T Nation

Getting Seriously Obese Friend Started

So my friend’s latest attempt to lose weight has him seeking my advice as to how to implement a lifting routine. This is quite a task, considering he is morbidly obese (450+ lbs) and has absolutely terrible conditioning. Not only that, but he is naturally disinclined to stray from his comfort zone (how anyone that large can ever be comfortable is beyond me), and pushing him too hard will scare him away from lifting. After thinking it over for a few days, I’ve come up with a basic plan:

Full body, 2-3x per week:
-some kind of bench press (machine or BB, because he won’t have the coordination to use DBs)
-seated row (although the ROM will be quite limited due to his girth)
-DB stiff-legged deadlift (weight won’t matter at first, merely looking to increase his ROM slowly over time and get him comfortable with the movement)
-machine overhead press (will insist on a machine, since his pushing muscles will be tired from the bench press)
-pulldown (self explanatory)
-wall squat or “ballet” squat (on the latter, he can hold onto something for balance and, like the SL DL, concentrate on increasing his ROM slowly over time)

On all lifts, I want him to shoot for 1 set of 15 reps, with as many rests as it takes to get to fifteen. Once he can do fifteen straight reps on a lift, I’ll up the weight, eventually adding more sets. I know the old “high-reps-for-weight-loss” isn’t followed anymore, but I’m going to use it to up his volume of work the only way I can, considering he’s too weak to get much out of lower reps. Simply put, the man just needs to move more. To that end, I may throw a couple of arm exercises on at the end just to give him more to do without running him into the ground.

I also thought about splitting up the body, but I decided to go for a minor PHA effect, as he will notice fat loss long before he’ll notice muscle gain, and the only chance this has of catching on is if he sees some quick progress.

If anyone else has some experience training people in this condition and can offer some advice, I’d really appreciate it.

Are you going to have him do any type of energy systems work? Walking, for instance?

At this point focus more so on nutrition than exercise.

sounds obvious but have him do what he’s capable of. I would focus more so on cardio at this point (walking if possible).

weights will be important but I wouldn’t focus too much on it at this point. He already has a lot of muscle mass, just doing some lifting 2x week minimum will help he preserve some muscle while dieting.

I’d get him to start working on JBs 7 Habits of Highly Effective Nutrition

I recommend pole vaulting.

[quote]brancron wrote:
I recommend pole vaulting.[/quote]

lol

fix his diet with caloric restriction at the same time to get him down to a more manageable starting point like 300, then focus more on training

Thats quite a bit to bite off, no pun intended.

Have you or he recieved medical clearance for moderate exercise?

[quote]leon79 wrote:
So my friend’s latest attempt to lose weight has him seeking my advice as to how to implement a lifting routine. This is quite a task, considering he is morbidly obese (450+ lbs) and has absolutely terrible conditioning.

Not only that, but he is naturally disinclined to stray from his comfort zone (how anyone that large can ever be comfortable is beyond me), and pushing him too hard will scare him away from lifting. After thinking it over for a few days, I’ve come up with a basic plan:

Full body, 2-3x per week:
-some kind of bench press (machine or BB, because he won’t have the coordination to use DBs)[/quote]

Why won’t he have the co-ordination to use DBs? Let him start with the 5pound DBs and work upwards.

So use DBs or arm at a time?

YOure asking a 450 pound dude to do something called a 'ballet" squat? How brilliant. Throw in an hour of krav-maga and Nigerian tap dance once that is done.

On a more serious note:

  1. Ask him to eat smaller meals more often. and give him a list of “healthy” foods to choose from. Ask him to make ‘healthy’ choices at fast food places (salads or subs w/o mayo, grilled chicken, roast beef, eggs, low-fat dairy etc)
  2. Ask him to walk more often and stop driving, climb a flight of stairs every once in a while. Buy him a pedometer and ask him to walk 1000 steps everyday. Raise that amount gradually.
  3. Get him to take a multi-vitamin daily with a fiber supplement. Also get him some source of iodine to add to his daily intake. Maybe a tablet of kelp daily. Supplemental zinc is also a good diea.
  4. Ask him to push up the weights from session to session. Stick with low volume routines 2 times a week and get him hooked on the rush of getting stronger with each session. that will do more to solve the problem anyway.
  5. Get him to do a rippetoe style routine whenever he lifts but replace the squat with the leg press till he has been training for a while. Ask him to try out bodyweight squats till he gets below 350, even getting up from the chair is like squatting a ton for this guy.
  6. get him one of those cab;le expander sets and get him hooked on getting stronger there.
  7. get him to drink a gallon of water daily.

Watch what happens in a few months.

It will be hard to explain why, but there is nothing I can do about his diet. He is not at all willing to make what most of us agree are reasonable adjustments to his diet, so my only avenue for influencing his fat loss is through exercise. I know it’s well short of optimal, but he doesn’t view this stuff like we do.

Because he has a very low tolerance/enthusiasm for exercise, I’m trying for a routine that will have a chance of getting him hooked, so that down the road he will be more willing to make dietary changes.

I know this is slightly out of place in the bodybuilding forum, but I’m not a beginner, nor do I want other beginners guiding my friends introduction to this lifestyle.

Tell him about the intragastric balloon.

[quote]tribunaldude wrote:

YOure asking a 450 pound dude to do something called a 'ballet" squat? How brilliant. Throw in an hour of krav-maga and Nigerian tap dance once that is done.

What I’m calling a “ballet” squat is designed to provide lower body work to someone with severely limited coordination and flexibility. It would be much less demanding than a free squat. Anyway, the point is moot, as he tells me he can use the leg press, which I would have recommended in the first place had I thought he’d be able to fit into it.

On a more serious note:

  1. Ask him to eat smaller meals more often. and give him a list of “healthy” foods to choose from. Ask him to make ‘healthy’ choices at fast food places (salads or subs w/o mayo, grilled chicken, roast beef, eggs, low-fat dairy etc)
  2. Ask him to walk more often and stop driving, climb a flight of stairs every once in a while. Buy him a pedometer and ask him to walk 1000 steps everyday. Raise that amount gradually.
  3. Get him to take a multi-vitamin daily with a fiber supplement. Also get him some source of iodine to add to his daily intake. Maybe a tablet of kelp daily. Supplemental zinc is also a good diea.
  4. Ask him to push up the weights from session to session. Stick with low volume routines 2 times a week and get him hooked on the rush of getting stronger with each session. that will do more to solve the problem anyway.
  5. Get him to do a rippetoe style routine whenever he lifts but replace the squat with the leg press till he has been training for a while. Ask him to try out bodyweight squats till he gets below 350, even getting up from the chair is like squatting a ton for this guy.
  6. get him one of those cab;le expander sets and get him hooked on getting stronger there.
  7. get him to drink a gallon of water daily.

Watch what happens in a few months.[/quote]

All good ideas-and all common sense-for someone willing to make wholesale changes, which he is not. I made a few suggestions concerning his diet, but it will take some time to bring him around. I think I can get him to slowly add some walking and pool work, but I know him well, and I know that he’s much more inclined to follow a weightlifting routine than anything else. Right now, I just need to get him doing something, and will make improvement as I go.

[quote]leon79 wrote:

All good ideas-and all common sense-for someone willing to make wholesale changes, which he is not. I made a few suggestions concerning his diet, but it will take some time to bring him around. I think I can get him to slowly add some walking and pool work, but I know him well, and I know that he’s much more inclined to follow a weightlifting routine than anything else. Right now, I just need to get him doing something, and will make improvement as I go.[/quote]

You have the right mentality as far as getting him started, especially in the workout department.

Something to help further your full body workouts:

When you start doing supersets, for example, make the workout as random as possible. What I mean is instead of putting exercises together that play off one another for muscle growth, i.e. shoulder presses with upright rows, have him do shoulder presses and squats in the superset.

What this will accomplish is a greater release of the body’s stress hormone, cortisol. It’s a nasty bugger to bodybuilders as cortisol dissolves muscle and fat indiscriminately, but it will be his best friend for weight loss.

Keep him on full body workouts; draw up three different programs and have him rotate through them, focus on combination lifts and their variations (i.e. Flat/Incline Benches, Barbell/Cable Rows, Deadlifts/Romanian Deadlifts, Shoulder Presses/Clean and Jerks). His weekly lifting schedule could look something like this:

Monday: Weights
Tuesday: Off
Wednesday: Weights
Thursday: Off
Friday: Weights
Saturday: Off
Sunday: Off

What this will do is two things: 1) He will get three days of lifting a week, three programs to which his body will not readily adapt to as easily to one or even two programs a week. Once in a while, jumble the order of the workouts during the week, too. 2) He will have several days for him to rest and recover for the next workouts as well as not burning himself out in the process. As you can see, he has the weekends to himself, or however he arranges his schedule there will be two days to be ready for the next round.

The program you outlined is good, focusing on all combination lifts with few to no isolation exercises for now. The only adjustment I would make is to put the deadlifting first because it will be the most taxing on his body, especially with higher reps, as well as producing the best overall bodily changes.

As far as reps go, rotate the reps off each time as well. Let’s say program 1 involves the flat barbell bench press, reps 15-12 for the sets. Program 2 could have Incline dumbbell/smith machine press with reps of 12-10, Program 3 could revisit the flat barbell bench again, only reps would be 8-6. By doing rotating rep ranges as well as rotating exercises, his body will not only stay in a predominantly fat burning mode, but it will also have to constantly bear increasingly difficult loads. Only by building strength can he hope to build bigger muscles. By building those bigger muscles, he can increase his strength, and the cycle can become perpetual. Progressive overload adds to fat burning.

Seeing as how dieting is out of the question due to his mental blocks right now, you can can change the full body workouts into ironclad cardio routines as well. Keep the pace high, and start easier. Give him maybe 7 exercises like this:

  1. Clean and Jerk/Shoulder Press (should the former be hard to perform given his inexperience and size)
  2. Deadlift/Squats (Squats when he is ready)
  3. Bench Press
  4. Assisted Pullups/Lateral Pulldowns
  5. Assisted Dips/Close Grip Bench
  6. Seated Back Row/Barbell Row
  7. Static Lunges with his own bodyweight

Start him with one set of 15 reps, ideally no rest. Use drop sets with the weight until he completes the reps (reps are the goal here) using a moderate weight to start. It should start getting difficult around reps 14/15. Get him through the workout one exercise at a time as quickly as you can. Once he completes the circuit, see how he feels. Try to add more sets in there, about 4 Giant Sets total is the goal. Steady and easy is the key for this in the beginning until he gets his endurance going. So, even though he’s using weights, this is a badass cardio routine that could put the most seasoned lifter through his/her paces.

As far as diet is concerned, the only hints I can offer are find meals that are considered clean/healthy but at the same time are appetizing. A little creativity with food could lead to some good results, or if worst comes to worst, have him up his protein to try and throw his metabolism into calorie burning mode and increase his fiber. A LOT. Fiber is so important I can’t stress it enough. For all we know, there could be an extra 20 lbs. of excess waste in his system (sorry for the colorful picture). If he flushed out excess weight, you could play the mental game that he is losing weight due to his work and hope that his gusto only increases. Moreover, the protein and fiber will curb his appetite, if even only a little.

Any questions, comments, concerns, don’t hesitate to throw me a private message, update my on his progress, anything. I might be a personal trainer, and while it’s true we do this to make money, I do it more for the purpose of helping people get healthy and feel better about themselves first and foremost.

Best of luck, keep me posted.

-Franchise

are you kidding me? Diet is make or break factor here. Meal size and motion. Move him. Walk for an ever increasing amount at least 2x per day. I would guess at 450 a 10 minute stroll is as much as he can handle.
Weight watchers. He needs the education and the peer support.

Alwyn I think said something. Have him start by flossing his teeth daily. If he cannot commit to that, pray for him and wish him well.

ok,I havent read all of the posts but I wil lsay this.

I had a friend,her mother was huge like that,she started out at 412 pounds.
she sat on the computer all day and she did her own shopping.

we had to do somthing for her so we started to take away her privilages like a child.
we made it where she couldnt shop for herself,her daughter handled her bills and her money.

we did a “meals on wheels” type thing where I cooked for her and then we brought it to her and had dinner together.

slowly got her to get up and out and walking.
she was so embarrassed to go out in public it was a slow duanting task but we got her out.
and finally talked her into seeing a doctor she couldnt pay for the medical so we got the state to take care of it so she had no excuse.

its been 7 years now and last I heard she is now about 280 or so. concidering how big she was going in that is a huge deal still over 100 pounds.

it took patience and “tough love”
first thing is diet,get that under control and get dude to a doctor. have all the vitals checked and dont really do much more than walking for now

work slow thats all I can offer hope it helps a little

[quote]leon79 wrote:
It will be hard to explain why, but there is nothing I can do about his diet. He is not at all willing to make what most of us agree are reasonable adjustments to his diet, so my only avenue for influencing his fat loss is through exercise. I know it’s well short of optimal, but he doesn’t view this stuff like we do.

Because he has a very low tolerance/enthusiasm for exercise, I’m trying for a routine that will have a chance of getting him hooked, so that down the road he will be more willing to make dietary changes.

I know this is slightly out of place in the bodybuilding forum, but I’m not a beginner, nor do I want other beginners guiding my friends introduction to this lifestyle.[/quote]

???

You need to explain to your friend that if he doesnt change the way he eats he will soon be dead. This guy has to want to change. If you think doing a few machine presses and going for a walk is going to counter the 5000 plus calories hes probably ingesting in soft drinks alone you might be waisting your time.

You need to explain to him that he needs to gradualy condition himself to eat healthier. I’m not saying start him off by following JB’s 7 habits or something extreme to him, im saying have him cut out one thing at a time. Maybe start with calorie containing beverages. That alone will probably make him drop loads of weight.

As far as excersise, I think ANY form of excersise at this stage will suffice. The main thing is you get his feeding habits under control. Otherwise there is no hope.

Unless he really wants to change, there’s not much you can do.

you said he asked for your help? If he doesn’t take your dietary advice refuse to help him, as others have said he doesn’t need to go balls to walls straight away just some changes. Too me it sounds like you’d be better off spending your time doing something else

I notice that you have pointedly avoided explaining why your friend looks to you for help (whutup’ with that? You some kind of role model for him? If so, why?), alternately, I cannot condone for any logical reason, why you spinelessly cave in to his whining refusal to accept a mere smidgen of diet advice from you, and you obviously know what it takes diet-wise, so why are you so weak-kneed on this in relation to him? Has he cowed you with a guilt complex on this or what?

You are clearly buying into his manipulation here…Fact:This person is toxic to your health and well-being! You need to make a decision ASAP: Comply to your program to the letter, or nice knowing you, I’m outta here…Quit finger-friggin’ around, you dont have time for these mind games overfat people are so expert at(ever notice how smart-mouthed, opinionated, and hard-headed overfat people are? It’s their defense mechanism to deal with their equally flabby ego’s and gives them the control their flabby bodies dont). Deal with it! Grow a flippin’ pair and get it done, Son…

Changing his diet shouldn’t be a choice, If you care about your friend you would be brutally honest before it’s too late

It is a useless endeavor. If he’s unwilling to even make small changes in his diet, he is a lost cause. It sounds shitty to say, but that’s just a fact. How long do you really think he’s going to make progress for, if he won’t change his diet at all, and while he may exercise, he doesn’t want to?