Massive Obesity
Massively obese people often have a very low levels of sympathetic activity. This causes their adrenergic receptors to upregulate. In other words, sensitivity to catecholamines is increased (via more receptors) in an attempt to compensate for the low levels of noradrenaline (NA) and adrenaline (ADR). Thus, when a massively obese person starts taking thermogenic supplements they may find that they are extremely sensitive to the stimulant effect. Although this condition is only temporary, some massively obese people may have to start with a very low dose of ECA. It would be tragic if someone, whose life could be saved by thermogenic supplements, gave up because of temporary side effects that can be avoided if one starts out at a low enough dose.
Indeed, initial sensitivity to thermogenic supplements may actually be an indication that your obesity is largely caused by subnormal sympathetic tone. Dulloo and Miller (6) noticed a big difference between lean and massively obese animals when they were screening thermogenic drugs:
"They were much less effective in lean animals. These findings lend support to the concept that obesity is due to a diminished activity of the sympathetic nervous system . . . Thus drugs that would correct the defect in the obese would effectively increase thermogenesis in these animals, whereas they would be of relatively little value in normal lean animals that have no such defective mechanism."
Are you beginning to see why some people do not respond to ECA? Thermogenic supplements correct a specific biochemical defect, and if your sympathetic activity is relatively normal, you may very well end up scratching your head and asking "what's the big deal with that ECA stuff?" Meanwhile, the guy down the street is burning fat like crazy and telling you that it's the best thing since sliced bread!
You see, after a short while, both the stimulation and the appetite suppression go away and -- in the long run -- the effectiveness of ECA depends on the normalization of noradrenaline and adrenaline release. Thus, if you are a massively obese person with extremely low sympathetic tone, you are probably going to be amazed at how effective ECA is. However, if you have a relatively small amount of weight to lose and/or relatively normal sympathetic tone, you might lose weight until the appetite suppression stops, but then the party might be pretty much over for you. Likewise, if your main biochemical imbalance is serotonin deficiency, then ECA can't do much for you. It all makes perfect sense when you read enough science to cleanse your head of all the prejudice and false assumptions about obesity.
Lets clear up another false assumption. Obviously, the beta-3 drugs that are being developed cannot completely normalize someone who has a serious noradrenaline/adrenaline (NA/ADR) deficiency because these drugs only act upon one specific type of adrenergic receptor. You see, although the beta-1 and beta-2 receptors are largely responsible for the temporary undesirable side effects of ECA, under-stimulation of these receptors (due to NA/ADR deficiency) will cripple your fat burning ability. This is especially important for massively obese people with extremely low sympathetic tone.
Up-regulation of the beta 1 and beta 2 receptor cannot completely compensate for a serious NA/ADR deficiency. Unlike ECA, the beta 3 drugs do not correct this deficiency. The beta-3 receptor has been estimated to be responsible for about 40% of noradrenaline-based fat burning (9). Do you see what I'm saying? ALL the adrenergic receptors contribute to normal fat burning. Thus, NO selective drug can completely make up for a serious NA/ADR deficiency. Understanding this important fact may be the difference between life and death for some massively obese people.
You see, obesity is a REAL disease and ECA helps to normalize our fat burning ability by correcting a specific biochemical imbalance. How could it possibly work for everyone? But the people who are most likely to benefit from it are the people who NEED it the most -- the massively obese. When people refer to thermogenic supplements as "appetite suppressants," they are ignoring the very heart of our disease and perpetuating prejudiced attitudes and ignorant treatment methods that don't have a snowballs chance of working in the long run. Let your speech reflect the science of liberation rather than old, offensive, "sloth and gluttony" nonsense. Obesity is a REAL disease. Think about it.
Furthermore, juvenile-onset morbid obesity is a chronic condition that requires life-long treatment. If you stop taking thermogenics, you will revert back to your old abnormal biochemistry and -- like a mirror image -- your set point will return to your previous level of obesity. Why can some people eat whatever they want and not get fat? Biochemistry! Your weight is a mirror image of your biochemistry. This is especially true in cases where a massively obese individual has a normal appetite. The downside to this reality is that, if you have several biochemical imbalances, ECA probably will not lower your set point as much as you would like. If you find yourself in this position, a couple of likely culprits are serotonin and insulin. Conventional weight loss methods have a near 100% long-term failure rate because they do not address the fact that obesity is a REAL disease. Such thinking reflects prejudice, not science.
OK, lets look at the science and see what we can come up with for a massively obese person who has a high initial sensitivity to sympathetic stimulants. Toubro et al. (3) started moderately overweight people out at the full dose (20 mg ephedrine & 200 mg caffeine) and found that the stimulant side effects can last for quite some time:
"The side-effects are minor and transient and no clinically relevant withdrawal symptoms have been observed . . . Eighty percent of symptoms lasted less than 4 weeks, 13% lasted 4-8 weeks, 5% lasted 8-12 weeks and the remaining 2% lasted 12-16 weeks."
There is no direct data to tell us if a person who starts at less than the full dose will adapt at the same rate, however, the Toubro et al. study should serve as a rough guide. Notice how very few people felt any stimulation by the third month? Using a model where the dosage is increased by one capsule per month until the full dose is achieved, an herbal formula where three capsules equaled the full dose would reach the full dose at the beginning of the third month (week 9). A four capsule formula would reach the full dose at the beginning of the fourth month (week 13). Here is an example for a three capsule formula:
Week 1-4: One capsule (1/3 dose) three times daily.
Week 5-8: Two capsules (2/3 dose) three times daily.
Week 9: Three capsules (full dose) three times daily.
5.0 Selecting a Good Thermogenic Formula
Despite the hype, herbal stacks are not better than home-brew stacks (mini thins and caffeine capsules). The "extra" ingredients in the herbal stacks add little to the fat burning effect. In addition, if you review the price data, you will see that the stacks with lots of "extra" ingredients cost twice as much. These "extra" ingredients are simply not worth the "extra" expense. On the other hand, due to the political situation, the home brew stack is becoming more expensive than some of the better herbal stacks.
At any rate, the important thing is the ephedrine/caffeine content. The ephedrine/caffeine combination corrects a specific biochemical imbalance that is extremely common among the obese -- and there are decades of scientific research on this. Ignore the hype. Real science gets real results! If you have not done so, check out the illustrations in my post, "How ECA Works." As they say, "a picture is worth a thousand words."
As discussed earlier in this FAQ, I prefer formulas that do not contain willow bark. I also do not recommend formulas that contain synephrine -- based on its mode of action, it is unlikely to increase fat burning. And these formulas are almost always more expensive. Although yohimbe is a legitimate thermogenic, I do not recommend formulas that combine ephedrine (or related alkaloids) and yohimbe. I have experimented with these combinations and after a short period of time the body temperature returns to the same level as with plain ephedrine/caffeine formulas. So what's the point of taking additional stimulants?
When Dulloo and Miller screened drugs to determine their thermogenic potential, they were looking for a way to normalize the sympathetic tone and adrenergic biochemistry of obese people -- without the problems associated with most stimulants. The synergistic effect of caffeine made it possible to normalize our biochemistry with a low dose of ephedrine. The result was ECA -- the safest and most effective obesity drug in existence. Obesity is a real disease and we would be well advised to ignore the endless marketing hype and follow the path blazed by scientists like Dulloo, Miller, Stock, Rothwell, Arch, and others.
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