body odor was quite Keto like, way more than any of my keto bouts. [..] I would say urine started to really smell after the flu was gone. Usual keto symptoms I guess.

This is a symptom some people report when they transition to keto. After nearly a decade I honestly don’t remember if I had this.

Going forward: Avoid PUFAs, try out a more mixed high-fat diet

The subject has already come up with another diet he’s going to try. Let a thousand diet experiments bloom. What more can a citizen scientist hope for than to inspire another?

As always, let’s close with a quote from the subject:

Well, this was an experience, overall I don’t think 3 kilos
was enough to warrant this level of restriction.

Cream, even though I don’t hate it, is not something enticing enough for me to actually enjoy in any meaningful way, so I think I was eating less calories than I wanted to, just because I found it unpleasant to just take a glass of plain cream.

I will try to avoid PUFAs and see if eating to satiety with high fat foods helps me equalize the weight. If I see it going up, another experiment is coming. To be clear this has been my fattest at 100 kilos, I never have been truly lean, but I don’t see myself as a terrible obese human with a totally fucked up metabolism, so I conclude that the princess is in another castle for me.