They are skinny because they run on cortisol, which is a stress hormone that is released at a time of stress, specifically low blood sugar and low glycogen (sugar in muscle mass) – both dangerous conditions. The cortisol’s job is to bring sugar levels back to normal, to sustain the body’s primary functions, and in the case of cyclist, to keep them going. Yes, all of that requires sugar, specifically glucose. The primary way the contosiol achieves this is by metabolizing the body’s muscle mass. In other words, it takes the existing lean mass and converts this protein to sugar, so the body can go on, and doesn’t die. It’s a dirty and biochemically very stressful process, and the Somali appearance is probably the least harmful of the effects.