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The truth about metabolic damage

Die Wahrheit über Stoffwechselschäden

Here's a quick summary:

  1. Are you struggling with a lack of motivation or a low libido, or do you just no longer respond to your workouts or diet even though you feel like you've been doing everything right?
  2. You can feel unwell and suffer from metabolic dysfunction without obviously suffering from an illness.
  3. "Eat less and train more" can lead even an experienced strength athlete into a state of metabolic damage.
  4. Your metabolism doesn't work like a calculator. It works like a thermostat.
  5. There are three ways to repair your metabolism, depending on which level of starvation mode you are in.

Starvation mode, metabolic damage, weight loss resistance, adrenal exhaustion. For some reason, these terms get under people's skin. You constantly hear "this is a myth" or "that's a myth" and why these things are made up. This reminds me of a saying by Osho, my favorite philosopher: "The less a person knows, the more stubbornly they know."

None of these concepts are myths and many people struggle with these issues. If you are one of those people in your early 20s with great energy, a perfect body, but little real life experience, then you will probably ignore this article out of hand or not take it seriously. But do me a favor: bookmark the link to this article. You may well need it at some point. If, on the other hand, you're someone who struggles with a lack of motivation, low libido, overtraining or illness, or you don't respond to your training or diet like you used to, even though you feel like you're doing everything right, then this is an article for you.

The underlying terminology

Honestly, I don't know where these terms come from. Like many things in the field of health and fitness, these were terms that were used somewhere and then became part of the dictionary. I am an integrative physician. I, and many physicians like me, have been dealing with the problem of metabolic damage for years. We've just never called it "metabolic damage" or "starvation mode." We refer to it as neuroindocrine immune dysfunction. Or we refer to it by some of its manifestations like "adrenal fatigue." Sometimes, when an actual diagnosis can be made, we refer to it as hypothyroidism or Hashimoto's or "adrenal insufficiency."

I have adopted the term "metabolic damage" as it is more descriptive and easier to understand than neuroindocrine immune dysfunction.

Dysfunction vs. disease

Here is some insight into the field of medicine and health that is important for further understanding. A person can feel unwell and suffer from metabolic dysfunction without being in an overt disease state. It makes sense to most people that you can suffer from metabolic dysfunction long before you develop a metabolic disease. And traditional medicine doesn't have much to offer as long as there is no diagnosis. This is the reason why the field of functional medicine was created.

Functional medicine is a medical specialty that deals with the gray area of dysfunction between health and disease. This is the type of medicine I practice - and this is also the field where non-diagnostic terms like "adrenal fatigue" come from. Let me give you a tangible example of this problem. Let's say you're not feeling so well - you're hungry all the time, you're urinating more frequently than normal and you're gaining weight. If you go to a traditional doctor with these symptoms, they will do a blood sugar test to rule out diabetes. If your fasting blood sugar level is below 119, then you don't have diabetes, but if it reaches 120, then you do. Do you see how ridiculous this is? Long before you reach a fasting blood sugar of 120, you will suffer from serious dysfunction. But no one is sure what to call this. Medicine has many names for this, which include blood sugar dysregulation, glycemic impairment, prediabetes, etc.. But none of these are accepted diagnoses. They are simply descriptive terms that describe a measurable disorder that has not yet developed into a disease. The terms metabolic damage, starvation mode suffer from the same problem. They describe a functional disorder that may or may not be related to a specific disease.

Long before attention deficit disorder, polycystic ovary syndrome, fibromyalgia and chronic fatigue syndrome became medical diagnoses, they were labeled myths and their existence was denied. At the same time, forward-thinking physicians have begun to treat these conditions and define their characteristics. To say that metabolic damage or starvation mode is a myth is like saying prediabetes is a myth. To say that adrenal fatigue does not exist is like saying that overtraining does not exist. These are functional disorders that have clinical signs and symptoms that can be detected on physical examination and blood tests. These disorders may not have a diagnostic label, but that doesn't mean they don't exist. This is the gray area between optimal health and disease - the area where functions begin to be impaired.

So what exactly is starvation mode?

Starvation mode and metabolic damage are real. To make this topic easier to deal with, I'll refer to this concept as starvation mode from this point forward (you'll see how metabolic damage fits in shortly). The funny thing is that when you see what starvation mode really is, you'll probably understand very quickly what we're talking about here. I've found that the confusion around these topics is usually due to the lack of an organizing framework to understand things. In reality, starvation mode is undoubtedly the most widely accepted occurrence in all diet research. But scientists don't call it "starvation mode", they call it adaptive thermogenesis. I call it the law of metabolic compensation. I call it a "law" because it is a reliable and predictable phenomenon that occurs in every dieting scenario. It's just the degree that varies. You can think of this as a natural protective mechanism that the metabolism has developed over millions of years. This protective mechanism is what kept us from starving when the next meal was never guaranteed. Whether you are a lean bodybuilder, an elite athlete or the average person trying to lose weight, you will be affected by your body's metabolic compensation.

Metabolic damage: an example

Let's go through this with an example. Things start with a diet. By diet, I mean a combination of eating less and exercising more. In the beginning, you seem to make good progress. You lose a few pounds quickly. So far so good. After a week of this diet, you will start to feel hungry as your energy levels drop and you experience cravings for salty, fatty and sweet foods. This is a sign that you are beginning to slip into a state of metabolic compensation. Think of this as starvation mode stage 1.

Due to this compensation, you will notice that your fat loss slows down. It may even come to a complete standstill. And if you are one of those people who experience a significant drop in metabolic rate, you may even start to put on weight. And your hunger and problems with energy and cravings will get worse.

But you're not playing games. You pride yourself on your iron will and solid work ethic. You're redoubling your efforts by cutting your calories further and upping your time at the gym. Nice. Now it's time to get moving again. Your weight drops another pound or two. But this trend doesn't last. A few weeks later, you're stuck on the next plateau. This time the hunger and cravings are even worse and your energy has gone down the drain. Your metabolism doesn't keep running like before. Your metabolic rate slows down even further. You may try even harder, but your body won't give in. You seem to be doing everything right, but your metabolism switches to stubborn. You have reached the state of metabolic resistance. This is starvation mode level 2. You don't understand what the hell is going on here, but you know how to deal with it. All you have to do is work even harder. You watch Conan the Barbarian and turn the theme music from Rocky up to full volume. You quadruple your efforts! You will get very little for your efforts this time. You've been dieting for weeks and you feel exhausted. And now you have other complaints. You suffer from flatulence and feel bloated. The protein that you used to tolerate very well is now causing you digestive problems. You also get heartburn. If you are a woman, your cycle becomes irregular or you no longer menstruate at all. If you are a man, your libido is in the basement.

Your sleep is interrupted and unpredictable. You have this strange feeling of inner restlessness but outward tiredness. You start to feel sick and unwell. You may be anxious, depressed or both. And you gain weight slowly, look bloated despite a low-carb diet and can no longer maintain your workouts. This is metabolic damage stage 3 and the final stage of starvation mode.

What you should not do

Get help now. All those statements that metabolic damage is just a myth are coming back to haunt you. So you go to a trainer. You tell him what's going on and he tells you "You're in starvation mode. You need to eat more and cut back on your training." He'll tell you to double your calorie intake and slow down your insane exercise program. Guess what will happen? You'll rise like a yeast dumpling. While your metabolism is moving slowly like a snail, you've done exactly the wrong thing. That was not a smart move. You gain 15 pounds in 6 days (I've seen this kind of effect in several patients)! Of course, it's physiologically impossible to gain that much fat in such a short period of time - it's almost all water, but it's a sign that your metabolism isn't working very well.

You want answers, which is why you're seeing a doctor. Maybe they'll diagnose hypothyroidism or some other problem, or maybe they'll say there's nothing wrong with you. Obviously, they won't have any answers. If you are really unlucky, he will advise you to go back to your approach of eating less and exercising more. But this approach will still not work and you will only get further into the downward spiral, causing further damage to your physiology and your psyche.

How to repair metabolic damage

Here's what you need to know about your metabolism. It doesn't work like a calculator - it works like a thermostat. And your thermostat is now broken. When the "eat less, exercise more" approach to changing your body is taken to the extreme, it's like a tug-of-war you can never win. You pull and your metabolism pulls back. You push harder and your metabolism laughs and almost sweeps you off your feet. What's the only way to win a tug of war against a team that's stronger than you? Let go of the rope when they pull and let them fall helplessly to the ground. That's the way out of starvation mode.

How to get out of starvation mode again

Regardless of which phase you are in, the first step is to stop eating less and start exercising more. At this point, you have two options: You can either eat less and exercise less or eat more and exercise more. This is the only way to reduce the stress on your metabolism without gaining weight. However, if you have already reached stage 3, then your only option is to eat less and exercise less.

How to get your metabolism back in order

1. metabolic compensation

This phase is easy to deal with. Take a "eat less, exercise less" or "eat more and exercise more" approach. Both will work. As long as you get away from the "eat less, exercise more" approach, you'll be back on track within a week.

2. metabolic resistance

This won't be that hard to deal with either. Just use a cyclical diet. Spend 2 to 3 weeks in an "eat less, exercise less" phase and then move to an "eat more, exercise more" approach. You may need to take a few more steps. This could include prioritizing rest and recovery. Walking, massage, sauna therapy, naps, sex/physical affection, laughter, time with pets, etc. - basically anything that lowers your stress hormone levels and rebalances your neuroendocrine system. Expect to be back on track within 1 to 3 months.

3. metabolic damage

Once you get to this point, you don't have many options. "Eat less, exercise less" is the only choice you have. You need to fully focus on rest and recovery. Walking and a few traditional workouts with weights will probably be all you'll be able to do. Consulting a doctor who specializes in functional medicine would be a good idea. Such a doctor will be able to evaluate thyroid function, adrenal function and gonadal function. This is beyond the focus of a trainer. Supplements and hormones may be needed. With the right help, you can be back on track within 3 to 15 months.

The ideal scenario? Try not to get into such a situation in the first place.


  1. Major, et. al.Clinical significance of adaptive thermogenesis. International Journal of Obesity. 2007 Feb;31(2):204-12. PUBMED
  2. Jason, et al. Chronic fatigue syndrome versus neuroendocrineimmune dysfunction syndrome:differential attributions. Journal of Health & Social Policy 2003;18(1):43-55. PUBMED
  3. Muller, et. al. Adaptive thermogenesis with weight loss in humans. Obesity. Feb;21(2):218-228. PUBMED
  4. Rosenbaum, et. al. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. American Journal of Clinical Nutrition. 2008;88(4): 906-912.
  5. Camps, et. al. Weight loss, weight maintenance, and adaptive thermogenesis. American Journal of Clinical Nutrition. 2013;97(5):990-994. PUBMED
  6. Tremblay, et. al Adaptive reduction in thermogenesis and resistance to lose fat in obese men. British Journal of Nutrition. 2009;102(4):488-492. PUBMED
  7. Labayen, et. al Role of baseline leptin and ghrelin levels on body weight and fat mass changes after an energy-restricted diet intervention in obese women: effects on energy metabolism. The Journal of Clinical Endocrinology & Metabolism. 2011;96(6):E996-1000. PUBMED
  8. Miller, et. al. Resistance to slimming: adaptation or illusion? Lancet. 1975;1(7910):773-775. PUBMED
  9. Winsier, et. al. Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. American Journal of Clinical Nutrition. 2000;72(5):1088-94. PUBMED

By Dr. Jade Teta

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