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Threats & Synergies
The worst thing any champion can do against an offensive Cho'Gath of any build is attack alone. Even with Taste Your Fear active, if you are built on at least 3 Feast Stacks, Kha'Zix won't be able to do much
Because Cho'Gath isn't often used, an odd build like this one will tend to throw many Garens off their rockers, especially if you build the skills the way this guide entails. If they build towards damage, you will outlast Garens with ease, and once they get in close, you can use Ruptures to make sure they stay close as your Vorpal Spikes wittle them away quickly. And if Garen is still higher in HP then you late in the fight, finish him off with a well placed dose of true damage from Feast.
Cho'Gath's worst enemy as an offensive tank, is a tank that can outlast him and keep him held in place long enough for other enemies to arrive. Careful when fighting one on one with guys like Braum, Nautilus, and Malphite, and when going against them, be sure to have Ghost, Rupture, and Rylai's Scepter handy for an epic escape.
How dangerous Rek can be to you, is completely up to how skillfully you play. If played right, you can journey into the jungle soley to hunt down some Rek'Sai purely for trolling enjoyment. Any Rek'Sai that wants to fight a Cho build like this and live, will need to max out Burrow early, or Rupture will have him begging for mercy. Rek can be vulnerable to Cho'Gath in general, as being silenced while still burrowed, will make Cho'Gath unable to deal any damage except with his weakest move, Prey Seeker, keeping him from gaining fury, and therefore keeping him unable to regain HP. However, that's only late game in this build, and you actually don't need Feral Scream at all. Just Rupture him in the jungle, and you'll find that once you close in, that he's pretty much a delicacy that just requires a little finesse to take on.