T Nation

Caloric Recommendations for Obese Clients


#1

There have been a few threads lately on training obese clients, so I want to pose this question. How do you recommend daily caloric guidelines for the morbidly obese? John Berardi's Winning Formula (issue 205) gives some pretty unusual numbers. Are there any guidelines for the obese as opposed to the already fairly healthy? Or do you just stick with a standard 2000-2500 calories?

Would it make sense to start somebody off by using Berardi's formula calculated for their target body composition?


#2

I would still use body weight if I were to go a calorie counting route with such a person, but you can go on a much more extreme version without worry of LBM loss due to the carried fuel. It depends on the amount of obesity we are talking.

In gereal I myself to cut weight go 250 under maint to start, judging on howe big this person is you could go 500-1000-1500,etc. below the figure. It depends their weight and composition.

The whole approach of going for near a goal weight may be a good choice also. I wouldnt go straight for that amount but 20-30lbs over the goal then adjust as you reach these levels.

Just my 2 cc

Phill


#3

Thanks Phil. It's interesting that the people who are probably best equipped with knowledge to help the obese (T-Maggers, J. Berardi, etc.) seem to know nothing about obesity itself, and the trainers who DO attempt to help the obese don't know nearly enough to do much good.


#4

Well I was 300lbs 4yrs ago so I would say I was obese.

If this means anything. Not that I am an expert. I just know what worked for me. That was dramatic weight loss down to 30lbs from my goal then slower progress from there.

Hope that helps
Phill


#5

barn-e, just my thoughts on the subject, but I feel that the caloric intake is less important than establishing new, good habits. If someone who is obeste starts with the basics (eating 6 meals a day, every 3 hours, eating protein every meal and ALL the green veggies their body can handle, along with some light, mild, not overly challenging exercise, and, of course, eliminating the worst of the dietary offenders like fried food, fats, etc.), they'll very likely make very good progress without ever counting a calories.

I can't recommend highly enough John Berardi's article, "7 Habits of Highly Effective Nutritional Programs." I would say that that's the first step. When progress finally halts or slows and after those habits have become firmly entrenched, the diet and nutritional requirements could be dialed in more precisely, with protein, fat and caloric requirements.

What do you think?


#6

Would it perhaps be better to do estimates off of lbm instead of TBW. Have them set calorie levels at say 12xlbm.

Example
300lbs individual with lbm of 170lbs

170x12=2040

I don't know much like others here but thought I would throw in my .02 cents.


#7

There's no doubt that the habits are the hardest things to establish. It's also very helpful to keep a log, if just to see where the bad habits are. (I learned I eat way too much cheese, for example.)

Here's where I find it confusing. Obese people tend to lose LBM while dieting, right? Is that because they are on a calorie restricted diet and aren't geting enough to support their LBM? (Try running Berardi's numbers with a 350lb man at 50% BF for example. No diet will ever recommend that caloric intake to lose fat.)

So, what do I think? After cogitating for a couple hours, I think the best thing is probably to establish what caloric level is being consumed NOW, and put that in context of Berardi's numbers. Is it high, low or close to LBM maintenance numbers? If it's actually low, then the body might be in starvation mode and actually need more calories. If it's too high, bring it down to about 85% of maintenance.

Then I'd work in appropriate macronutrient ratios and appropriate food selection.

How does that sound Socrates, I mean, TT?

Kevin521, where do you get the number 12? Is there some formal basis for it?


#8

barn-

I agree with Tampa-T 100%. Read Berardi's 7 habits and stick to the basics when trying to lose lotsa fat.

Now if you are hell-bent on counting calories (even from the get go) I would suggest having the individual start a diet lot RIGHT NOW. Have them do this for a week and get an idea of what their average daily total caloric intake is. Then I would calculate the calories required for healthy weight loss (looking for somewhere in the range of 1-2 lbs per week, maybe a bit more for the obese) and start working the calorie consumption in that direction. I wouldn't slash/add calories too fast here either (adjust from the individuals current level +/- 250 kCals per week) as it very well could throw an already messed up metabolism a curve ball. Hope this helps-

C-M


#9

i agree with TT, i've used Berardi's 7 habbits list with overly obese clients and have had great success with it. Most of these people have such poor eating habits that giving them cal,p,c,f recomendations is way to much for them. Recently i had a client who drop 25lbs of fat in about 10 weeks with minimal lean body mass loss, and she wasn't even following my advice to a T. Im now trying to get her to start looking at some numbers as to how much she is taking in.