PN Case study 12

• Back

Devon's Story

Hey there stranger!
My name is Devon, and I'm 24 years old.

Growing up I was an overweight kid. I hated PE and always felt socially awkward. Not easy talking to girls or hanging with the popular kids when you look like an overinflated balloon, right? Whenever I was eating in public I always felt people stare at me and food became an issue for me. I hated the guilt whenever I would grab a burger, eat snacks at movie nights and so on. I like to control what I eat. I never want to be the fat kid again!

I had a friend who lost a lot of weight doing CrossFit and eating paleo. I started doing what he did, and it worked. Even Though I lost the weight, I never felt 100% with my body. My mom keeps telling me I shouldn't keep losing so much weight and I'm too skinny. What does she know? My parents aren't fit, and they don't understand who I am, or why I love training so hard.

I've started doing MMA classes. GSP is one of my heroes!! I want to look like him. I still do my CrossFit classes, but it's mainly MMA now. Oh....And I'm going to compete in my first triathlon this year! That's going to be awesome. I just need to cut some more weight before I'm ready to compete.

I also hired a PN Coach to help with my diet! This is my year!

• Back

• Back

Coach Allan's Notebook

So I've been worked with Devon for six months now. Devon is focused on his weight and his looks. It's evident there's a discrepancy between what Devon sees in the mirror and what others (including me) sees.

Devon is always looking for the best diet, and he's tried everything out there. He's not very consistent in keeping up with the different way of eating he tries. He is usually drawn towards diets that are very strict. It seems like Devon thinks the more strict a diet is, the more effective it must be. Adherence to a strict diet can be problematic. In the case of a vegan raw diet, it is labor intensive and requires a lot of preparation.

This study looked at the factors affecting adherence to a raw vegan diet. They concluded: "In addition to already following the diet, the variables that best predicted adherence to the diet were more education, greater comorbid disease, greater self-efficacy for adherence, fewer close friends and relatives, and worse physical quality of life."

Devon is not eating raw vegan because of ethics, but because he thinks it's the healthiest diet at the moment. I fear, he will have a tough time sticking to the raw vegan diet. This, in turn, could mean Devon will suffer another let-down in his quest towards what he perceives as the "perfect" body. It could push him to seek out diets that are even more extreme than the raw vegan diet.
Note: I am biased; as I do think a Raw Vegan Diet is extreme

Since he took up MMA, he has been increasingly conscious about cutting weight. In our last session he told me, he was having problems with keeping to his diet. He's revealed, he's been trying to go raw vegan while doing carb cycling. This has resulted in binge eating and not sticking to either diet.

Food Log
Since Devon often changes his diet, I've decided in, conjunction with Devon, to do a food log. To make it simple for Devon, I asked him to take a picture of his meals. Since Devon is a big Snapchat user, we decided to use this platform for his food logs. Devon will snap me a picture after each meal. Below are some samples from his food log:

Two day food log:
Day 1:
Breakfast: Banana/apple smoothie with raw almond milkBefore-noon snack: 1 AppleLunch: Tomato salad with spinach and almond dressingAfternoon snack: 1/2 banana Dinner: Cream of Broccoli Soup with cashew, garlic and onionsLate night snack: 1 carrot
Day 2:
Breakfast: 1 glass of water with a scoop of Raw Food Protein PowderLunch: SkippedAfternoon snack: 2 Granola bars (not Vegan Raw Food) and 1 banana and some nutsDinner: Mexican Cauliflower Rice with tomatoes, broccoli, spinach and garlicLate night snack: Dried pineapple and mango with a handful of cashew nuts

Going over Devon's food log, I'm concerned about nutritional deficiencies, and I'm noticing he's skipping meals on day 2. It would be fair to assume, Devon's not in tune with his hunger cues and I suspect his metabolism is low due to his very low-calorie diet.

To avoid deficiencies on a vegan raw food diet, there needs to be a lot of variety in food choices.

The study Vegan diets: practical advice for athletes and exercisers writes: "Poorly constructed vegan diets however might predispose individuals to macronutrient (protein, n-3) and micronutrient (vitamin B12 and vitamin D; iron, zinc, calcium, iodine) deficiencies "

The study also finds: "...data suggests that a negative energy balance is common in endurance athletes and athletes participating in weight-making and aesthetic sports (such as combat sports, gymnastics, skating and dancing, etc.)...The consequences of insufficient energy are important. Immunity might become compromised, leading to illnesses and time off from training and competition. Weight loss can ensue, and can lead to the loss of muscle mass, reduced strength, lower work capacity and a lack of satisfactory training adaptation"

It is evident from his food log his diet is highly hypocaloric. He's not meeting his energy demands, and it's affecting his health. He has been complaining about how he is often sick with colds.

His arms and legs also show signs of bruising from his MMA workouts. His poor nutrition and lack of recovery can result in bruises takes longer to heal.

This study associated a 100 percent raw plant-based diet with a lower bone mass. Given the nature of a contact sport like MMA, Devon's current diet could heighten his risk for bone fractures.

Bright Spots
Devon shows he has cooking skills. I feared when he mentioned he wanted to do Vegan Raw Food; he would more or less just eat salads or fruits. This is not the case. Devon has been experimenting with Vegan Raw Food cooking and has made some delicious meals for himself. He gets some calories from the added fat from oils and nuts used in these recipes.

I also notice Devon is eating protein powder. This means he is thinking about his protein intake and doesn't object to the idea of supplementing his diet.

• Back

• Back

Next Step

A part of me feels, Devon is outside my scope of practice. But I also know, Devon would never seek help on his own. So not trying to help him would probably just send him spiraling further down an already unhealthy route.

Here's some of my ideas of what to do next:

A Point of view
I recently watched an episode of The Joe Rogan Experience on youtube. Rogan had invited John Danaher. Besides being GSP's coach, Danaher is also called the Yoda of MMA. There was something Danaher said, that stuck in my head: "If you give a man a point of view, you can change him."

You can watch the clip here

I want to know more about, what his ideal body looks like. We sat down and searched online and found a couple of examples of body types. Even though Devon is very skinny, his ideal body type isn't a marathon runner. He wants to look like a mixture of GSP and a Crossfitter - lean but also muscular. A friend of mine is a vegan crossfitter, and he has a body which is in the vicinity of what Devon wants. He has agreed to come and meet with Devon, and walk him through the amount of food he eats during a typical day. My hope is, he can give Devon a new point of view in regards to his diet and caloric needs.

A new food journal
So the initial food journal gave me some overall ideas about what Devon eats. I can't help shake the feeling, that Devon was trying to please me and didn't report everything he ate. Besides a granola bar, there isn't any indication of what he's binging on. I suspect he's strict diet regiment has him going overboard in sweets and fast food on his carb days. There's probably a lot of self-blame and loathing involved when he binges.

Instead of focusing solely on what he eats, I also want to know more about his state of mind when he eats. Having Devon rank each of his meal from 1 - 10 on a normal eating scale could help him to be less extreme in his approach to his diet.

Bloodwork
I will suggest Devon to contact a naturopath due to possible nutrient deficiencies. His anxiety could also be a sign of hormone imbalances.

Using Devon's superpower
Devon likes to read about nutrition and training online. While he's making poor dietary choices, and he's shopping around for the next super diet, I feel he can benefit from better sources of information. It could prove beneficial to Devon to provide him with some links; he can research on his own. An example could be this article called: "What Does The Science Say About Raw Vegan Diets?"

• Back