The Most Expensive Eating Disorder | Hacker News Reader

The Most Expensive Eating Disorder

desmolysium.com

111 pointsnickwritesit75 comments

>It seems that he is spending a lot of his time & effort on maintaining his hair (huge kudos for admitting that!). If his body was functioning like an 18-year old he should not need to do that. If Bryan really set back his true aging clock he probably would not be battling with ongoing hair loss (as he most likely did not battle hair loss 20 years prior), or at least it would stop (which does not seem to be the case).

Androgenetic hair loss (what Johnson has and what the medications he takes are designed to treat) is caused by genetic sensitivity to DHT and DHT levels in the body, not aging. People who don't have the genetic predisposition to AGA or who have very low DHT levels can often make it to 60+ with no visible hair loss. It's not like they're "not aging," they just don't have the combination of genes and DHT levels needed for significant hair loss to occur.

> is caused by genetic sensitivity to DHT and DHT levels in the body, not aging

Is the formula something like: DHT sensitivity * time = hair loss ?

I'm not super well versed but my understanding is that that's right, with your actual DHT levels being the third variable. There are other non-hormonal causes of hair loss, like alopecia areata, but they're much less common.

DHT damages the hair follicles that are sensitive to it, causing them to grow back thinner after each growth and shedding cycle (which is typically a few years). As a result most men don't have visible hair loss until years after puberty kicks in.

It's interesting because there are medicines that can block DHT or reduce it's effectiveness, but they have other negative side-effects. It's almost like if you have this gene and are a healthy man, you should loose your hair - I wonder what the evolutionary mechanism of that is.

The mechanism of baldness is related to the mechanism of growing a beard isn’t it? For me personally I started going bald in my mid-20s, and since then as I lose hair off the top of my head it seems to reappear on my face. So perhaps it’s just a virility/experience signal.

Maybe in the past the fact that someone had survived long enough to go bald or grow a big beard would signal that they had the skill or hardiness to avoid dying young, which might make them more attractive and likely to pass on the gene.

That's some real baldness confidence

None, and in fact it has been proposed that men suffering from AGA, especially if it's early onset, may have something equivalent to polycystic ovarian syndrome in women.

https://pubmed.ncbi.nlm.nih.gov/28711970/

    The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). 

    Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. 

    Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities. Large cohort studies have clearly shown a higher prevalence of type II diabetes mellitus (DM II) and cardiovascular diseases (CVDs) in elderly men with early onset AGA. In addition, prostate cancer, benign prostate hyperplasia (BPH) and prostatitis have been described.

    These findings support the existence of the male PCOS equivalent, which may represent an endocrine syndrome with a metabolic background, and might predispose to the development of DM II, CVDs, prostate cancer, BPH and prostatitis later in life. Its acknowledgment would be helpful for the prevention of these long-term complications.

So does a man without hair loss imply they are slower aging?

Biological aging is a fuzzy concept that we define relative to various social constructs and other objective markers compared to the general population.

I don't see much issue with its usage in this context.

You could define it as "the degradation of cellular maintenance". Androgenic hair loss is more like a non universal signal of hormonal maturity, like pubic hair growth.

I saw Bryan recently on a Magnus Midtbo episode on YouTube. In that they discussed that his body fat had been extremely low, and he had gone up to around 10% subsequently on medical advice, i.e. that his body fat had previously reduced to unhealthy levels. 10% is low, but it's not what he looks like in the photos on this article, and it should be sustainable long term with some effort. He says on his website under his current protocol that he eats 2,250 calories a day (10% deficit from RDA), which doesn't sound crazy to me. I mean, it's not what normal people do but he's not doing what normal people do by definition, and at least what he's eating doesn't seem out into crazy unhealthy territory to me.

He definitely came across as a little eccentric in the video, but very enthusiastic about the project, I found it pretty charming and would definitely find it pretty interesting to chat to him I think.

I bounced off 3% body fat (also measured by a DEXA scan) back when I was cycling competitively. This was surprisingly easy to achieve with high volume structured training and a food plan. Coach advised me to only remain so lean for target races. Coach was right, my immune system was weak and my mood was terrible until it got back up to 8%. Good racing results though.

I can’t imagine bothering with any of that if I didn’t have something I wanted to win.

I was so fit in my 30's, I measured a heart rate of like 38 sitting in a work meeting.

I could amuse nurses in an emergency room by clipping my finger into the machine, instead of the patient I was with, to set off the alarms with the low numbers.

One time I came in with some severe stomach flu. I was lying on my back and the nurse said to another, "Come here! Look this guy is so thin, you can see his heart beating in his abodomen. (Due to the aorta passing through there, and the heart behind it being massive.)"

When your HR is low, you can get pretty dizzy if you stand up at the wrong moment between pumps.

When I was training to run a leg of a marathon relay a few years ago, my resting heart rate dropped a lot. One time I mentioned my overnight HR of 38 to my wife, a doctor. Next thing you know, I’m in a different doctor’s office being fitted for a Holter monitor. Everything was fine. Turned out my heart was just in great shape.

The doc said that they’re more aware of low HRs now because so many people are wearing 24/7 heart monitors, aka smart watches. Numbers that use to be taken as signs of “holy crap, something bad’s happening” are sometimes more like “huh, guess the normal range is wider than we thought”.

But for anyone reading who has a fast or slow heart rate: let your doctor be the judge of that, OK? Lots of the time it is something wrong, and you don’t want to dawdle on that one.

there’s a famous story about Wayne Gretzky’s (170 lb weight, 140 lb max bench) recuperative abilities being so powerful that the Oilers’ trainers thought the testing machine was broken.

I don’t understand including the bench number. It’s really low and seems unlikely it was that low?

that was his max recorded bench with the team.

I strength train two or three times a week and my heart rate last night was 42. I think a low heart rate is at least partly genetic. Definitely agree about the dizziness.

How often were you going to the emergency room?

Informative article! I did have a question about this passage though.

"It seems that he is spending a lot of his time & effort on maintaining his hair (huge kudos for admitting that!). If his body was functioning like an 18-year old he should not need to do that. If Bryan really set back his true aging clock he probably would not be battling with ongoing hair loss (as he most likely did not battle hair loss 20 years prior), or at least it would stop (which does not seem to be the case)."

Is this true? I suppose it's a question of what one defines as aging but I thought male pattern baldness resulted from hair follicles physically shrinking in response to exposure to androgens. That's a very different process than an accumulation of senescent / poorly differentiated cells, which is what I have always heard described as the key hallmark of aging

it's kind of bullshit because plenty of guys lose some/most of their hair in their teens

It seems a bit.. abrasive and brash to label this an eating disorder, no?

As a doctor and technical founder/CEO myself, I really like patients who are into their own health and fitness, obviously this guy has the means and resources to take it to an extreme, but I think the lesson he wants to impart is that there are benefits to investing in your own health, the same as people invest in self-tooling such as expensive Macbooks/Mac studios, running shoes, and much more.

The whole world would see such titan sized improvements in GDP along with personal lives. Men and women would be happier if everyone strove to be fit, "younger" (with respect to wellness and fitness) and in better shape, not to mention that would translate to very real economic benefit in every country.

I don’t think you understand how down the rabbit hole this guy goes.

> Bryan Johnson’s supplements list includes more than 100 compounds taken as powders, tablets, and capsules, designed to support different aspects of his health.

This is an insane thing to do and I have delved deeply into supplements myself and it is stunning how hard it is to find evidence that any of them do anything beneficial long term.

This matches me own experience and daily diary of trying things, rating how I feel, bloodwork, etc. The only thing I’ve ever found beneficial long term is testosterone, sunlight, and exercise.

He sells supplements, including specific ingredients for which there isn't much evidence of efficacy. Even if you assume most of what he preaches and sells is scientific, some of it is unscientific which sort of undermines the entire pitch, I think.

Testosterone in the form of steroids and TRT? Not judging just curious.

Just trt, actually going too high >1000 feels awful to me.

Just fixing this world decline helps so much.

https://sci-hub.se/10.1016/j.euf.2020.02.006

Yeah, you won't find evidence for two decades because of the time and resourcing it would take to fund it, plus none of them being in metabolic wards.

You can sit around and wait for "The Science" or you can be a data point for yourself.

There is also big question isn't it is more harm to the system removing its ability to produce what it should produce by itself.

Given where his body fat and his core body temperature is these days, let's withhold judgment a bit before we crow about "titan sized improvements in GDP".

He's running an n=1 experiment well out of established parameters, and the outcome is far from guaranteed.

The author's point is that these extremes aren't healthy and fit.

GDP is a pointless metric, if we all get cancer GDP is going to go way up.

I like this reasoning. When evaluating if an individual has an eating disorder it is vital that the physician doing the evaluation spend the requisite time imagining various scenarios relating to the gross domestic product of the country they are in, or the earth as a whole

Uh are you a psychiatrist because it doesn't sound like it? This definitely looks like it could meet DSM criteria as an eating disorder.

To the muggles out there, generally speaking non psychiatric doctors (and many older, out of date psych professionals for that matter) know about as much about modern psych diagnostic criteria as a potato.

It's inappropriate in general to diagnose people with psych disorders based on their social media and public persona

I generally agree that we shouldn't armchair diagnose people, especially not for gossip's sake. But in this case Bryan is actively promoting a lifestyle which looks symptomatic of a disorder, so it's probably in the public interest to point that out.

The post author did so in a thoughtful and respectful manner.

Exhibiting symptoms of a disorder is not the same as having a disorder which is why it's irresponsible and inappropriate to diagnose people based on their social media.

eh eating disorders in particular have quite the social contagion. anorexia definitely spreads via social media.

Bryan clearly is not anorexic because he gained a bunch of weight/fat when his doctor told him he was at a dangerous weight. Someone suffering from anorexia is not going to increase their body fat by 5-10% on their doctors recommendation.

I'm not saying he's anorexic. I'm using it as an example of how eating disorders have a significant social contagion component to them.

> Also, in the interviews I have seen of him, his blinking frequency is quite high, presumably because he is so low in body fat that his lacrimal ducts cannot manufacture the lipid portion of tear fluid properly.

Bryan Johnson is one weird dude and I would bet against his regimen's effectiveness. But stuff like this is just silly and makes me doubt the rest of this post.

Are you an MD like the author? And even if not - what is your rebuttal here?

I'm not an MD. Jumping from "he blinks a lot in interviews" to "his lacrimal ducts cannot manufacture the lipid portion of tear fluid" is silly. It's like something from a TV show doctor. He's being interviewed and some people blink a lot when they're nervous!

> He's being interviewed and some people blink a lot when they're nervous!

We're talking about a guy that chooses to be in front of a camera, weekly, for millions of views.

It isn't so straight forward.

Van Morrison is a world famous musician who has performed on stages since the 1960s. When he last visited my city about a decade ago he played for nearly the entire duration of the show with his back to the crowd as a way of minimizing the performance anxiety that he felt.

The lacrimal duct doesn't produce the tear film lipids, it's the meibomian gland. Also I think he meant the lacrimal gland, not the duct, but that'd still be incorrect.

Feels like a bit more body fat would suit him a lot better. The lean look is fine if you're under 25, but at some point you have to admit that it's over.

> the way he looked while taking “TRT” looked nothing like a “testosterone replacement dose” but rather like a (mild?) steroid cycle

This seems to be common with TRT takers, who tend to have the physique (or some slightly strange-looking approxmation thereof) of a man 10 years younger. I guess it's not supposed to give you an abnormally high testosterone level, but you'll get that level consistently and reliably, regardless of mood or external events. Can't get that when you rely on your body to do it itself! It all adds up!

A TRT dose set based on the population average might also prove usefully higher than your body is tuned for too. And I expect you can just say that you're not feeling it, and they'll give you a bit more.

> but at some point you have to admit that it's over

I am confused by what you mean. Being lean should be a goal throughout life, no?

It should, but you can't expect to be as lean aged 45 as you were aged 20. And if you manage it anyway, you'll probably find (as - in my view - Johnson shows) that you look weird, in a way that you wouldn't have done when you were 20.

Regarding how much, I did say "a bit more". I'm not suggesting he should be watching My 600 lb Life for inspiration. 15% body fat, say? Maybe a bit less? Maybe a bit more? I dunno. He can afford his own dietician. I'm just going by my eyes here. He is lean, but in my view it just doesn't look very good on him.

(EDIT: this did prompt me to update my other post. TRT takers often exhibit a similar phenomenon: they've got the muscles and leanness of somebody rather younger, but the overall effect still just looks... kind of odd.)

Had to click through and look, he looks great IMO. There are people who look odd at a sub 15% bf at any age but he isn’t one, to my eye. He does have a bit of the TRT look but not extreme.

Edit after actually reading: the article is a compelling analysis & critique. While I think he looks good physique-wise, even bodybuilders would say it’s grueling & suboptimal for health & performance to stay very lean all the time. I thought he looked lean but not to that point where the body rebels; the markers seem to say otherwise

No? What makes you think that lean is the optimal body state for all individuals?

High body fat is correlated with all sorts of negative health outcomes, no?

That doesn't necessarily imply that super low body fat is optimal.

I think we are speaking past each other due to definitions. I wouldn’t think “lean” is the same as “super low body fat”. I assumed the lean we were talking about was maybe 10-13%. Whereas super low would likely be in the sub-8%.

Maybe, but 13% is still well under what I would suspect is the bar for being correlated with negative health outcomes. Most sources seem to suggest that 18-20% is still a healthy level.

What is over? You should maintain a lean, muscular body for as long as you possibly can.

Indeed you should! All that's over is automatically looking good while you do it (or so I claim). Time to accept that you might actually look weird, even though you have the ideal body fat level for somebody 25 years younger. Maybe skip the shirtless pics. Or why not just let yourself get a bit (but not much!) fatter?

Anyway, I'm relying on my own eyes here, and you should do the same. Don't be afraid to let your eyes see that Johnson is rich enough to afford a team of people looking after him, and has the vital signs of a 20 year old. Meanwhile, I'm just some internet rando!

I will never understand how Bryan Johnson is helping anybody. Ok, if he lives longer then what? Do we all have to do what he does (impossible)? How is he contributing at all to science? He is a walking confounding variable. Even if he succeeds in living a long time, humanity won’t be able to take anything away from it.

Yep. There's nothing scientific about trying 1000 different treatments on yourself. You'll probably drive more interest in the field if you live to be 120 or something, but that's about it. Mostly reeks of ego, selfishness, and a fear of his own mortality.

Speaking as a healthcare worker, people in this country don't need a longer lifespan, they need a better quality of life. Most Americans become pretty sick by their 40s-50s due to lifestyle, diet, and lack of access to healthcare. You have hypertension and/or diabetes in your 30s, which progresses to chronic kidney disease in your 40s, and by your 50s you're spending half the week sitting in a chair getting dialysis. His wealth has made him so far removed from the reality of most people.

>selfishness

towards whom?

Is ~2200 calories a caloric deficit for Bryan Johnson's size and activity level? If you're not in caloric deficit you won't really feel bad if you're hitting macros.

If we’re discussing just that one data point, I don’t think so. I think it could be, but it could also be okay. One of the challenges is knowing what’s he is actually doing commensurate with what he says he’s doing.

His workout is really hard, it it’s not a lot of resistance training. He’s gotten good at it so it has the benefits that a hard workout would. When I did it for a week, I suffered but I couldn’t match the metabolic demands that my Olympic lifts oriented training workout entailed when I lift heavy.

I’m very strong but I eat between 2500-2700 kcals in my 50s and I lift heavy. I eat a bit more on big run days.

Given the length and nature of his gym routine, o don’t think his burn ratio is that high.

As for the rest.. his temps and sleep patterns, I couldn’t say. He says he sleeps well and there is data to support the observation that he had trouble sleeping. I can sleep 8-9 hours without waking up, and that is definitely correlated to my workout habits and my peace of mind.

Brian is interesting but we may have partial data from him that is out of sync with what we think his other practices are at the same point in time.

It's not what he's doing that bothers me. It's the desire to blast it out to everyone and be so public about his experiments with an air of scientific advice and authority. What he's doing is not science or scientific in the slightest. Just because you use scientific tests and devices and such doesn't mean you're doing science, or doing anyone (including yourself) any good.

It sends the message to people, if you're rich, you can make up your own rules. Well, life doesn't work that way as he is soon to find out. If there is one thing I have seen in my days of living on this earth is that life loves irony.

I appreciated reading the author's medical explanations of this guy's physical manifestations.

Hearing this guy receives tons of criticism seems wild to me. "Live forever or die trying" isn't exactly a rare posture. I'd wager it's about as common as "I'm going to die anyways so why bother."

Explore the possibility space. Balance compassion for self and others. Good luck to everyone.

Let him cook, he has the dough and the want to do it, op can call what he likes too, whatever suits him

From the author:

Some of the strategies I employ include:

I put a prime on sleep, diet, and exercise. I optimize my hormones. I downregulate the mTOR pathway. I take pharmaceutical drugs aimed at improving metabolic health. I employ several behavioral, hormonal, and pharmaceutical strategies to delay cancer, atherosclerosis, and neurodegeneration. I cleared my body of (some) senescent cells with senolytic drugs. I monitor dozens of health markers. I take a handful of supplements. I put a prime on my mental health.

This sounds like the pot calling the kettle black.

The critique was not his use of pharmaceuticals. The author even mentioned he adopted a supplement straight out of Bryan's regimen.

Yes, but to the normal person, they both seem wildly obsessive. My acute observation is simply that anyone who has that much time and energy to think about and experiment with "biohacking" is clearly lacking in some other areas of life. In particular the author here mentions that his number one intervention / beneficial "hack" has been increasing human connection.

But it seems painfully obvious that with such a large amount of focus poured into one area, not to mention being in medical school, they are clearly not maximizing in that area. Most people are simply much too busy with actual human stuff to go so deep into this area. The other side of that being that when you are that busy you don't feel the need to delve so deep into an area because you are meeting those targets organically.

The most recent thing I've heard him say is his body fat percentage is 10% currently.

It's odd that's not reflected in the article, and the conclusions are very much different if that's the case no?

I don’t see why he’s getting all this hate. He tests a lot of products on the market and publishes the results for free. What’s to dislike?

Some microbrands do meteorite dials https://zeloswatches.com/products/copy-of-mako-500m-diver-st...

Why am I expected to know who Bryan Johnson is?

cause you were reading an article about him?

Don't get the first disclaimer

> as he is propelling the whole field forward

Towards what, even more self-deluded people with expensive eating disorders?

this is spam. he's optimizing his health. dont hate the guy for trying to improve the health of himself and others.

Eating disorders are mostly fantasy

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