ex150 trial results: 9.6lbs average weight loss

n=10, 70% completion rate

Somehow, everybody really only likes to quote the first half.

Overview

I have been delaying writing this post for a few weeks now.

Just like the proverbial dog chasing an automobile, I realized that I didn’t know what to do next.

When I first asked for volunteers to try ex150, I was worried: what if this crazy cream diet doesn’t work for anyone else? What if it only works for me?

Spoiler alert: it seems to work for nearly everybody. Young and old, men and women, obese to normal weight, very active to lazy.

For some reason, this didn’t make me happy, but anxious. Because now it’s not over.

Do Minimal Viable Trials that Don’t Scale

There are 2 ideas from the software startup world that I tried to apply to this trial.

1. Minimal Viable Product (MVP)

2. Do Things That Don’t Scale

Software is famously only really good at scaling things. If you write a program that can do a task once, it can do it a million times for only a marginally higher cost.

But this led a lot of software companies to sit in their basements for 10 years, trying to develop the perfect product that would make them rich when it finally came out.

And when it came out, nobody wanted to buy it.

The idea behind the MVP and Doing Things That Don’t Scale is that you learn as you go. While your software might be impressive at what it does, that’s only helpful if it does something useful.

So, instead of tinkering in a vacuum for 10 years, you build the minimal product that could possibly “fit” your intended market - and you present it to them. It might not be 100% what they want, but it should at least be somewhat close. Then you iterate and develop something slightly better. Over time, this helps you find “product-market fit,” aka a product that people are actually interested in buying. This is also referred to as “talking to your customers.” Crazy, I know. But remember, we’re talking about programmers here.

I think that a lot of mainstream nutrition science has fallen for a similar fallacy as the 10-year tinkerer in the garage: they come up with all sorts of theories, hypotheses, and models, and they work great in mice or rats or people who live in a metabolic ward for 3 days under 24/7 surveillance.

But none of them seem to make a dent in the real world. Mainstream nutrition science is not connected to reality.

The gall.

Ever notice how nobody in the Mediterranean is eating the Mediterranean diet? That’s because it was cooked up by an American academic on vacation, who created some illusory diet he imagined the locals might eat, and that might be healthy. He was wrong on both counts, but when has that ever stopped anyone?

Law of Small Numbers

When Slime Mold Time Mold came out with the results for their first Potato Trial, they reported having 209 participants. At that level of participation, I couldn’t possibly create a personal connection with each of the participants. People become a statistic. The trial design becomes very important, because you can’t course-adjust or learn qualitatively. All you have is the data that comes in.

SM TM still managed to get a pretty good impression of the qualitative factors, like palatability of the diet, enjoyment, satiety, subjective well-being, ease of sticking to it, and other factors important for any real-world diet, but nearly impossible to quantify.

The diet needs to work for people who are not me

I was convinced this was super important. I realize I’m a whacko when it comes to diet. When I was in college, my roommate commented one day that I’d been eating the same bacon & eggs breakfast for 3 months in a row. I had not noticed.

People worry about me.

Yea, I’ll happily eat cream for the rest of my life. Why not? That’s not difficult for me.

But I’m not like other people. Apparently.

So I decided it was important that I “talk to my customers” and find “product-market fit”: the diet actually had to work for people. Anybody with a serious amount of fat to lose (e.g. 50lbs or more) will need to stick to a diet for at least half a year, possibly several years. And they will likely have to make some pretty big changes that they need to keep up even when reaching the goal weight, or it’ll all just come back.

In other words, I wanted to hear and learn from the trial participants as much as possible. I set a goal participation number of maybe 10-20 people at most. It ended up being 10.

I set up a group chat for the participants, and it was surprisingly active during the trial. Not everybody joined in, but quite a few people commented daily, encouraging each other or sharing tips. It was great. Everybody was super nice.

And I learned a lot from the participants. That’s why you see so many qualitative/subjective quotes in the case studies. The sheer poundage is important, as a diet that doesn’t help you lose fat isn’t useful to lose fat. But it’s just as important that you will actually stick to it, enjoy it, manage to fit it into your life, and not hate yourself while on it.

Intake questions

Whenever somebody contacted me about partaking in the trial, I would first send them a bunch of intake questions. These weren’t designed to weed out anyone, I didn’t reject a single person who was interested. It was merely to put into perspective their experience on the diet, and help me understand their personal weight situation.

Here are the questions:

Before

Diet goal? Specific, e.g. lose X lbs
Coffee/tea drinker?
Done low-carb/keto/carnivore before?
How much control over diet
When will you do the trial?
Do you want to join the trial community?
Can I share your thoughts publicly (anonymous of course)?

Track daily

Weight
Adherence
Subjective well-being

After

Spreadsheet
Experience report/summary

You can contact me at any time with questions or anything else

On quitting

Totally fine to quit
Please report when you're quitting, the reason, and data so far

I thought a lot about the quitting. Clearly some people were going to quit, and I wanted to know why. I also knew that they wouldn’t, at that point, be super stoked to be talking about it. Nobody quits a diet because it’s working too well and they’re feeling amazing, so those people wouldn’t be in a great mood. But they would be very important to learn from, maybe the most important.

The Funnel

First, these participants are obviously not randomly selected from the wider population. People who read a blog about obesity are likely obese. People who sign up for a cream diet trial probably tolerate and enjoy cream. In fact, I think I specifically asked for people who like cream.

I asked if people had experience with low-carb/keto/carnivore, and 10 out of 10 did to various degrees. I wasn’t going to reject anybody who was new to low-carb, but that just tells you the level of pre-selection happening.

In short, it was like looking for football fans at the Superbowl.

So let’s look at the funnel:

16 people contacted me in total
10 decided to start the trial (62.5% conversion)
7 finished the trial (70% conversion)

Of the 3 that didn’t finish:
1 aborted after 5 days due to keto flu impairing his outdoor work, and let me know
2 never replied again

I assume that the 2 who never reported back found the diet hard to tolerate and quit relatively early.

I don’t have any weight data for the 3 that didn’t finish, and I didn’t write any case studies. That might’ve biased the overall perception a bit, since 100% of the people I posted case studies for saw good results. But I thought that was ok, since “Person never reported back. The end.” isn’t a super interesting case study, and I was going to mention the dropout rate in the final report (this post) anyway.

Of the people who contacted me, but never began the trial, most had personal reasons - upcoming family plans, an injury that would make a crazy diet an additional stress factor, uncertainty they’d be able to tolerate the diet after clarifying some issues.

Demographics

To my surprise, 7/10 participants were women. I don’t know what exactly I was expecting, but since I’m a guy, and I write like a guy, and the diet is kinda nuts, I just assumed I would get at least half guys?

Ages ranged from 26 to 64.

Starting weights ranged from 125lbs to 301lbs.

Height ranged from 5’3 (160cm) to 6’3 (190cm).

Starting BMIs ranged from 22.2 (normal weight) to 38 (very obese).

Most of the participants were not particularly active, but a few were extremely active.

9/10 participants reported consuming coffee or tea regularly, with 1 reporting “sometimes tea.”

Almost all of them reported having “very good” up to “100%” control over their diet. People who have terrible control over their diet probably don’t sign up for cream diets.

Almost everybody reported “lose weight” as their goal. Some also reported looking for good mood and energy levels.

One participant was worried the crazy diet might destabilize her mood, but luckily, that didn’t happen.

One participant, who wasn’t quite diabetic, but did worry about her elevated blood glucose, sought to lower her fasting glucose levels.

7 participants were American.
2 were European.
1 was British (is that European? I don’t know any more).

Weight loss

Here is a combined graph of the participants’ weight change over the 30 day trial:

What’s interesting is that you can pretty much predict the final weight loss tally from the initial water weight loss. The 2 participants with the steepest drop in the first 5 days finished #1 and #2 overall. These participants had the highest BMI to begin with.

The 2 participants with the least initial water weight loss had the lowest BMIs to begin with.

So the initial water weight drop seems related to overall fat mass, which is also my personal experience.

Participant result stats

Here are some relevant data points about the participants. I converted all heights to meters, because BMI is calculated using the metric system.

Most participants saw a very significant percentage change in their weight.

• They lost 9.6lbs on average

• They lost 4.74% of their body weight on average

• They reduced their BMI by 1.5 on average

In comparison, Slime Mold Time Mold’s potato study caused an average weight loss of 10.6lbs in 4 weeks (vs. my 30 days). Very similar, which is interesting because the 2 diets are pretty much the opposite in a sense - very-high-fat vs. very-high-carb. But both are low in protein and practically PUFA-free.

The SM TM study had a way bigger number of participants, so it would be cool to scale up the N on ex150 and see if the average weight loss stays the same, goes up, or goes down. In both the potato study and here, very strong fat loss outliers made up a good portion of the average loss.

For reference, the “miracle weight-loss drug” semaglutide produces a -14.9% weight delta - in 68 weeks. Several people in the ex150 trial achieved better than -6% in just 4 weeks. On average, participants reached about 1/3 of the semaglutide effect in just 4 weeks.

Sure, some of that is water weight. But I’d bet that some of the semaglutide loss is also water weight.

What I find interesting is the % delta over BMI. Obviously, somebody starting at a higher BMI has the ability to lose a higher % of body fat. Normalizing by BMI should give us a weight loss rate independent of current/start BMI.

And, in fact, we do see that. Almost everybody is in a pretty narrow range of around 0.11-0.18%.

The outliers are participants #2 and #6.

#2 included carbs weekly due to social obligations, and ate “a brutal amount of carbs” towards the end of the diet, reversing much of his loss throughout the trial. It makes sense that his weight loss rate would be lower.

If he had simply stopped recording his weight about 3 weeks in, when he was about 8.5lbs down, he would’ve had a rate of 0.13%/BMI, right in there. But I prefer taking people “as they come,” and his personal experience demonstrated that a heavily ketogenic diet isn’t necessarily a great fit for everyone, even if just socially. So we’ll take his final result of “only” 5.7lbs down.

#6 is honestly a surprise. She started with a normal BMI of 22, yet she had the 2nd highest weight loss by percentage change after #1. Her rate of 0.29%/BMI is nearly double that of the next highest (0.18%/BMI). She was the only participant to never cheat - maybe this was her secret?

Seeing most people lose weight at a very similar rate when normalized for BMI is pretty cool. This seems to suggest the diet works similarly for people of various BMIs, even when those starting with more weight have a bigger weight loss potential.

Takeaways

Everybody lost weight

I was surprised. I didn’t expect it to work for everyone. Even #2, who didn’t like the keto part and ate liberal amounts of carbs throughout, was down 8.5lbs at one point.

Even people who’d stalled out, or lost a lot before, lost weight

#1, who lost the highest % of body weight and in absolute terms, was already 50lbs down before she began ex150. And then lost another 14.7lbs.

It improved blood glucose dramatically for the 1 person who tracked it

Only one of the participants tracked her blood glucose, and they dropped from “high” to “totally normal” within 5 days of starting ex150, and stayed there unless she cheated. This was expected, as ex150 is very ketogenic.

Some people enjoyed the diet, some found it boring

This is a bit subjective and my reading of the experience reports, but I’d describe it like this:

• 4 people enjoyed or mostly enjoyed the diet.

• 2 people were split, e.g. they were very bored, but they had no issues sticking to it.

• 1 person really disliked the diet limitations and found it hard to stick to.

Several people actually really enjoyed the diet, as do I. Most of them reported that they liked the ease and simplicity, and not having to think about food. It helps if the 1 meal you’ll have every day is your favorite meal ;)

It also helps if you really like cream. #1, who lost the most weight in absolute and % terms, turned out to have a very similar upbringing and entirely the same food preferences as me. So the diet was basically designed for her.

Almost everyone found it easy to stick to

If I told you I had a diet that made the average person lose 9.6lbs in 30 days, what % of participants would you guess were able to easily stick to it?

The reason most people don’t stick to diets is allegedly that they don’t have “discipline” or something, and they long for more variety and more energy-dense foods.

Apparently this memo didn’t make it to the participants of this trial, who ate the majority of their calories from heavy cream, infamously energy-dense as it is about 35% pure fat by weight. And they also ate the exact same meal every day, mostly without any issues.

While the pre-selection might come into play here, I think this validates my hypothesis of why most diets don’t work: you can’t out-discipline biochemistry. If the diet leaves you biochemically starving, you will, sooner or later, give in.

Given that ex150 is ad-libitum of a very energy-dense but boring/plain food, and pretty much nobody had problems sticking to it, I think I’m onto something here.

It’s not that diets don’t work because people don’t adhere to them.
People don’t adhere to diets because they don’t work.

When the diet doesn’t biochemically work against them, people apparently have no issues whatsoever.

Undereating was a big problem for several people

Three people reported undereating pretty severely, to the point where they got fatigued or other symptoms. Most of them figured it out and added more cream, some more successfully than others.

The hunger signals on a heavily ketogenic diet like ex150 are severely blunted. Especially for those who worked out, this meant they needed to consciously eat more cream than they “felt like” or they would get fatigued, tired, or cramped.

As I reported previously, a lean, very active friend of mine regularly consumed over 4,500kcal/day just in heavy cream when on ex150, in addition to his normal meals.

One very active participant ate 2,700kcal/day during her trial - and lost 11lbs.

Could it be that ex150 increases the metabolic rate, causing people to burn this much energy and thus requiring them to consume more?

Maybe. It could also be that many people, especially those trying to lose weight, have been restricting their caloric intake for years. Upon consuming ad-libitum fat without the side-effect of fat gain, maybe their metabolisms just ramped back up to “normal?”

What would I change?

Sending in spreadheets vs. live data

I asked people to record their weight daily, and send me their data at the end, in whatever format they liked - a spreadsheet, a text file, just type everything into an email.

There are 3 downsides to this. First, I obviously have to convert it all into the same format to display. That wasn’t a super big deal with only 7 participants finishing the trial.

Second, I didn’t get any data from the participants until they finished the entire trial, or they told me in our little community chat. Luckily, most of the participants were eager to share their weight loss journey, and so I had some glimpses throughout.

The third downside: I didn’t get any data from the participants who didn’t finish. I don’t know if they made it 2 days, 7 days, 10 days, or never even started. That would be interesting to know.

Slime Mold Time Mold created a Google Sheet for their trial, and so they got all their data live and pre-formatted. I can see the upsides to that.

It wouldn’t scale

The communication with the trial participants was pretty detailed and personal, involving long emails, chats, and discussions. This was, of course, the goal of this first, small trial: getting to know “my customers.”

But it wouldn’t scale to even 20 or 50 participants, I think. Mentally keeping track of 7 people, with all their individual backgrounds and parameters, was just about the limit I could handle.

Toward the end, I realized that I had forgotten details about the first few participants, because it had been several weeks since I’d finished their case studies.

For any more serious number of participants, I would have to automate a lot of the intake and even support, and necessarily decrease the amount of personal interaction.

What’s next?

Like I said in the beginning, I’m like the dog who caught the car. I didn’t expect it to work this well for so many people. And I didn’t have a plan beyond “Wouldn’t it be cool to do an ex150 trial?”

Presumably, the next steps would involve nailing down what makes the diet work, and broadening the scope.

I think that, in weight loss terms, the diet worked well enough for everyone. Even the person who lost the least weight, and cheated at least weekly, lost a decent amount.

The no. 1 change people said they’d make after finishing the trial, and also the no. 1 question in my mind:

How much can we relax the diet?

The main questions here are variety, and protein.

How much more protein?

ex150 is extremely restrictive in protein, to the point that it is likely not sustainable long-term. I personally have been on ex150 for nearly a year, but I’ve regularly taken breaks where I eat a lot of protein to “refeed” myself.

Most of the trial participants who chose to continue with a version of ex150 also added more protein.

I’m hoping that it’ll still work with “adequate protein,” maybe defined as 0.5g/lb of lean or ideal body weight. But we’ll have to try it.

Other “harmless foods” like the illegal carrot salad

Several trial participants added “harmless” but pleasurable foods to the diet, e.g. an “illegal” carrot salad. Since the main tenets of the diet are “no PUFA, high saturated fat, low protein, low carbs” it is very possible that we could add tons of variety in terms of low-carb vegetables (pickles/cucumbers/tomatoes).

The daily meal itself might work over a pretty big variety of choices - what if we did different sauces? Swapped out something else for the beef, maybe eggs or lean chicken/pork/fish? (Lean because remember the PUFAs.) Maybe even cheese? Maybe a vegetarian version with tofu?

Are other saturated fats besides cream ok?

Some people don’t particularly like heavy cream, or are even allergic to dairy in some way. Maybe they could use cocoa butter/suet/coconut cream instead? Or is there something special about heavy cream?

Longer-term trials

This trial lasted for only a month. I lost plenty of weight over the first few months of ex150, but then stalled.

So it would be super interesting to see others do it longer, too. Will they stall?

For this, the diet would have to be more sustainable. I possess the superhuman ability to eat the exact same meal every day for almost a year now, but apparently, not everyone is like that.

And I wouldn’t be comfortable recommending such low protein intake to people for longer than a month or so. I take regular DEXA scans to make sure I’m not losing muscle mass, but not everybody does this. I’m also young enough and have enough muscle mass that I’m ok to lose a little bit. So having an adequate amount of protein in the diet would be a requirement.

It would also have to be more varied so people wouldn’t get bored: this would involve identifying harmless substitutions and additions.

Increase N

This would of course be the biggest lever, but I think it’s important to dial the diet in a bit more first.

One reason I wanted to be in close contact with the trial participants was so I’d be able to learn from them individually, or help them out if they had questions.

For a larger number of participants, say several hundred like in the Slime Mold Time Mold potato study, the diet would have to be a lot more “normal” and turn-key.

My study design and the current ex150 diet pretty much limited participation to people ready for extreme experiments.

Remember, 100% (!) of the participants had prior experience with low-carb, keto, or carnivore, many all three.

And all of the participants reported having “Very good” to “100%” control of their day-to-day food intake.

These were not average people.

In order for a bigger trial to be useful, I suspect the diet would have to be way more accommodating to the average person, maybe including snack ideas, strategies to socialize or eat at restaurants/work functions and holidays, and so on.

It would also have to be user-friendly enough that participants could just read about it, and then go do it, without much help or support from my side. Simply because I wouldn’t have the time to talk to hundreds of people.

What would be cool: a community of people helping each other. It was really nice to see the participants in this trial help and motivate each other, and answer questions even when I wasn’t present.

Non-ketoers?

If you recall, 10/10 of the participants had experience with low-carb, keto, or carnivore - most of them with several or all 3.

Would the diet work equally well for people who aren’t as experienced with low-carb? Or is it just a crazy special case of keto?

With an increased N, a more random selection of people would be interesting as well.

Huge thanks to the trial participants

I can’t thank everybody enough. Even the people who contacted me but ended up not doing the trial, or aborted it, taught me a lot. Seeing the differences and similarities in people’s weight loss backgrounds was fascinating.

Everybody was super nice, both in personal communication and in the community. Open-minded, helpful, and looking out for each other. That was super wholesome and made the trial such a breeze, and really fun.

Instead of “having” to pore over the data when a participant sent it, I actually really enjoyed reading the experience reports and visualizing each person’s weight loss journey for the first time. I counted the days until individual participants finished their trials. I was that excited to see the results.

Overall it was a very fun experience to run this trial, and I’m blown away by the results.

Thanks everyone, you were awesome.