Under Eating, Over Training Syndrome Part 3
Restoring balance after long term or yo-yo dieting.
Probably one of the most challenging aspects of dealing with a client who has been undereating and over training for some time is the combination of physiological dysfunction and also psychological stress.
As well as the potential physiological issues as outlined in the part 2 of this series, we have to remember that psychologically those that do under eat and over train chronically, may have some major blocks and fears of certain foods or lifestyle change.
Commonly I will receive resistance from clients in this position when recommending them to:
- Lower the amount of training they are doing
- Change the type of training they are doing
- Increase the level of calories consumed
- Increase the amounts of fats or carbs consumed
The process of change for both physiological and psychological reasons needs to be slow, and so long as progress is in the right direction then this is the correct thing to do.
Unfortunately the goal of ‘weight loss’ in someone that has been trying to force their body into weight loss for years or has a history of yo-yo dieting may not be realistic in the initial stages, thus focus instead should be put on improving health instead. This is why I have my clients take my online health quiz, because that way we can shift the focus away from body composition to health.
Knowing where to start
To begin with you must understand where you are coming from, so a detailed food diary for a week, with calories and macro’s is always best. Something like www.myfitnesspal.com can be of use.
Once you have an understanding of intake you can then set some small adjustments such as:
- Increase caloric intake by 200kcals per day
- Raise carb intake by 50g per day
- Introduce these carbs in the meal before and after training to help fuel your workout and improve recovery
Making small adaptations can be important on a psychological level because many clients with this issue have a significant fear of gaining body weight or fat and thus by making gradual changes using good quality whole foods we are better able to improve health but also help to prevent fat gain.
In many instances clients will actually start to lower body fat as they experience an increase in hormones like thyroid hormone and an increase in total nutrient status, which has the potential capability of improving overall cellular function and energy production.
The goal is to try and increase caloric intake further and further over time, taking them closer and closer to a level that is acceptable.
In my opinion no one should ever be on a diet for longer than a few days that is below the basal metabolic rate (BMR) and the goal should be to return the client to a level of calories that is no longer in negative balance. If you are using low calorie days when dieting then higher calorie days should be cycled in as part of the plan to prevent suppression of many bodily systems.
Calculating your BMR is pretty easy, there are many websites online such as this one, where you can calculate your rough BMR. This is always a little different from one person to another and with lowered metabolic function at that point in time it may be lower than what is predicted, however this should be the absolute minimum goal for someone who is not training, and using the Harris Benedict Equation you should be able to calculate close to your target caloric intake.
Fixating someone on calories is not always the most sensible idea, and in many cases my goal will just be to encourage the right types of foods, not skipping meals and creating a positive relationship with food once more, whilst working on reducing caloric expenditure and increasing the rest and recovery lifestyle exercises.
What lifestyle changes are best?
For many the chronic exercise aspect of those that train lots and eat little is escapism from other life stressors. Understanding any deeper underlying issues or stressors is important, however I feel there are some good lifestyle practices that can better help someone handle and overcome stressors whilst reducing their training volume and stress.
I like my clients to introduce these in at times that they would be normally doing their intense exercise. I am also open to more restorative exercise like yoga during these times.
Other luxury’s to optimise health
Lab testing can be a significant help when trying to get someone to recover as quickly as possible and formulating correct supplement programming. With regards to these type of clients I would recommend the follow tests if budget allowed.
1. Comprehensive blood chemistry including:
- Thyroid markers TSH, T4 and T3
- Liver & Kidney markers
- White blood cell and a full breakdown of the distribution of white blood cells
- Markers for iron status and anemia risk
2. Urine Organic Acids Test (looks at functional nutritional insufficiencies that may influence energy production & thyroid function).
3. Red Blood Cell magnesium, zinc, selenium, copper & potassium