Book Summary: “Life in the Fasting Lane”

Life in the Fasting Lane is a well-written book, great for beginners.

The book has 3 co-authors, so it provides a useful mix of perspectives.

Overall, it shares a valuable combination of basic science, practical fasting tips, and troubleshooting ideas for beginners. Not to mention plenty of personal experience.     

In case you haven’t had time to read it yet, today I’ll share a detailed summary of the book.  

Obviously I can’t cover every detail, but I suspect you’ll gain a lot of useful insights by reading through it.

Let’s get started.  

A Brief Note About the Authors

Dr. Jason Fung is a medical doctor (originally a kidney specialist), who has used fasting in his obesity clinic for many years, helping people lose weight and reverse diseases like diabetes.  He’s also a best-selling author of several other books about fasting and nutrition.

Megan Ramos is a clinical educator who has worked with Dr. Fung in his clinic for many years.  She’s counselled thousands of patients on the day-to-day aspects of using fasting to improve their health.

Eve Mayer is an entrepreneur and educator who had a long personal journey using fasting and other methods to lose weight and improve her health.  

Introduction

• Eve Mayer talks about her struggles with obesity and yo-yo dieting throughout her life.  LCHF (low-carb high-fat), and later learning about fasting from Doctor Fung helped her get over the hump.  
• Megan Ramos tells her story, including an early diagnosis of PCOS, fatty liver, and later type 2 diabetes at age 27. She’s worked in Doctor Fung’s clinic since age 15, but didn’t start fasting until after her diabetes diagnosis.  
• Dr. Fung tells his story, from becoming a nephrologist and treating kidney disease to eventually trying to prevent kidney disease, learning that calorie restriction or “eat less, move more” didn’t work, and becoming an obesity specialist focusing on fasting.

Chapter 1: The Science of Fasting

• Eve explains some basic concepts about fasting, in layman’s terms.  
• Dr. Fung explains relevant hormones and digestive processes, and how fasting reduces disease.
• Key Point: To lose weight, you need to keep your metabolic rate up while increasing satiety/lowering hunger, and keeping insulin low. Fasting accomplishes all of these purposes. 
• Megan discusses a few diseases (dementia, cancer, metabolic syndrome) and the evidence that fasting can treat or prevent each one.

Chapter 2: Mental and Emotional Effects of Fasting

• Megan explains that her female clients often become emotional if they’re losing belly fat on a multi-day fast, probably because estrogen is released from the belly fat.
• People who undergo large fluid shifts can be moody and irritable, possibly because of electrolyte changes. 
• Dr. Fung: Fasting is free, flexible and sustainable. Fat people are unfairly stigmatized. People can control what they eat, and if they exercise, but they can’t control their hunger or metabolic rate.  
• Women especially are discriminated against in the workplace for being overweight.
• The “calories in / calories out” model is overly simplistic and doesn’t account for other variables, such as the majority of energy being burned through metabolism rather than exercise. 

Chapter 3: Hunger Control

• Eve: Understanding hunger as a “bully” was helpful to her.  As you stop trying to please the bully, and understand it better, it has less hold over you. 
• Dr. Fung: Hunger is not a choice. Explains the contrast between a small low-fat, carb-heavy meal and a meal with protein and fat. The latter will stimulate peptide-YY (protein) and cholecystokinin (fat). The processed carb meal also doesn’t have fiber to stretch the stomach. 
• Discussed ghrelin at length. The “hunger hormone” fluctuates daily.  It’s lowest in the morning and has a trained response to be high at mealtimes. 
• If we kind of ignore hunger, it will go down within a couple of hours, and also gradually drops while fasting. This response is greater in women, so fasting helps women even more to control their appetite.
• Megan: People can eat a lot of carb-heavy foods without feeling satisfied and end up eating several times a day. 
• High-fat meals increase satiety, and fasting also decreases hunger. 
• To re-shape habits, try replacing snacks with something like tea, only eating at the table, set the alarm for times you usually get hungry, drink some water (or tea), and avoid snacks on planes. 
• Her clients often have increased confidence in general after they control their hunger.

Chapter 4: Forget Counting Calories

• Eve: Did a million diets involving calorie counting, was always miserable, and the weight came back and then some. 
• Megan: A calorie is a calorie, like a dog is a dog, but there are many breeds of dogs. A can of soda and a handful of almonds have the same number of calories but affect you completely differently because of the hormonal systems.  
• Just like insulin causes weight gain when prescribed to diabetics, foods that raise insulin cause weight gain (and make you feel hungry sooner after).  
• The “energy balance equation” ignores BMR. Cutting calories makes the BMR go down, and vice versa. Calorie-restricted diets make the BMR go down more and more over time. Fasting gradually helps the BMR recover (as they’ve measured in some patients). 
• Doctor Fung: From the 1970s to the present, eating has become the default action (with small frequent meals, ubiquitous snacks, restaurants, etc.).  Previously, not eating was the default action based on the availability of food as well as cultural norms around snacking. 
• The modern environment causes automatic weight gain. The previous environments in the 70s or before caused automatic weight loss. 
• Don’t blame the individuals, people don’t have less willpower, it’s the environment that needs to change. Intermittent fasting (IF) basically creates the “environment” that existed a few decades ago and before.

Chapter 5: What to Eat (and What to Avoid)

• Eve: Fasting is beneficial even if you don’t change your diet, but it’s more beneficial if you improve your diet. 
• She sticks to low-carb 90% of the time, but has some treats the other 10%. 
• Megan: Not everyone has to do low-carb, but that’s generally what she recommends. It depends on the person how strict they need to be. 
• She doesn’t recommend counting carbs because it’s too much to think about, just getting used to which foods to eat and which foods not to eat. 
• Eat vegetables that grow above the ground, meat, fish, whole fat dairy, some nuts, and berries once a day (no other fruit). Avocados, leafy greens, plain yogurt, and so on. 
• Don’t eat candy, cakes, cookies, and anything made with white flour, white rice, potatoes, even beans (unless you’re vegan), “processed” cheeses, etc. 
• Goes over glycemic load and also fatphobia since the 1960s. 
• Some fairly recent studies show fat/saturated fat did not increase cardiovascular risk and actually lowered arterial blockages, “fat is good for you”. 
• Differentiated ketosis (after about 24 hours of fasting) from fat adaptation (after about four weeks, burning fat and not craving carbs). 

Chapter 6: Change the Way you Look at Food (Habits, Addiction, etc.)

• Eve: Used to see food as comfort, love, family, connection, etc. When she started fasting, she consciously changed to thinking of food as energy. It can still be enjoyable, but shouldn’t be the friend that we look to for comfort.  
• Suggests keeping a journal of everything you eat for a week and how you were feeling at the time. Also, make a list of foods that makes you feel good afterwards and foods that don’t make you feel good afterwards. 
• Megan: Our ancestors couldn’t survive if they overate.  The “whole foods” they were eating would activate various satiety mechanisms, especially meat but even fruits or vegetables. Now, all the processed foods are designed to be rewarding and addictive. We’re also surrounded by food all the time. 
• Food addiction is common and difficult to combat because of social pressure and constant food availability. It’s more difficult than drug addiction, based on her experience with clients. 
• Her suggestion is to identify cues that normally would lead to eating comfort foods, and then replace that routine with a different routine that is also rewarding in some way, such as talking to a friend, going for a walk, meditating, listening to a podcast, playing a game, or many other possibilities.

Chapter 7: Ready, Set, Goal

• Eve: You may feel like your body and mind are “broken” after years (or decades) of unsuccessful weight-loss attempts, but with the right steps and with the right mindset it may be easier than you think. 
• It’s important to set one main goal that you’re working towards to help you stay motivated with fasting. (Story about her dad coming off blood pressure medicines thanks to fasting.) 
• Megan: People try to set too many goals.  She asks them what is going to kill them first, and how strong is their “fasting muscle”. 
• If they’ve never fasted before. They shouldn’t try 24 hours right away. They can start with something simpler and less frequent like 12 hours.  
• Various ways to get motivated, including visualization of your future self, memories of something you don’t want to have happen again, fear about going to the hospital or getting cancer or heart attack, etc. 
• She carries around a picture of herself in a bikini and the paper from when she was first diagnosed with diabetes. 

Chapter 8: Getting your House, and the People in your Life Ready for Fasting

• Eve: Go through your house, work, car, etc to get rid of junk food. 
• Even if you have occasional treats, don’t make it easy to access them. 
• If you live with other people who are eating differently, see if you can separate your food from theirs and label it. Ideally have theirs be sort of out of sight, like inside a box.  
• Communicate your goals and the reasons for them to the people you are living with.  They may have questions and concerns, this is natural.  If you don’t know the answer, do a little research and get back to them. They should be kind, but you may need to communicate firmly if they are not supportive.  
• Anticipate logistical issues with family/friends and think of solutions. 
• Megan: Her women clients have usually been on a bunch of low-calorie diets and wrecked their metabolic rate. Her male clients usually have not done this, so their metabolism is higher. 
• Upon fasting, women usually start quite slowly, and pick up over time while men start faster and level out over time. 
• She gives some specific numbers, such as men losing about 1 pound per 36 hour fast, and women about half that much in the early stages. 
• Doctor Fung: HGH increases about five X during a two day fast. HGH is one reason women don’t lose as much weight. It’s increasing their muscle mass and bone density, both of which will increase weight while they simultaneously lose fat. So he advises, don’t be concerned about the scale. 

Chapter 9: Sex, Hormones, and Pregnancy

• Megan: People think fasting might lower their sex drive, but the opposite is usually true. 
• For most women, fasting increases their libido and it also increases their chances of getting pregnant. There are rare exceptions, but usually by taking enough healthy fats and getting enough sodium the temporary drop in sex drive is improved. 
• Doctor Fung: There’s not much research on sex hormones and fasting, most of this is based on experience. 
• One thing he notes is if you’re trying to get pregnant, fasting is highly recommended and helps with PCOS. Once you become pregnant, however, you should stop “fasting”, but can still do modest TRE.  
• Eve:  Her friends wonder if fasting will wreck their sex drive or make them moody, but she found the opposite to be true.

Chapter 10: Working with your Doctor

• Eve: You don’t need your doctor’s permission to fast. 
• Go to your doctor only for a specific reason, or a specific question, such as when to adjust your medications now that you’re starting to lose weight, for example. 
• Doctors don’t get much nutrition education.  She followed their advice for decades and tried a million things that never worked until now. 
• Doctor Fung: It varies a little bit, but doctors get maybe 10 to 20 hours of “nutrition education”. Most of this is more like biochemistry, such as learning about vitamin deficiencies (that we may never see in our career). 
• Doctors are good at some things, like prescribing medications or doing surgery. But they’re not very good at helping people with nutrition or weight loss. 
• Your doctor could be an expert on nutrition and weight loss, but it’s very unlikely. 

Chapter 11: Let Go of the Shaming

• Eve:  She was successful in many other areas of life, but always felt shame and loathing related to being overweight. So she had to compartmentalize. 
• Now she realizes it was not her fault. 
• We should not feel shame for being overweight, It’s probably not our fault. 
• Practice simple self-esteem boosting techniques, like daily gratitude, daily service, daily affirmation. And if we make a mistake don’t beat ourselves up, laugh about it. 
• Doctor Fung: The “calories in / calories out” model is responsible for much of the obesity in America today, and there is an implied fault / guilt to the overweight person. 
• This is false, it’s not the patient’s fault.  It’s the establishment who’s been giving them the wrong information, and shaming needs to stop. 

Chapter 12: Preparing to Fast

• Eve:  It took her a while to figure out how to fast properly, she did a lot of reading and experimentation. 
• She likes to keep it as simple as possible now, and use easy terminology. Fasting just means eating less often. 
• Megan:  Analogy of fasting and exercise, gotta start slow, gradually challenge yourself over time.  
• How “extreme” you eventually need to get depends on your goals and metabolic health, etc. Start with “training wheels” to make it easy. 
• She lists various drinks and other things that they recommend, including coffee, tea, lemon water, apple cider vinegar, bone broth, etc. 
• Avoid sugar and artificial sweeteners (she specifically mentions stevia — they recommend against it because it makes it harder for some people to fast). 
• Brief mention of autophagy (starts 24 to 36 hours, plateaus 72 hours).
• Goes over some very common questions (more FAQ later), says fat burning starts about 16 hours. 

Chapter 13: Stop Snacking

• Eve: She used to eat 8 or 10 times a day. 
• She thought fasting was crazy when she first heard about it, and started with a 36 hour fast trying to prove Dr. Fung was wrong. 
• Later she wised up, but recommended starting slowly as Megan recommends.
• Gradually reduce the number of times you eat daily (by once each week). 
• Eventually, stop snacking for good. 
• Doctor Fung: Conventional wisdom is to eat small frequent meals, no science to back this up. 
• Snacks or small meals whet the appetite without satisfying us, like appetizers or hors d’oeuvres. 
• If we stop snacking our hunger will decrease overall.

Chapter 14: Stepping into Fasting

• Now that you’ve stopped snacking, it’s time to start fasting. 
• Step one is to skip breakfast. You could do this just once a week at first and gradually increase, depending on how difficult you find it. 
• (You could also skip dinner instead. The point is to start skipping a meal and shorten your eating window.) 
• When you’re fasting, drink something like tea, coffee, or water, and minimal fat if necessary. But no food or sugar or artificial sweeteners. 
• Gradually progress until you’re skipping breakfast every day. 
• Eat your remaining meals during about one hour each (no more than eight hours apart). Eat healthy, satisfying, filling foods. 
• The next step is to skip lunch. 
• Again, you can do this periodically, not necessarily every day.  
• With all the steps, remember what your goals are. 
• You may or may not need to do longer fasts. But if you’re ready to progress, the next step is to skip dinner as well (which means fasting all day, or about 36 hours). 
• Ideally, get some extra sleep.  Gives some sleep hygiene tips. 
• Remember to hydrate, stay busy, and distract yourself.  
• If you want to try something longer, keep going until midday the following day. 
• Try it out, see how it feels, and make sure you progress gradually. 
• Not everyone needs to do extended fasting, but there are various reasons for trying it out, from curiosity to further health benefits. 
• You might want to involve your doctor on longer fasts, especially if you are taking medications. 
• Doctor Fung: If you’re fasting less than 36 hours, refeeding is not a big deal. 
• For fewer than 5 days, just refeed slowly and mindfully, with plenty of water.
• After a really long fast, start with a handful of nuts or something really small to “warm-up” your digestive system. Then eat like an hour later. 

Chapter 15: Exercise for Health, Not to Lose Weight

• Eve: She used to exercise a lot, but it didn’t help her lose weight. 
• When she finally started fasting, that’s when she actually lost weight and improved her fitness. 
• Megan: Similar experience to Eve, and she used to hate exercise because it was painful and difficult. Now, she finds it relaxing and it greatly improves her mood.  
• Doctor Fung: Growth hormone and noradrenaline increase blood glucose very early in the morning, so when you wake up you don’t need to eat — you’re still burning that sugar. 
• Working out on an empty stomach is fine, and probably better. (Story about his UFC client.)

Chapter 16: Feasting without Guilt

• Eve: Don’t feel guilty about eating. Fasting and feasting cycles are normal. 
• When you have your meals, do so slowly and mindfully.  Take the time to enjoy the flavors. 
• Talked about artificial sweeteners, her addiction to sweets, and eventually cutting out the sweeteners (which sometimes raise insulin, and often make it harder to fast). 
• She used to have binging problems, eventually did therapy.  Therapy or cognitive behavioral training may be helpful. It’s mostly about the voices we use to talk to ourselves.  
• Megan: It’s okay to fast and feast, this is a normal human cycle. 
• Many people have learned to be afraid of eating until they feel full, and also are afraid of skipping meals, because of the messages in the media and the weight-loss industry.  
• It’s normal to “feast” during holidays and other festivities, but you can mitigate the damage by doing some extra fasting before and after
• It also helps to keep your eating to mealtimes, spoil your appetite intentionally, start with higher fat and higher protein foods, don’t eat mindlessly (if you don’t have time to eat, don’t eat), be conscious of sugary drinks (including alcoholic drinks), etc.
• Several good tips in this chapter. 

Chapter 17: Tracking your Progress and Setting New Goals

• Various ways to track your progress include weight, body fat measurements, how clothing fits, flexibility, how far you can walk, sleep quality, and many more. 
• Some people react calmly to weighing themselves, others are too emotional about it and should probably do it less frequently or not at all. 
• If you reach your first goal, you can recognize your achievement and feel content.
• Then either set a new goal or set a maintenance goal.  
• Either way, it’s good to have some sort of tracking system, such as continuing to monitor measurements, using a spreadsheet for your body fat or weight, etc.
• Maintaining your goal can be just as difficult as achieving it.  
• Don’t forget to acknowledge the progress you’ve made. 

Chapter 18: Solving Symptoms while Fasting

• Megan: There are various common symptoms that may happen while fasting, but everyone reacts differently. 
• Very rarely, more serious issues may occur, in which case you should seek medical attention. 
• Common symptoms include headaches, thirst, difficulty sleeping, constipation, diarrhea, fatigue, feeling cold, bad breath, etc. 
• Most of these either go away on their own or may be helped by better hydration or increased salt intake. 
• (Provides a brief take on how to handle each common symptom.)

Chapter 19: Fasting Mind Tricks

• Eve: She thought she would have a battle with her stomach when she started fasting, but she didn’t. She had a battle with her mind and her habit of living a food-centric life. 
• Mainly, she got bored because she wasn’t spending as much time preparing and eating food (among other food related activities). 
• She found it useful to get busy doing other things, and she shared a long list of recommended activities to do when you’re fasting. Basically anything kind of fun or productive that doesn’t involve food.  
• Some things not to do, at least for a beginner:  looking at social media, grocery shopping, cooking (+ some tips about what to do if you normally cook for your family), washing dishes, going to the movies, going to parties, and traveling. 
• [I would note that I have done several of these things while fasting, without much trouble. But people who are inexperienced may have more mental blocks related to these issues, more cravings, etc.]
• Doctor Fung: One additional fasting mind trick is to remember that fasting is normal, many people do it, and it’s common in many societies/religions now and throughout history. 

Chapter 20: Fasting and your Social Life

• Eve: You don’t have to make dramatic changes to your social life (unless your social life consists of eating all day every day). You can be flexible about which days you fast, not necessarily avoiding free meals or special events. 
• Don’t be a martyr, don’t complain about how you feel, just say “no thank you, I’m not hungry” if somebody offers you food. 
• There’s not one magic fasting formula because everybody is different, and everybody has different family, cultural, and other demands. 
• Megan: Don’t be too rigid, nor too casual with your fasting. Be flexible and adjust your schedule as needed so you can still enjoy events with family and friends. But don’t be so lackadaisical that you start skipping your fasts all the time. 
• Patterns that work well for some people include 24 hours three times a week, 72 hours consecutively, 36 or 42 hours two or three times a week (or with a flex day on the weekend).  
• There are holidays scattered throughout the year, not to mention weekends, so there’s always something going on. You have to be somewhat committed but also flexible in order to stay consistent. 

Chapter 21: Getting Back on Track

• Everybody slips up, that’s normal. Learn to forgive yourself, laugh at yourself, and get back on track. 
• Skinny people don’t always eat right either, but they typically go back to eating better afterwards and do it most of the time.  

Chapter 22: Finding a Supportive Community

• When you start fasting, you don’t need to tell everyone about your fasting plans. 
• Wait till you’ve educated yourself and had some experience before you tell family or close friends. 
• People may have a few more questions or concerns than what you can handle if you haven’t done your research. You’ll also feel very vulnerable because you’re trying yet another weight-loss plan. 
• Once you’re ready though, and the moment is right, share in a non-defensive way, with confidence. 
• Even though you shouldn’t tell everyone about your fasting, it’s good to have a support group. 
• You can start by talking to some family and friends, but they might get tired of hearing about your health goals. 
• Online communities, including Facebook groups or other specific free or paid communities can be helpful. 
• You can also try following a few specific “experts” in the field, using their online newsletter, podcast, or website and possibly also some low-carb or fasting people on social media. 

Chapter 23. Your New Life

• Eve: It seemed daunting at first, but ultimately fasting created freedom for her. 
• She was afraid when starting on a long road trip vacation for example, but learned to enjoy being in nature and interacting with other people rather than constantly thinking about food and snacks like she would have before. 
• Celebrate your successes, ideally with something besides food, but even doing it with food is okay.  Like a steak and salad at a fancy restaurant for example.

Bariatric surgery

• In case you’re considering it, she shares her journey, including a lap band, a second lap band, and a gastric sleeve. 
• Every time, she had temporary success for about three months.  Then the hunger came back with a vengeance and the weight gradually came back. 
• Dr. Fung: Bariatric surgery doesn’t work very well in the long run. 
• It was uncommon until after 1999, shot up like a rocket over the next five years, but has gradually declined over the last several years as word has gotten around that it’s not all it’s chalked up to be. 
• Shares some statistics from the Cleveland clinic about high rates of side effects (complications, nutritional deficiencies, and so on), or needing a second operation, etc. 
• Fasting is a much better long-term weight loss solution and should be embraced by the medical establishment. 

Final Thoughts

I hope you found this detailed summary of Life in the Fasting Lane useful!

Naturally, you’d benefit even more from reading the whole book.  But the summary is a pretty good start. 🙂  

You can find the book on Amazon.  I prefer audiobooks so I used the OverDrive app to borrow it from my local library.  And there’s always Audible (where you can do a 30-day free trial and listen to the audiobook).

Whatever method you use, I think you’ll gain a lot of valuable insights by reading Life in the Fasting Lane!