I find it very hard to consistently lose fat. Even with fasting at 1200 calories/day fat loss will stall for me after 2 weeks. I have about 5 years of consistent data on the same bioimpedance home scale and a few years of 2x/year dexa scans.
Unrelated to fat loss I recently had to take a 5 day course of Prednisone. I felt great while on it. At the gym I noticed I had about 5 extra reps on every exercise. On the scale I was losing 1lb of fat and gaining 1lb of muscle every day while on it. I looked shredded after the 5 days. When I stopped the drug the fat starting slowing increasing.
Overall question: What is happening here? Is it possible this is simply an artifact of the way scale works with fluid retention or other confounders? Is possible a lack of inflammation unlocks some vector of metabolism that is otherwise blocked for me?
Since there are real downsides to taking Prednisone long term, is some way to replicate the mechanism with another drug class or supplement?
Adiponectin?
Type of doctor would understand all this and can help me sort out what is what?
I have no personal experience, but my wife was a competitive swimmer training 2x a day x 6 days per-week, right up to her early 20s. Most of the athletes in her squad were using prednisone before comps, even as young teenagers… So I’m not surprised you found it effective.
Clearly an artifact as nobody gains a pound of muscle in one day. Losing a pound of fat possibly but highly unlikely. Avoid prednisone unless you medically require it. Just too many negative effects. And fasting is not the way to loss fat if you want to keep muscle.
I’ve never met anyone who found this easy.
In my experience fat loss requires:
Caloric deficit, which requires some combination of (i) reducing intake, (ii) exercise, and (iii) cold therapy (this also helps reduce inflammation, which supports fat loss), but not too much of a deficit such that you drive yourself into starvation mode.
Sufficient intake of protein to preserve muscle mass and support your activity level - Attia has recommendations on this. I find I need between 1 gram of protein per pound of lean body mass and 1 pound per pound of body weight. It takes a lot to consume this level of protein.
Supplements to help address inflammation including (i) low dose aspirin and (ii) fish oil 10,000mg/day.
Multivitamin/Multi-mineral supplements.
Electrolytes: 3-5 g of sodium, ~1 g of potassium, 500 mg of magnesium, and maybe 600-1000mg/day of calcium.
Fiber: lots of fibrous vegetables (broccoli, cauliflower, etc) and/or some combination of resistant starch (e.g. potato starch), inulin, and psyllium seed husks.
No medium to high glycemic carbohydrates.
Hydration - 3 to 4 liters pre day. Ice water will move the calorie deficit in your favor.
Discipline (really an alignment of all the different “voices” or “interests” in one’s head).
I find I can vary fat and carbohydrate levels (still keeping them pretty low) to achieve faster or slower fat loss.
It would help to know your current weight and body fat measures.
That said, in my experience, fasting (essentially caloric deficit) doesn’t do enough unless one supports it with the kind of things described above.
If something like the above doesn’t work, the composition of your microbiome likely presents a problem.
Researchers have done a number of studies exchanging microbiomes (essentially fecal transplants) between mice with low body fat and mice with high body fat. Without changing calories, the lean mice increased their body fat and the high body fat mice got leaner.
Prebiotics and probiotics (e.g., Akkermansia Mucinilpha) may help, but short of fecal implants I don’t know that anyone has a tested protocol that works.
Prednisone reduces inflammation and when starting can alleviate symptoms of various conditions, elevate mood and/or produce euphoria which can be perceived as increased energy .
Prednisone often increases appetite, which can lead to higher calorie intake and potentially more energy. If increased appetite has you consuming more protein, this alone could drive the results you’ve reported.
Certainly possible. Hydration and fluid retention will significantly affect body composition. You can test this yourself by:
Weigh yourself first thing in the morning after urinating (and defecating if you need to) and before drinking or eating.
Hydrate by consuming 1 to 1.5 liters of water over the next 1/2 hour.
90 minutes after waking urinate and/or dedicate as needed and then weigh yourself again.
Take in nothing else but the water prior to your 2nd weighing.
When I do this I’ll weigh up to a couple of pounds more at the second weighing and I’ll measure 1.5 to 2 percentage points less of body fat.
I absolutely agree. The only nuance would be if you had Addison’s disease where your adrenal glands were truly failing (which is very rare) then one could feel a lot better with prednisone. However, you’d need this diagnosis first.
That is unlikely to be the situation - and short term use of steroids increase risk of sepsis, fractures, and blood clots to the lung BMJ Article on Issues with Taking Steroids Short Term
Long term is a whole other animal, obesity, diabetes, osteoporosis, muscle wasting, skin and subcutaneous wasting, immunosuppression … to name but a few.
Unless there is a good reason, diagnosed by a physician for being on steroids … I’d not be taking these at all.
I think metformin helped me lose weight. I started metformin about 6 years ago when it was talked about for longevity. I didn’t know that it induces weight loss in some people and can modulate compulsive behavior. After about a year on it I had lost nearly 20 lbs and also I didn’t pick at my fingernails any more. I didn’t associate this with metformin until about 3 years ago, when I read that it can have such effects. Now I’ve switched to Oramet, that is ER metformin and dapaglifloxin, and I’m down to the weight I was in high school, so 205lbs to 155lbs in six years without really trying. I know there is the issue with metformin and muscle growth, but I don’t perceive any muscle loss, actually quite the opposite. Maybe I’m just a “super-responder” to metformin, or maybe it’s other factors or just getting older, idk, mtc. Best Wishes.
@Alpha you’re making it way too complicated. While everything you listed is good for a person’s health, only one thing is needed to lose weight: Fewer calories in than calories out.
Respectfully, I think “Fewer calories in than calories out” simplifies it too much. Losing weight while losing muscle mass doesn’t have the same benefit as losing weight while maintaining muscle.
Muscle, strength, and functionality from having it all support longevity and healthspan.
The OP clearly wants to lose weight and has expressed an interest in figuring out how to get the benefits of Prednisone while trying to stay healthy. Isn’t that an appeal for biohacking information?
While you are correct about it not being simple to lose weight and maintain muscle, you have thrown in a lot of unnecessary stuff.
It’s really just calories in less than calories out with adequate protein intake and resistance training.
@bobby4862, My reply isn’t about prednisone but about a class I took last year that I think could possibly be helpful for your fat loss/muscle gain.
Last year I took a class called Data Driven Fasting which utilizes blood glucose as your body’s fuel gauge to help guide when you eat. It was very simple and effective but challenging as your personal glucose trigger gradually drops over 30 days. This helps ensure the body is tapping into burning body fat. In the end it’s still calories in and calories out but it takes out the guess work. It’s not free but I believe it’s less than 50 USD currently. For the class people need a basic glucometer which is an additional small expense. You can read about it more here if it is of interest to you. I’m not financially associated with them-just a happy customer.
In contrast to the subjects in the BMJ article, who were taking 20 mg per day, I may take 5 mg every two weeks or so if I have a disk flareup. I then taper down for a few days to prevent withdrawal symptoms. Does this seem like a dangerous approach to you?
I’d be hard pressed to show any adverse event from 5 mg of prednisone every 2 weeks. However, I’d point out that this would be a homeopathic dose, not expected to do anything. This is a medication with a half life of around 20-30 hours.
There are no studies that show any benefit for things like degenerative disc disease, even in big doses. There was one, which I think was 60 or 80 mg daily for 21 days showed a statically barely significant benefit - but no meaningful clinical benefit (this was for radicular back pain).
That being said - we see huge variances in individuals experiences … but pharmacologically - see no reason for use of steroids for that indications, and the dose and dosing frequency would be inconsistent with making any clinical benefit.
Along with this - everyone’s experience and response to therapy is their reality, with placebo or real.