I nearly died on the shitter myself, as you can raise your blood pressure quite a bit when straining.     No bullshit, scariest thing in my life. I hit 250lbs, finally had a panic moment, and decided to kill my sugar addiction by going cold turkey first, so I didn't eat anything at all, and only drank water with a little bit of lemon and salt in it and a multivitamin once a day for 3 weeks.     I felt perfectly fine, and lost a lot of weight (granted a lot of water weight), and then when I decided to break my fast I went with bone broth first as recommended, felt fine, so then started introducing solid foods (cheese, avocado, bacon)... big mistake to go too fast with the solid food. I had massive stomach cramps, felt like I had to crap but couldn't, strained to crap to get relief, sweat literally pouring out of my body I was soaking wet, my skin was bright red, and I could feel my heart pounding in my chest.... luckily didn't die, eventually had horrible bout of diarrhea, and vowed never to go on a fast again. Fast forward and I did regular keto diet along with walks every evening for an hour followed by weight lifting for an hour before shower and bed, and I'm down to 180lbs (still a bit more to lose) and already some good growth in my arms and chest.   But yeah, its quite possible had I been a little older, I could have been another fat fuck dying on the toilet statistic.