27 September 2011

Cyclic Hedonic PSMF Diet for Satiety, Adherence, Reward

Thai green curry
I. A diet that doesn't suck
II. Why diets eventually suck (bullet style)
III. Instant gratification and goal-setting
IV. Cyclical IF and the PSMF
V. Reasons behind the diet
VI. Other ways I've maintained adherence
VII. A case study: me
VIII. Throwing supplements into the mix (optional)
IX. Closing

A diet that doesn't suck
Over the years, I've progressively changed my dieting style. Each step is generally in the right direction as far as improving overall adherence. Here's how it's evolved:

Vietnamese beef pho
1. Beginning: 3 meals/day
2. 3 meals + 3 snacks/day
3. High school: 3 meals + 3 protein shakes/day
4. 6 meals/day, Atkins style
5. College: 6 meals/day, low carb, mostly protein shakes + nuts (Dave Palumbo style)
6. Recently: 1 meal, intermittent fasting (IF), no food restrictions
7. Current: 1 meal, cyclical IF with protein-sparing modified fasts (PSMF), no food restrictions, no protein shakes

The jump from number 5 to 6 greatly improved my adherence, but not entirely. The problem was in my head.

I'm a goal-oriented person, which I'd like to say is a good thing. However, humans are evolutionarily hardwired for instant gratification; I'm personally more likely to accomplish a goal if it's in the near-immediate future.

That said, there's already a problem with dieting, a relatively long-term commitment. Neurophysiology explains why the problem exists.

Why diets eventually suck (bullet style)
There's lots of chemicals involved, but there are 3 we'll worry about today:

Had too many carbs.
1. Leptin, a hormone that for our purposes acts as a satiety/fullness signal and increases fat burning. Levels of it drop a lot within a week of dieting.

2. Serotonin, a neurotransmitter implicated in mood (depression and anxiety), sleep, appetite, and alpha-male syndrome in animals. Dieting lowers serotonin (low-carb diets even more so), while eating a boatload of carbs increases it (people tend to get drowsy afterward).

3. Dopamine, the reward hormone crucial to pleasure-seeking behavior. You can probably guess that dieting lowers it.

Exercise, overfeeding (especially with carbs), and fish oil supplementation either increase the synthesis of the above or improve the sensitivity of the receptors that bind them. Some regular combination of the 3 should help combat some of the physiological problems associated with dieting, which in theory should make it more bearable.

In reality, it doesn't. Not without some tweaking, at least.

Instant gratification and goal-setting
I'm a man of extremes. While it sits well with many, moderation feels like stagnation to me. I'm someone who'd probably do only marginally well on the marshmallow test. I can hold off for a bit and distract myself, but I'd like my marshmallow pretty soon - within 24 hours. That's why I landed on Diet Incarnation No. 7.

I mentioned earlier that I'm more likely to reach a goal if it's in the short run. And in the big picture, several completed short-term goals contribute to the realization of a more long-term aim, which in this case is the attainment of low body fat. There's nothing earthshaking about this approach to dieting; most people set a weekly weight loss goal (e.g., 1 pound of weight loss/week). Breaking it down even further, many strive to achieve a daily energy deficit to ensure they meet their weekly weight loss.

So what are the short-term goals of my diet?

Cyclical IF and the PSMF
My diet breaks down into 2 alternating days:

A sign of better things to come.
1. PSMF: A single, ~1200-calorie meal eaten in the PM and consisting of ~225 grams of protein in the form of boiled chicken breasts and shrimp, the incidental fat found within the chicken, and 8 fish oil capsules. The "goal" of this day is fat loss.

2. "Mini-refeed": A term I first learned of from Martin Berkhan, this day consists of a gigantic and very satisfying ~2800-calorie meal eaten in the PM and consisting of whatever I want that day. The "goal" of this day is to restore leptin, serotonin, and dopamine and the sensitivity of their receptors.

Reasons behind the diet

1. PSMF: Studies have shown protein to have the greatest satiating effect of all macronutrients. However, similar to the relationship between carb consumption and serotonin synthesis, the hunger-curbing properties of protein are most effective when it's eaten in isolation. That has been the experience of myself and a few others, at least.

Under normal conditions, 1200 calories a day doesn't make for a very fulfilling diet. However, eating over 200 grams of protein in one sitting removes any desire I have to eat anything else for the day. Additionally, as advised by Martin, nothing is done to make the chicken or shrimp palatable. Both are boiled dry and no condiments are added. This is crucial to maximizing the effectiveness of the mini-refeed.

The purpose of the PSMF is twofold. First, due to the absence of carbs and the fact that I prefer training on this day, the PSMF serves as a caloric sink that improves partitioning during the mini-refeed that follows. Second, and more importantly, it's meant to enhance the hedonic quality of the refeed. This is important; if the refeed doesn't hit that "hedonic threshold" (the level of which depends on the person), then in that person's eyes, it isn't worth subjecting himself to the PSMF day. This also explains why the target calories for the PSMF are so low; it allows for a larger feast the following day. And for me, anticipation of a rewarding refeed makes the PSMF day bearable, and overall adherence to the diet is more likely.

Examples of my refeed foods.
2. Mini-refeed: Despite the nominal goal of this day being the restoration of hormone levels to normal, the real purpose of the refeed is to make it so that the diet feels like less of a diet. Most diets are  devoid of the hedonistic aspect of eating. On these days, I'm practically eating at above-maintenance levels while still losing fat in the overall picture (that's what the PSMF days are in place for). In addition, by frequently refeeding, I'm somewhat avoiding the natural deterioration in mood, metabolism, and hormone levels that a  stringent PSMF would normally cause. That definitely beats going day to day on a measly 1800 calories.

If we examine the day-to-day goals of this diet, we see that the goals aren't always to "achieve the day's deficit to burn fat". That's not what I'm telling myself, at least. It gives me a mental break and allows me to reward myself very frequently. And that's the winning ticket if I want to guarantee adherence.

Lastly, notice that when averaging the 2 days, my daily intake would amount to 2000 calories a day. Not that extreme of a diet when you take a step back.

Other ways I've maintained adherence

1. I don't step onto the scale. It messes with my head too much, and I forget that the mirror is a better means of physique assessment. Even then, I try not to look into the mirror too often. I remain steadfast in my belief that on my PSMF days, I'm losing fat. However, the water weight caused by the mini-refeeds will mask it.

2. I use someone as a frame of reference. Pick someone you don't see too frequently, yet whom you can rely on to see around roughly the same time of year. A cousin at your annual Christmas gathering, for example, who happens to be quite receptive to the changes in others and is vocal about it. This person can act as a more objective means of feedback (more objective than your own eyes, at least) on how much progress you've made since the last time you saw each other. This is similar to Martin's technique of using checkpoints throughout the year to assess his physique progress.

3. I avoid proximity bias. In a roundtable interview JC Deen conducted with several respected names in the fitness industry, John Romaniello, one of the interviewees, explained a phenomenon called proximity bias, where we dismiss the advice of family and close friends because we've known them so intimately that we can't see them as a legitimate authority on anything but maybe parenting. The bias applies to the self as well. I can dispense advice to clients about how to lose weight, but I don't always adhere to those same guidelines when trying to lose weight myself. What I've just described is known as the coaching paradox. A creative way in which Martin has dealt with the problem is to treat himself as a client and write up a diet/training template for himself.

4. I don't think about the marshmallow (for 24 hours, at least). In his article "How To Walk The Talk and Unlock Your True Potential", Martin discussed the addictive personality type. A person with this trait will lock onto a thing or hobby and becomes obsessed with it. The behavior has to do with dopamine and the brain's reward system. What Martin suggests is not to try and abolish it; this entails defying human physiology, and that's something that normally can't be done without drugs. Instead, people displaying addictive behavior should channel it into another hobby in order to avoid short-circuiting their efforts in the former. Martin's example of this was playing Starcraft 2.

Intermittent smoking/starcrafting, anyone?
While it isn't universal, many gamers lose weight because they forget to eat. Their hunger signal may, to some degree, be appeased by the dopamine kick they get out of the game. In a similar vein, some habitual smokers get the kick they'd normally get from eating by smoking a cigarette instead. Some dieters will do this - turn to smoking - because nicotine increases dopamine. Thus, smoking is a rewarding, reinforced behavior. On the flip side, people trying to quit smoking will eat more and gain weight. In either case, the person is replacing one activity with another to  instinctively compensate. On a related note, depressed people who turn to smoking may unknowingly be trying to get out of their rut. There are other, healthier alternatives to that, of course.

A case study: me
Currently, I'm in my 7th day on this diet. No problems with adherence yet, which is more than I can ever say about most diets I've tried. My progress is below.

Day 1 (PSMF): 1200 calories
Goal achieved: fat loss, increase lifts in the gym
Day 2 (mini-refeed): 2950 calories
Goal achieved: hormone restoration
Day 3 (PSMF): 1205 calories
Goal achieved: fat loss
Day 4 (mini-refeed): 2870 calories
Goal achieved: hormone restoration
Day 5 (PSMF): 1230 calories
Goal achieved: fat loss, increase lifts in the gym
Day 6 (mini-refeed): 2890 calories
Goal achieved: hormone restoration
Day 7 (PSMF): 1200 calories
Goal achieved: fat loss

Throwing supplements into the mix (optional)
A cup of sunshine.
There's a few pharmaceutical options we have that can help things along. For appetite control and a slight increase in fat burning during the fast, caffeine can be pulsed. Alternatives include coffee and green tea.

For those who have access to it, bromocriptine can work wonders on satiety as it acts as an exogenous substitute for leptin. Generic bromocriptine mesylate will do. If taken on the PSMF day, it should evoke a general desire to stay away from food after having the meal. If taken during the mini-refeed, it will make the refeed that much more filling, a characteristic every good refeed should have. No recommendations regarding bromocriptine dosing will be included here. For that, purchase Lyle McDonald's book by the same name. Though it was originally used in the clinical setting to treat people with Parkinson's and acromegaly, 2 years ago the FDA approved it for use in the treatment of Type-2 diabetics.

Currently, my dieting experience is more goal-oriented than it is process-oriented. Although being the latter is arguably more important, having been goal-oriented this whole time (as a result of my difficulties with adherence) has forced me to continue experimenting with new ways of dieting. Some techniques work, and some don't. I take the ones that do work and throw them into my goody bag. Later, when I finally reach my overriding goal, I can transition into a more lifestyle-friendly diet and be more process-oriented. The word itself entails a continual process of self-improvement. As one wisely put it, when one is process-oriented, the goal merely becomes an eventuality, an event bound to happen as long as the process is consistently undertaken. The upside is that when I reach this point, I won't be so fixated on body fat.

My diet is a step in the right direction toward being process-oriented. For now, it serves as a proactive measure against failure.


  1. Hi I really like your blog since you have refreshing new ideas. My goal is to have six abs, too. Ive beat with everybody in college and said everybody that I will have until november sixpack. But I have a four pack, what would u recommend too do to get to the six pack/abs? Also you can only eat carbs after doing high intensity training, right? How do you train once a week doesnt have it to be 3x times a week?

    Thanks for the help and awesome blog.
    You´re fan from Germany ;)

  2. Thanks Anon.
    Drop your calories a bit more and be patient.
    Give yourself a few months to get your six pack. You can eat carbs whenever you want. I only train 1x/week because I'm lazy and I like to drop the fat by dieting. But I do make sure to train heavy so I can keep my mass. -M

  3. Hi Martin, if you want adherence, try this: www.nosdiet.com

    I passed by all the diets that you list. At the end, the only one that matters is the amount of calories, all the diets works if the calories are low, the problem isn´t the fat loss, is the long term adherence. Tipically, when you eat "normally" after a diet, you regain the weight.

  4. i just started doing a cyclical psmf diet. I decided to google "cyclical psmf" to see if anyone else was doing it. Found your blog, very informative and well written. Cheers.

  5. Anon,
    Glad it helped. Best of luck with your health/physique goals. -M