🔓 PLUS PREVIEW: When to Push Through Pain, Pre-Exhaustion Training, and Conquering Cravings

0:01 [SPEAKER_00]: Welcome back to the Barbell Medicine podcast. [SPEAKER_00]: I'm Dr. Jordan Faganbaum. [SPEAKER_00]: This is a preview of some of the additional content that we regularly send out to our Barbell Medicine plus subscribers. [SPEAKER_00]: And if you like what you hear, you need to join. [SPEAKER_00]: Subscribers get the full ad-free experience, a ton of bonus content, and on top of all of that, massive discounts.

0:19 [SPEAKER_00]: To include 25% off all courses in seminars, 15% off consultations, 10% off all of our programs, early access to podcasts. [SPEAKER_00]: And that's for about the cost of a cup of coffee [SPEAKER_00]: All right, that's it for the pitch on to the show. [SPEAKER_00]: Let's get into the first question.

0:41 [SPEAKER_00]: So how often should an individual be experiencing pain or discomfort related to training? [SPEAKER_00]: If you can even attribute it to training. [SPEAKER_00]: That's actually a good question. [SPEAKER_00]: Uh, this person says, I sometimes experience pain or discomfort in the same areas when I'm pushing my training sessions over a training block.

0:58 [SPEAKER_00]: However, I'm curious as to whether or not there are some sort of established normal ranges of injury rates for people with the history of injury or pain and if so, do they vary based on the different areas of the body, so low back, need, et cetera. [SPEAKER_00]: So just to directly answer the question, no, there's no universally established, quote, normal range for the frequency of pain or injury recurrence.

1:18 [SPEAKER_00]: That said, it is common and it's often acceptable to experience some like low level self limiting discomfort or pain. [SPEAKER_00]: So like less than 3 out of 10 on a 0 to 10 scale during training that happens frequently. [SPEAKER_00]: I don't know that it's caused for a concern. [SPEAKER_00]: So for example, a pretty gnarly case of blade onset muscle soreness, for example, would probably be.

1:36 [SPEAKER_00]: that intensity. [SPEAKER_00]: But if it's not limiting performance doesn't cause like fear or anxiety around the issue and it's gone within a day or two like I'm not just talking about Dom's but whatever this this is. [SPEAKER_00]: I don't know that it's caused for concern. [SPEAKER_00]: I mean, we know injury rates, we have that data, right?

1:55 [SPEAKER_00]: So like two to four injuries per thousand participation hours is the general sort of range that we expect from resistance training, even for competitive barbell sports. [SPEAKER_00]: So if somebody's getting injured far more frequently than that, I guess that would be the normal, you know, if there was a normal range, if someone's getting like, [SPEAKER_00]: Look, dude, every thousand hours that I can log, I'm getting, that doesn't injuries.

2:18 [SPEAKER_00]: I'm like, that's probably more than I would expect. [SPEAKER_00]: On the other hand, if someone has no injuries for every thousand participation hours, I'm like, I do wonder, is this person actually exercising? [SPEAKER_00]: Or like, living, you know, are they in a bubble? [SPEAKER_00]: If so, like, send me the bubble.

2:31 [SPEAKER_00]: But probably the biggest modifying factor here and also I get you to weigh in on this is like the history of injury, right? [SPEAKER_00]: So if somebody has like, yeah, had a little back tweak, you know, four weeks ago or have had it persistently over the course of my adult life as far as I can remember.

2:47 [SPEAKER_00]: Yeah, I mean, it wouldn't surprise me that a person with that kind of history has more frequent sort of flare-ups just because of the history, I don't, you know, there are some [SPEAKER_00]: ways you can modify that trajectory like probably involving a change in training, you know, priority and kind of it's not our true rehab block, but it's more like we're missing some tall training tolerance here and what you're trying to do does not match up with your current fitness and training tolerance.

3:14 [SPEAKER_00]: So we need to take a step back and kind of fill in those gaps. [SPEAKER_00]: I mean, that's how I think about it. [SPEAKER_00]: Does that? [SPEAKER_00]: uh, square with your thoughts on this. [SPEAKER_01]: Yeah, I mean, I think both of us probably in looking back on our own training experience personally and with trainees, we have our own little like in column quote, quote, problem areas, so to speak, that the things that based on our prior experiences, prior injury history, things like that that might be a little bit more likely to get sensitive every now and then based on the, you know, relative training load and other factors that all go into the complex sort of pain experience.

3:47 [SPEAKER_01]: You know, I know that for me in the past, I've had a little bit more often like 10 to an issues with my elbows, I've had a little bit of some low back aches here and there, but I very infrequently deal with hip issues, for example, whereas I know that you have experienced more hip issues than I have.

4:05 [SPEAKER_01]: And those are just things that we are not like constantly ruminating over or worrying about or thinking about, but rather recognizing like when [SPEAKER_01]: We think about them a little bit differently probably. [SPEAKER_01]: If I have a little bit of a hit bake, it doesn't really flag much of anything for me and I'll probably, you know, my default will be to expect it'll probably get better in short order with maybe a little bit of modification or just some time, whereas in your case, given that you've got maybe a little bit more significant history in that area, it might flag as something that you might want to get on top of a little bit quicker.

4:36 [SPEAKER_01]: And not just as soon as it's going to be fine, it's like, well, you have the [SPEAKER_01]: and so being a little bit more proactive in that area might make sense. [SPEAKER_01]: So that's kind of my approach is if it's just a seemingly like a fluke thing that's not a recurring issue for me over time, and as you mentioned, not particularly severe, I'll give it a little bit of time.

4:56 [SPEAKER_01]: I might modify my next session, etc. [SPEAKER_01]: But if it's an area that is kind of starting to flare up where it's like cash I've dealt with this several times over the years, then I'm inclined to approach it a little bit differently. [SPEAKER_01]: But getting back as you mentioned to the original question, [SPEAKER_01]: There's not going to be like a normal quote unquote range around this, it's really like how much are you experiencing and is it something that's, you know, you're willing to tolerate for the outcomes that you're getting from your training.

5:20 [SPEAKER_01]: If it's like, well, I'm not making that much progress and I'm dealing with all this pain all the time, then I would say we need to modify things more significantly. [SPEAKER_01]: If you are making fantastic progress and you're having little aches and pains here and there that you're getting better on their own, I would say, I mean, [SPEAKER_01]: And then lastly, I would say, if you're like, well, I'm unwilling to deal with much of any pain.

5:43 [SPEAKER_01]: Well, we probably need to have a conversation about expectations. [SPEAKER_01]: And then also there might still be some room for modifying your training in a way that reduces that risk further. [SPEAKER_01]: But I don't think that there is a lot of room for like the type of folks out there in the industry who promote like here's my system for pain free training like forever.

5:59 [SPEAKER_01]: That's unrealistic, right? [SPEAKER_01]: So those are kind of like the different tiers that I would think of here. [SPEAKER_01]: how much are you experiencing, how much are you willing to tolerate in terms of severity, frequency, intensity, etc. [SPEAKER_01]: And then what's the context of like how much progress are you making?

6:12 [SPEAKER_01]: And is it does that make it worthwhile for you or not? [SPEAKER_01]: Or is it like a time-limited thing where I got these aches? [SPEAKER_01]: But I got a meet coming up and I'm making great progress. [SPEAKER_01]: Maybe he'll, you know, compete and then I'll change things more substantially.

6:22 [SPEAKER_01]: After that, there's all sorts of ways that you can go about kind of triaging, prioritizing, deciding what your next steps are going to be. [SPEAKER_00]: Yeah, and I would just to add to this that, you know, we think about areas or particular places that, you know, get get injured, we think of low back, shoulder knee, these are all very common, but not just in like barbell sports training, just in like human existence.

6:44 [SPEAKER_00]: So it's not like the prevalence of low back injuries and low back pain after exercise or sport or whatever is very similar to what you see in nonactive individuals just because it is an area that people frequently experience pain and so. [SPEAKER_00]: Again, it only like raises a red flag if somebody's had this recurring sort of like yeah every five or six weeks I have like a little back tweak and I'm like to me.

7:10 [SPEAKER_00]: That's mostly a programming thing right and you notice that neither of us like Initially went to technique what your form looked like it's like the programming probably needs some adjustment and one thing that caught my attention here You know when I'm pushing it in a block and I'm like what are we pushing?

7:27 [SPEAKER_00]: And I don't mean that in an accusatory way, but it's like [SPEAKER_00]: If you are trying to force, like wait on the bar, extra reps, more sets, you're increasing training load as in an effort to drive progress, I think that's backwards. [SPEAKER_00]: I think that's backwards, rather, I would wait for the fitness to show up and then you get to progress all those things, so you shouldn't actually feel like [SPEAKER_00]: you're pushing.

7:48 [SPEAKER_00]: You should feel like it's challenging. [SPEAKER_00]: The work is, you know, does require your attention and focus and so on and so forth, but it shouldn't feel like, yeah, this session that I just did is harder than the same session I did last week or two weeks ago or three weeks. [SPEAKER_00]: It should be about the same level of hardness.

8:02 [SPEAKER_00]: And so I do think that the pushing thing. [SPEAKER_00]: I'm not saying that you're doing it wrong. [SPEAKER_00]: I'm just does raise a flag. [SPEAKER_00]: I don't know. [SPEAKER_01]: Yeah, I mean, we certainly need to be trying in our training. [SPEAKER_01]: Yeah, but if we're trying harder and harder and harder every single week and, and, you know, I think back to like the days when I was doing more foolish programming where I'd have to get increasingly hyped up every week to, you know, hit my new five rep max every single week and like that was profoundly dumb at that time and led to some not awesome outcomes, both mentally and physically.

8:31 [SPEAKER_00]: So it would not advise. [SPEAKER_00]: Yeah. [SPEAKER_00]: So my my kind of practical approach to this and it could [SPEAKER_00]: between like a rehab setting like somebody's like legitimately just started like a rehab training program based on a some sort of injury that that they were very concerned about versus like competition prep and you're really close.

8:49 [SPEAKER_00]: Yeah, I don't it could be different, but let's just assume that we're going to treat these things the same way. [SPEAKER_00]: I don't think your pain should be greater than three or four out of ten, you know, it shouldn't get sharp or increase in intensity during the set during the activity if it is.

9:02 [SPEAKER_00]: that kind of signals that we should probably consider a modification, especially if it's still persistent after 24 or 48 hours or otherwise interferes with stuff that's going on outside of the gym. [SPEAKER_00]: I mean, most people listen to this podcast they're not like living to train, right?

9:16 [SPEAKER_00]: It's more like, yeah, this is something I do for not only enjoyment, but also for health and for performance and other sort of areas. [SPEAKER_00]: And so I just think like most of your training should not be terribly uncomfortable. [SPEAKER_00]: Like, yeah, you should try. [SPEAKER_00]: But it shouldn't be terribly uncomfortable.

9:32 [SPEAKER_00]: Shoot, alright, well, easy day, alright, now on to the next one. [SPEAKER_00]: This is about pre-exhaust, training. [SPEAKER_00]: Docks, what are your takes on pre-exhaustion exercises before hitting compound movements? [SPEAKER_00]: Specifically doing something like leg extensions before squats.

9:48 [SPEAKER_00]: I have found that this technique seems to help with the mind muscle connection, but also limits the amount of weight I can use on the main lifts. [SPEAKER_00]: Awesome, you ever do this? [SPEAKER_01]: Uh, not really. [SPEAKER_01]: This is, I mean, I recognize this is the thing that people do much more often in, in the body building space.

10:04 [SPEAKER_01]: Um, I think that I don't, I don't, I don't, I don't identify as one. [SPEAKER_01]: Nor would I be mistaken for one. [SPEAKER_01]: Yes, right. [SPEAKER_00]: Thank you. [SPEAKER_00]: Do you guys body builders? [SPEAKER_01]: Yeah. [SPEAKER_01]: Unless it's somebody who doesn't know what the difference is between body building.

10:16 [SPEAKER_00]: Yeah. [SPEAKER_00]: They don't have like muscles. [SPEAKER_00]: Yeah. [SPEAKER_01]: Bodybuilder. [SPEAKER_01]: I think that the probably the main situation where I might have done something like this before or thought about it or programmed it is in the context of rehab actually more so than more so than like thinking that it's optimizing my hypertrophy outcomes or something like that, but what about you?

10:34 [SPEAKER_00]: Yeah, the same thing. [SPEAKER_00]: I've done this in a rehab setting for a few reasons one. [SPEAKER_00]: I want to do the quote rehab exercise or target the muscle directly that I'm working on rehabbing first and then it also helps me limit the load on the subsequent exercises which is kind of like a way to protect myself.

10:56 [SPEAKER_00]: So but that actually kind of speaks to why this might not be the best option for either strength or hypertrophy. [SPEAKER_00]: So we need to talk about this. [SPEAKER_00]: So yeah pre-exhaustion training in this case like leg extensions before squads or you [SPEAKER_00]: dumbbell flies before a bench press or something like that.

11:12 [SPEAKER_00]: It's a technique that is used to theoretically generate a high degree of metabolic stress and local fatigue in the targeted muscle or muscle group and subsequently use lighter weights. [SPEAKER_00]: But it's probably not best for either strength or hypertrophy. [SPEAKER_00]: Now in hypertrophy, the most critical stimulus for long-term growth.

11:30 [SPEAKER_00]: is mechanical tension, right? [SPEAKER_00]: And so making sure the muscles are producing enough force and doing a lot of work there, a lot of volume there. [SPEAKER_00]: And you would do that with a variety of different movements, the use of full range of motion, add an intensity that gets you somewhere near failure.

11:47 [SPEAKER_00]: But the muscles need to be producing a lot of exposure to a lot of mechanical tension, and then you got to do a lot of it, right? [SPEAKER_00]: So volume there. [SPEAKER_00]: For strength, the most critical stimulus for long-term strength is you need some hypertrophy to facilitate that, but you also need increased neural adaptations.

12:04 [SPEAKER_00]: And these are best achieved in the specific application by maintaining a high amount of force production throughout the sets that you do. [SPEAKER_00]: So a high fidelity, high integrity, high amount. [SPEAKER_00]: a force production throughout the set. [SPEAKER_00]: So you wouldn't see a lot of velocity loss, for example, and you'd be using enough weight to require your muscles reduce a bunch of force.

12:26 [SPEAKER_00]: And so pre-exhaustion by definition induces fatigue into the target muscle or muscle group. [SPEAKER_00]: So you get, you're going to do less total amount of reps, so less volume, just bad for both strength and hypertrophy. [SPEAKER_00]: You're going to use less load, which is probably bad for strength.

12:42 [SPEAKER_00]: And you're going to get more velocity loss, if you did the same number of volumes, you said, look, I don't believe you. [SPEAKER_00]: I'm going to do the same amount of volume. [SPEAKER_00]: Yeah, you're going to get more velocity loss. [SPEAKER_00]: It's going to be higher RPE for a given amount of training.

12:51 [SPEAKER_00]: And so that's going to be worse for strength. [SPEAKER_00]: So I think it's worse for both. [SPEAKER_00]: Now, in my opinion, this mind muscle connection that you're feeling is probably a result of more fatigue, so like you get a pump. [SPEAKER_00]: Like, for example, you're like, oh, I'm working this muscle.

13:05 [SPEAKER_00]: It's more fatigued. [SPEAKER_00]: I can feel it more. [SPEAKER_00]: I'm like, well, that's great. [SPEAKER_00]: But I don't know that it's actually helpful for like hypertrophy or strength outside of if it were to otherwise increase your training load. [SPEAKER_00]: Is that the central paradigm here?

13:17 [SPEAKER_00]: If you're thinking about, how do I get stronger? [SPEAKER_00]: How do I get more muscle or whatever? [SPEAKER_00]: The whole thing is how much training load can you do? [SPEAKER_00]: The more training load you can do, and that's not just weight on the bar, but it's the amount of work that you're doing in total.

13:28 [SPEAKER_00]: Generally speaking, we would predict more adaptations. [SPEAKER_00]: And if doing this pre-exhaustion training makes you do either less volume, less intensity, or both, [SPEAKER_00]: It's probably compromising training load. [SPEAKER_00]: Now, if it doesn't compromise training load that much, we're talking like, you know, single digit percentages, then it's probably neutral, right?

13:46 [SPEAKER_00]: But if you're doing way less volume, way less loading, right, more getting closer to failure for the same load, then it probably is compromising. [SPEAKER_00]: You're outcomes. [SPEAKER_00]: This is the same way we feel about super sets, right? [SPEAKER_00]: That's why we like agonist and tag into super sets or alternate peripheral super sets over agonist agonist [SPEAKER_00]: And therefore, use this as a time saving technique, but also not compromise like strength or hyper-treat to the extent that that's something we can control.

14:16 [SPEAKER_00]: But I agree it's useful in the rehab setting. [SPEAKER_00]: And I think it's mostly just for like load, it's like a load constraint. [SPEAKER_00]: If you blast your quads before you go to squad or late press or whatever variation you're using, you're going to use less weight and maybe that just saves somebody from themselves because they're like, you know, I could use more weight.

14:37 [SPEAKER_00]: They can be useful. [SPEAKER_00]: They can also, if the first exercise or first few exercises are more like direct focus on the joint area, the muscle area, whatever that their person's experiencing pain not only does it serve as maybe a desensitization, but also they can actually push that training a little harder.

14:52 [SPEAKER_00]: It's not like [SPEAKER_00]: I'm so fatigued. [SPEAKER_00]: I'm just going to mail it in on this work. [SPEAKER_00]: So yeah, the last applications, I can think that would be useful here, maybe like CrossFit or like a muscular endurance sort of challenge where you're going to be exposed to the sort of stuff in a lane.

15:06 [SPEAKER_00]: You're not really it's more of a sports specific training than than like I'm going from max hypertrophy and max strength. [SPEAKER_00]: You're like, I just need to get ready for the sport. [SPEAKER_00]: Because you'll see stuff where it's like, all right, you got thrusters, right in a push-ups or burpees.

15:19 [SPEAKER_00]: You're like, whoa, whoa, it's agonist agonist. [SPEAKER_00]: What am I doing here? [SPEAKER_00]: And it's like, well, that's a sport, so you better be ready for it. [SPEAKER_01]: Yeah, I like that last, that last one. [SPEAKER_01]: Sometimes I've seen certain crossfit workouts programmed in that way, and I'm like, gosh, I would not write a workout like this for training purposes.

15:34 [SPEAKER_01]: But if that's the test, man, that's going to be super challenging on some, a lot of the shoulder stuff, I think, in crossfit ends up being [SPEAKER_01]: Quite challenging because of that type of thing. [SPEAKER_01]: They might do hands-dend push-ups and like ring muscle ups or you know all sorts of other You know, agonist agonist things that you'd have to be well trained to be able to tolerate.

15:52 [SPEAKER_01]: So if that's your If that's your bag, you got to train that way. [SPEAKER_00]: So yeah, yeah, as far as like I like the pump trying to do that You can I have used this pre-exhaust technique and short periods of time at like the end of a hypertrophy block or something just to kind of like [SPEAKER_00]: send it.

16:09 [SPEAKER_00]: I know that I'm compromising training load a little bit, but at that point I'm just trying to e-gout every possible sort of adaptation I can. [SPEAKER_00]: We're already kind of like accommodated to the training load. [SPEAKER_00]: So it's like maybe this unique sort of stressful, like it'll be maybe enjoyable, and then maybe we can get a little bit out of it, but I don't think long-term compromising the training load total is a good idea.

16:33 [SPEAKER_00]: So [SPEAKER_00]: All right, a lot of resources also for each answer in the show notes below. [SPEAKER_00]: So check those out, agreement. [SPEAKER_00]: All right, next question. [SPEAKER_00]: This is about prior dietary patterns effects on choices on food to eat today. [SPEAKER_00]: This person asks, I find that the way I eat prior to how I'm eating today affects my cravings and appetite.

16:54 [SPEAKER_00]: If I eat pizza McDonald's every day for the last week and then I shift to eating a different dietary pattern as more home cooked meals, then there is acutely a higher tension on adherence for today. [SPEAKER_00]: However, the important thing I want to note is that this difficulty feels transient as in if I then keep eating that way for another week that new prior timeline of eating makes eating that way easier and reflecting on that makes this whole process seem much more reassuring and makes me more coherent.

17:20 [SPEAKER_00]: So my question is, is this normal? [SPEAKER_00]: I'm not saying it's easy, but it is kind of reassuring to know that you won't feel the inclination to eat a meatlovers pizza at our p10 forever. [SPEAKER_00]: It does seem like that dies down if you give it some time. [SPEAKER_00]: and not understanding that it gets better, I have to assume dings a person's confidence in the process, or their self-efficacy, which would cause the first day of your shifting the pattern that just doesn't feel super great.

17:44 [SPEAKER_00]: Interesting question. [SPEAKER_00]: I actually think there's maybe more meat on this to chew. [SPEAKER_00]: So to start, yeah, that transient nature of the difficulty experience when switching from hyper palatable foods, pizza, McDonald's, these ultra-process foods, [SPEAKER_00]: and are somewhat engineered to make us eat more.

18:03 [SPEAKER_00]: That's, I mean, that's pleasurable and cheap. [SPEAKER_00]: You ubiquitous marketing, all that sort of stuff. [SPEAKER_00]: Switching from that to home cook meals, yeah, it's pretty normal and predictable. [SPEAKER_00]: He've had some sort of like hedonic adaptation, right? [SPEAKER_00]: The brain has kind of been adapted to this high food reward.

18:18 [SPEAKER_00]: Is it very palatable? [SPEAKER_00]: the complex, you know, orchestra between salt, fat, sugar and, you know, mouth feel all these sorts of features provided by pizza and fast food. [SPEAKER_00]: Well, yeah, when you remove that stimulus, the brain is like, whoa, this, uh, I'm a little, I don't like this.

18:34 [SPEAKER_00]: So you, you can have them cravings. [SPEAKER_00]: until it adjusts to be lower with the home cook meals. [SPEAKER_00]: And you're also disrupting a habit, which you've built over the past seven days, these like context, routine, reward, loops. [SPEAKER_00]: So breaking, you know, it's not a super strong habit if it's just only seven days, but like you can imagine a person has been eating this way for years.

18:53 [SPEAKER_00]: Right, and so there are specific contexts associated with these, you didn't have it. [SPEAKER_00]: It's a time of day, location, emotional state, you know, just your routine. [SPEAKER_00]: And so it takes time to build a new routine. [SPEAKER_00]: And yeah, there's some like acute cognitive tension there.

19:06 [SPEAKER_00]: Austin's described this as like dietary RP, it's higher, like immediately upon making any change. [SPEAKER_00]: On the other hand, [SPEAKER_00]: I actually think there might be a little bit like less thaning of that too at the same time. [SPEAKER_00]: So like you do have some factors going against you.

19:21 [SPEAKER_00]: But you also have some factors helping you out here. [SPEAKER_00]: One, it is likely that somebody who's eating a dietary pattern like that, a lot of pizza that McDonald's fast food, ultra-processed foods generally speaking, may have been eating in a calorie surplus or energy surplus for that period of time.

19:36 [SPEAKER_00]: And so like the body for some folks will recognize that and say, look, I don't need to crave more food. [SPEAKER_00]: you're sort of like above that. [SPEAKER_00]: And so if anything, your body might be compensated by saying, I'm going to tamp down hunger a little bit. [SPEAKER_00]: Satiety's going to be a little higher.

19:52 [SPEAKER_00]: And the other some hormonal stuff baked into that brellin, for example, it might be a little bit lower during that time. [SPEAKER_00]: And so you could effectively make this switch despite these sort of like kind of crave it. [SPEAKER_00]: It will have it situation, but the body's like biological sort of feedback is like, yeah, this is fine.

20:10 [SPEAKER_00]: And I think this ease that you're experiencing in the short-term will call it one week two weeks three weeks four weeks been, even up to like, you know, a couple months, it's likely to be transient. [SPEAKER_00]: And also be affected like if you were to shift into a calorie deficit, I would predict that your appetite and cravings would go up.

20:29 [SPEAKER_00]: There are biological defense mechanisms here, plus like the your emotional connection to those foods previously, right? [SPEAKER_00]: Some psychological stuff there, environmental stuff. [SPEAKER_00]: If you draw past this every single day, so I think it's almost like multiple relationships that change over time.

20:46 [SPEAKER_00]: So initially, yeah, a little bit of elevated dietary RPE from making the change. [SPEAKER_00]: Mostly related to habit, right? [SPEAKER_00]: And sort of like the tastiness of the food. [SPEAKER_00]: But you're also helped out by just, you know, you're probably overeating period. [SPEAKER_00]: And so biologically, you get a little support.

21:03 [SPEAKER_00]: But then over time, that kind of flips and almost everything's going against you. [SPEAKER_00]: Biologically, you're like, [SPEAKER_00]: shoot. [SPEAKER_00]: I'm in a calorie deficit so the body's going to try to adapt on some level with a metabolic adaptation and you get some subsequent signaling that your hunger's going to go up, satiety, sensitivity's going to go down and then some psychological sort of cravings and such particularly if your diet's very restricted for example and then socially like yeah oh well I've been you know only home cooked meals or meals prepared inside the home and now in your friends like hey what are you doing to come up to dinner you know so [SPEAKER_00]: Yeah, I don't know.

21:35 [SPEAKER_00]: Is that kind of, uh, you kind of agree with that. [SPEAKER_00]: That assessment here. [SPEAKER_01]: Yeah. [SPEAKER_01]: I think it's a reasonable take. [SPEAKER_01]: I want. [SPEAKER_01]: I would want to point out though that the amount of individual variation here is in normal. [SPEAKER_00]: Yeah.

21:46 [SPEAKER_01]: It's like because I'm envisioning there are definitely people who, you know, might be listening who are like, bro, I don't know what you're talking about. [SPEAKER_01]: I get always house a pizza or a present company. [SPEAKER_01]: Yeah, exactly. [SPEAKER_01]: Right. [SPEAKER_01]: Or those kind of cravings are that kind of drive towards those things [SPEAKER_01]: And so this is a big part of our conversation around, you know, weight management, body composition management is individualizing the process and individualizing the intensity of the intervention.

22:15 [SPEAKER_01]: And so for some people, those who are quote unquote naturally thin, lean, those who have really trouble gaining weight. [SPEAKER_01]: they don't really tend to experience, you know, those types of, those types of things. [SPEAKER_01]: In fact, it's, you know, quite challenging for them because they get full so quickly and so easily without, you know, they don't choose that.

22:32 [SPEAKER_01]: That just is their existence. [SPEAKER_01]: That is their reality will power. [SPEAKER_01]: That despite being in the current food environment, [SPEAKER_01]: And then, at the opposite end of the spectrum, those who feel none of those things. [SPEAKER_01]: I recently, I don't know, you know that YouTube channel Jubilee, where they just get people and have them argue with each other, and I guess it's for the algorithm.

22:53 [SPEAKER_01]: The one that just one of the most recent ones that just came out was a pro versus anti-ozampic episode. [SPEAKER_01]: And it was, I only saw some clips of it that were getting passed around, but one woman who was on this, it was just absolutely infuriating to listen to her because it was 100% total and complete rejection of the idea of individual variation.

23:17 [SPEAKER_01]: It was pure. [SPEAKER_01]: I did it. [SPEAKER_01]: Therefore, I'm 100%. [SPEAKER_01]: She said, I'm 100% confident that anyone can basically do this. [SPEAKER_01]: I'm like, hmm, that is a bold. [SPEAKER_01]: Yeah, I did it myself, therefore everyone can do it and I'm, you know, morally superior for having accomplished it without the use of medicines and blah, blah, blah, blah.

23:37 [SPEAKER_01]: It's like, okay, not the biological reality. [SPEAKER_01]: There's just fundamental variation here. [SPEAKER_01]: So this person's experience, I think, to some extent, jives with some of the things that I've felt like maybe when I'm [SPEAKER_01]: you know, traveling or on vacation and going out all the time and having, you know, treats more often than I might when I'm at home and cooking my own food, you do kind of get into a little bit of a different mental state and, and dietary habit cycle, and then you have to kind of break back out of that when you get back home and get back into a more traditional routine.

24:06 [SPEAKER_01]: And there's a little bit of a transition. [SPEAKER_01]: there and but it does certainly get get easier with time but I also recognize that like man other people's experience is also going to be super different than this in terms of to to the point that you mentioned that idea of like dietary RPE how hard is it to make that shift [SPEAKER_01]: For me, it's like not difficult at all to make that shift.

24:24 [SPEAKER_01]: What I'm flipping back from maybe vacation mode to being back at home, or being out or back or whatever the case is, but other people, it's like extremely difficult. [SPEAKER_01]: And so our interventions for managing health, as well as body weight body composition, need to, you know, attend to that consideration.

24:39 [SPEAKER_00]: Yeah, I've reminded this is end of October. [SPEAKER_00]: We're in Rosemann, California, and if you don't know where that is, [SPEAKER_00]: You shouldn't spend a little nowhere. [SPEAKER_00]: Track day at at Willow Springs. [SPEAKER_00]: And so it was like 90 something degrees all day. [SPEAKER_00]: I had two meals, but they were like small meals.

24:57 [SPEAKER_00]: I was certainly was under fueled, right? [SPEAKER_00]: And we were like packing up, working on the car, doing all sorts of stuff. [SPEAKER_00]: And I don't know, I was ravenous. [SPEAKER_00]: And I could not wait to like get home, make dinner is gonna be like a four hour drive. [SPEAKER_00]: And I see it like a, like a mirage in the desert, [SPEAKER_00]: Oh boy, I mean, I haven't had McDonald.

25:20 [SPEAKER_00]: I mean, I don't know, yeah, whatever, but yeah. [SPEAKER_00]: So got the nuggets 20, 20 piece or whatever, 12 feet, yet in the McNuggets. [SPEAKER_00]: And then fries, McFlurry had to take advantage of that. [SPEAKER_00]: And so that was Saturday, right? [SPEAKER_00]: And I'm like, man, that hit spot.

25:36 [SPEAKER_00]: I'm really glad that I did that. [SPEAKER_00]: Sunday, [SPEAKER_00]: I went to McDonald's again, because I wanted it, and it was fun, as soon as I got home though, back in my normal food environment, it was not challenging for me to like make that change. [SPEAKER_00]: Okay, I'm back to eating my normal, normal stuff.

25:52 [SPEAKER_00]: Yeah, but I also still enjoyed the McDonald's as well. [SPEAKER_00]: But that was my personal experience, right, and further, I do think that there's some like complicated, like historical stuff that plays in here like if my traditional dietary pattern is x right and I'm shifting it to why.

26:11 [SPEAKER_00]: It like I'm going to default back to X or like have the propensity to go back to X and it relapse in this case I'm relapsing to like healthy dietary patterns, but I think the opposite is also likely true for folks and it's a lot of that it's like well, why was their dietary pattern. [SPEAKER_00]: or what it was, likely related to food environment, likely related to how there's genetics, interact with that food environment, not like a morality, willpower, type thing, and just one more little quick thing that we've discussed a few times to that woman who's saying, look, if I can do it, I got a hundred percent confidence that other people can do it.

26:43 [SPEAKER_00]: I wonder how she would react to the evidence showing that, look, when you expose people, who were kept under lock and key in a metabolic ward, to the same calorie deficit from maintenance that's ab and accurately measured, that they will lose up to 10 fold different amount of weights. [SPEAKER_00]: Despite having the same energy deficit, well, how do you think she would respond to that?

27:06 [SPEAKER_01]: uh... some sort of post-talk rationalization that uh... fails to recognize biological differences between people that that's all right that people didn't try hard enough i don't know try harder to have better genetics and just reject the study that doesn't fit her biases yeah that's true that's true fortunately there's a number of them and see how should the mental gymnastics required yet like i don't know if it just makes more sense to me they [SPEAKER_00]: Yeah, it varies amongst people.

27:30 [SPEAKER_00]: People are different experiences. [SPEAKER_00]: Everything in biology is pretty messy anyway. [SPEAKER_00]: It's very rare that you find something that always does this or never does this. [SPEAKER_00]: So like, yeah, smooth brain, smooth brain take. [SPEAKER_00]: All right, that is a wrap on this preview of our additional content that we regularly send out to our barbell medicine plus subscribers.

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