Setting calories for extremely obese.

[juggy38]

So I know for typical or semi athletic male humans an easy starting point is current body weight x 14/15 calories,

How the hell do y’all guys start a diet for someone that is 5’ 8” 416lbs?

And I KNOW anything would work at this point, but with pre diabetic glucose levels, and the responses oh him “well I don’t keep up with what I eat…I was just kinda thinking along the lines of….

300g protein…..he’s a heavily boned, wide shouldered, barrel chested black male (D2 linebacker 190lbs ago) I’m sure he can put the food away….so more animal flesh the better….


Then just add healthy whole foods until we hit 3,300 calories? Is that too low?

Also he loves to bench, OHP, but his size, leg training is a problem.

I was thinking heavy sled drags/pushes, and leg press for legs.

Lat pulls and chest supported row for back

Split….maybe full body EOD. Off days would be elliptical/bike. (I don’t think his knees would tolerate long incline walking 5 days a week.


What you guys think? He’s my buddy and I know he’s gonna go balls out, recently divorced and finally healing, I don’t want him to get injured with weights. This would be much easier to
Build a spilt if he was 300lbs.

Any tips appreciated.

 

[juggy38]

And I mean I know the general rule of thumb is don’t go below BWx 10 calories for leaning up, but he doesn’t move that much. 4,000 calories seems absurd for his activity level…..

But then I’m sure walking from the parking lot at 400lbs is a fucking HIT workout.

Idk. Way out of my wheelhouse

 

[jeroendebleser]

I normally advise to start with the kcals set as high as possible (while still being in a deficit obviously) and gradually lower them over time BUT if he's extremely obese and basically knocking on heaven's door every day I would set the kcals (very) low from the get go...

He needs to lose that fat weight ASAP.

You could look into what they prescribe for gastric bypass surgery patients (they are often prescribed a diet before they get their gastric bypass surgery) and mimic that. It's basically going to be very low kcals all the way from the beginning until the end.

Good luck to him!

 

[Cabron]

he’s a heavily boned, wide shouldered, barrel chested

lol

i bet once he gets down to say... 170lbs, all of that will dissipate, and he will look like a normal human with a normal skeleton


aside from the loose skin

losing weight is simple, but not easy. he has to want it

if he doesn't have the willpower, then he will likely die quite a while before his time. it's his choice

 

[qbkilla]

Hard to say when someone is that big, IMO your plan is solid. How is his heart? I would worry about physical activity being that over weight maybe ramp up the training to make sure he is ok (rather than longer workouts right off the bat).

Mushroom, sauerkraut, green beans, no sugar almond milk, def use those high volume foods so he doesn't over eat his target calories.

If he's hungry maybe internment fasting, so he doesn't feel like he's eating tiny meals throughout the day if he's used to eating alot.

 

[OuchThatHurts]

If his weight has stabilized at current levels, rather than make dietary cuts at all, get him in supervised periods in a pool with low impact aquatic aerobics as virtually any, ANY, activity will throw him into a caloric deficit at this point. If he is binge eating, it might be good time to try determine his mental health status and to have ongoing support for the long road ahead.

From there you could move on to short walks of 15-20 minutes daily or semi-daily. He is far from a treadmill or free weight exercise at this point and even a small injury will set you back for months.

I would try to get advice from a registered dietitian, a licensed physical therapist, and a behavioural psychologist to help him sort all this out in the years ahead.

It will have to be a team effort. I was able to navigate a similar program but far less extreme example. It was no picnic. But it was life-changing for all of us.

https://www.professionalmuscle.com/forums/index.php?threads/friend-11month-before-and-after.170906/

 

[Deansreturned]

Would it make sense to get a body composition analysis done?

Then plug figures into a TDEE calculator, take into account his activity levels and then create a 500 calorie deficit per day from there?

Not sure if this is applicable in this situation or what the recommended daily intake would be for his current stats

 

[Delt123]

Did he go to the gym prior to coming to you?

For some training and dieting will be a complete different lifestyle than they used to so going all out from the start might not work out that well.

What I have done with gen pop people who refuse to diet is make a diet with ‘non diet’ food. I had one girl on several McDonalds meals per week. She lost weight regardless and it installed some structure is her eating habits as well as less ‘resistance’ to dieting. Eventually we lowered the frequency of those bunk meals and got her on proper meals.

Filling the macros with mostly protein and carbs, I have found a lot of gen pop people struggle to eat the meals because they’re full. Most aren’t used to eating 100gram of oats or 150gram of rice.

 

[MR. BMJ]

I would concentrate more on easy corrections....less sugary drinks, less processed foods, more nutrient dense foods, fruits and vegetables, lean protein sources with each feeding, increased fluids, etc, etc. Have a 'healthy meal q 3 hrs, and slowly add in cardio exercises that do not add a lot of pressure and jolting to the knees and joints, such as stationary bike (or biking outside if he can get on one that can handle his weight), swimming, walking, etc. Add in a simple weight training program if he has access. Run with that for awhile and monitor. Have him write down what he eats and a close approximate....though it will still be usually inaccurate, self-reporting from the general public always is. Keep with that until it stops working, then fine tune it some more. Make sure they are not sneaking in junk foods and drinks as snacks...or even handfuls of nuts that add a lot of calories, despite being healthy (calorically dense reasons). Have them find a good support group and eliminate all people who are negative. Something simple like half the plate veges, 1/4 protein, and 1/4 healthy CHO's are good for beginners.

***EDIT: I re-read, he is not so much of a beginner as my noted suggestions above. I'd still keep it simple though, and make sure he is consistent.

 

[tornquad201]

I always use LBM as you don’t need too support your body fat it’s stored energy . Feed your muscle and use your fat for energy at 400 they have lots too burn .

 

[Berst]

Get him to walk twice per day. He may not be able to do much at all to begin with as it might hurt his feet/shins, but he will be able to make easy and consistent progress.

If he cannot do that yet, get him to do basic exercises in a pool until he is heavily out of breath, as often as possible, ideally 5-6 days a week.

Get him to send your photographs of every single meal and snack for at least the first month.

 

[b-boy]

What I did for an overly obese friend of mine.

I went to the grocery store and bought a bunch of chicken breast, Lean beef, faye yogurt and protein powder from TN. We also bought a bunch of veggies. Went to his house cut the chicken breast into cubes and cooked a bunch and cooked some lean ground beef and a bunch of veggies.
Here was the game plan, you eat at least 3 cups of veggies a day, 200 grams of faye with 2 scoops of protein powder mixed in (protein pudding, he loved it) and then eat as much chicken as you want, if your hungry eat some chicken, have 2 8 oz servings of beef daily, so pretty much eat all the fucking protein you want. Dude lost 130 lbs and is still losing weight started at 395lbs and not very tall, he already looks like a different person.

Any time you tilt the protein to energy ratio heavily towards protein you will lose fat.

 

[juggy38]

Many thanks guys.

So yes, he works at the hospital with me. This last year was hell on earth for him. His mother caught Covid, and had permanent damage. He had to move her in with him. She passed away last November. And his ex wife was a evil hooker with two kids not his. She worked part time.

He was financially supporting that household on a base of $23 an hour and ungodly overtime. Like 52-60h a week for weeks on end. He drank a lot, he was depressed.

He’s in a good place now, came up to me and he wants to do this.

Obviously he can pack away food, but he filled out a questionnaire I had from my old ISSA certification class.

He’s been living off of beer, hospital cafeteria food, and KFC or pizza.

I just don’t want him to be starving, but at the same time get the scale moving

I do like the pool idea. He says he gets about 4000 steps a day. I told him get 5000 steps this week every day and we will slowly go from there.

I’d think 3000-3200 calories from chicken veggies and a little bit of eggs/avocados/berries….the scale should move. I guess we will just establish healthy habits, and tweak it from there.

 

[juggy38]

Did he go to the gym prior to coming to you?

For some training and dieting will be a complete different lifestyle than they used to so going all out from the start might not work out that well.

What I have done with gen pop people who refuse to diet is make a diet with ‘non diet’ food. I had one girl on several McDonalds meals per week. She lost weight regardless and it installed some structure is her eating habits as well as less ‘resistance’ to dieting. Eventually we lowered the frequency of those bunk meals and got her on proper meals.

Filling the macros with mostly protein and carbs, I have found a lot of gen pop people struggle to eat the meals because they’re full. Most aren’t used to eating 100gram of oats or 150gram of rice.

Yea he’s been going to the gym for about two weeks now….mostly bench, machine pressing and rowing, arms, and leg press and lunges.

I told him to quit the lunges immediately, I think the risk/reward is too bad. That’s why I thought weighed prowler pushes and drags would be a knee safer leg training.

 

[Bio]

Before I even thought about the actual diet protocol, I would have him cut all sugar and high glycemic carbohydrates for a few weeks and let his body adapt to that. Then like b-boy said.

 

[Cabron]

Before I even thought about the actual diet protocol, I would have him cut all sugar and high glycemic carbohydrates for a few weeks and let his body adapt to that. Then like b-boy said.

exactly this.

i imagine he is pounding down quite a bit of soda and/or sugary energy drinks

for him to be that heavy at that height, he must be putting away 6-7k calories every day - which is very difficult to do unless you are drinking a considerable amount of them.

 

[Tomgrass]

Intermittent fasting to kill hunger effect supported by lot of coffee and later start meal ALWAYS with
Lot of lean meat
Lot of veggies
Spoon of olive oil
Carbs last- ideally potatoes
2-3 big meals like this plus cardio fasted will sort him out for good.
He need to create habit which last forever.

 

[Flex500]

I would set them much, much lower...around 2,000 to 2,500. Even if you are not moving at all, it takes quite a bit of food to maintain that much weight and you are talking critically important to lose a lot of weight...quickly...at that weight. Putting him on 2k-2.5K would also keep him well nourished.

Bboy's suggestion is right on the money and honestly not even far from what you see in the medical community. If he worked with one of the docs I work with (one I respect that is smart) he'd be put on 1,500 calories ASAP....lean meat and vegetables.

Back to bboy's approach...it's easy to follow and essentially has the same impact. Buy the leanest meat, lots of vegetables, and cut out all processed sugary foods, drinks, and you really don't have to worry about dietary fat (he has plenty on his body to support life). Doing this (if he actually sticks to it) you will find many people end up around 1,500-2,000 calories and are quite full and content.

 

[TheOtherOne55]

Every massively obese person is different. Some are completely imobile at 416, others are on their feet all day and moving around. Which one is he?
Also, you need to get him to be frank with you and tell you what he eats all day. That will at least give you a rough estimate on how many cals he is consuming for maintenance. From there, it should be easy. You dont need to starve him. He'll lose weight regardless.

Before you make any adjustments, have him cut stuff like fruit juice and soda out immediately. The vast majority of soda drinkers have no clue that they are consuming liquid calories and a shit load at that. Putting him on strictly protein from where he's at now is a shock and most will quit quickly. Ease him into it. First, no soda. Then no snacks. Keep him to meals. Then, educate him on constructing a "meal." High protein, lower carb, etc. Eventually itll be 2 months in and he's eating relatively clean and 1/2 the calories he was originally consuming. That plus some activity, fat will melt off him.

 

[Nike22]

Before I even thought about the actual diet protocol, I would have him cut all sugar and high glycemic carbohydrates for a few weeks and let his body adapt to that. Then like b-boy said.

For sure this plus intermittent fasting. Print up a list of the glycemic index for different carb sources.
Really get him to wrap his mind around the difference between white and wheat bread vs Rye. White rice vs Brown. Eating an orange vs drinking OJ.

It would probably be a good idea to go shopping with him, do some cooking with him just to show him how to "do it healthy"

At one point I took a 4 year alcoholic break from the gym and got up to 275 of pure fat. Intermittent fasting worked for me because eating 2,500-3,000 cals inside of 8 hrs meant I had pretty big satisfying meals. Cut carbs and boosted fat lots of good fat, 6 eggs a day, 1-2oz of walnuts, salmon, fish oil. Tried to keep carbs at 100g or less on days I didn't work out, 200g or less on workout days. After a few months of progress, threw in some test & NPP, one reasonable DNP run and I was a new man in 6 months.