T Nation

Morbidly Obese Sister Needs Help


#1

My sister is 25 years old 5'4 and almost 400lbs. She has consistantly gained 20 lbs per year since around age 12. She is finally trying to do something about it and is losing weight so she can have the gastric bypass surgery. So far in about 3 months she has lost 17 lbs. I really want to help her out and am hoping she will see she actually can lose weight and doesn't need to get the surgery. She is seeing a nutrionist but I am not convinced they are giving her the best advice. She is a very picky eater which has always been a part of the problem.

Right now her nutrionist is telling her to get between 1400 and 1600 calories per day, which seems fine but she is also saying she only needs 50g of protien per day and isn't having her track her fat or carb intake. She has been logging her foods and counting the calories but most days is only getting around 1000-1200 calories per day. She eats mainly vegetables which fill her up but has very few protien sources. She won't eat meat so she only gets protien from shakes, bars(which I told her she shouldn't eat because the carbs are so high) and greek yogurt.

Suggestions for getting more protien would be helpful, I'm trying to get her to eat meat she doesn't have an ethical problem with it, she just thinks its gross. Her nutrionist may be giving her sound advice but I don't know enough about weightloss so I thought I would ask some people who know. Also I'm trying to get her to exercise even if its just the treadmill or elliptical machine but it is hard for her she gets out of breath just walking around the grocery store.

I want to help her succeed she is serious but I really don't think she needs the surgery as she isn't having medical problems yet but I'm sure they are right around the corner. Where is a good place for her to start with the exercise and what should a diet for someone so overweight look like? Thanks a lot for any help guys


#2

exercise:
walking. 20 minutes in the morning. 20 minutes in the afternoon. 6x/week. As the weight drops off and fitness increases, then increase time. If any joint pain then the next session may be skipped.

diet:
breakfast: 2 eggs on ezikeil bread. Alternate with oats and bluberries.
morning snack: greek yoghurt with small handful of raw nuts.
lunch: protein source and vegetables. Does she eat fish? Chicken is "girl friendly" meat aswell.
dinner: same as dinner. small carb source allowed on days that she walks. Preferably small serving of sweet potato or rice.
snack: only allowed once a day and it consists of a protein shake and peanut butter.
supplements: fish oil, iron, vitamin D.

Come back to me in 6 weeks and I will update the program.

Good luck buddy.

Bird-style.

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#3

This post was flagged by the community and is temporarily hidden.


#4

Have her talk to some others that have had that surgery. I know a woman, that had it about 8 years ago. She lost alot of weight the first year. But then she started having problems of not being able to keep her food down. She would constantly throw up after she had eaten. even small amounts.

A few years later, because of all the throwing up, the acids in her stomach started destroying her teeth. She then had to have all her teeth removed. She has gained back almost all the weight she originally lost. while she is still a bit lighter, shes almost back completely to where she was before. I would have her really think long and hard about this operation. It can have some ugly ramifications.


#5

Thanks Rogue and Bird. We were all confused about how she was gaining weight as well when all we ever saw her eat was vegetables. Then she moved out a few years ago and my mom found empty pizza and cookie boxes and chips she had hidden all over in her room. Her diet has been almost completely carbs and fat with little to no protien.

The weight loss surgery was her idea, her boy friends mom and aunt both had the surgery but have not had the adverse effects. She is sick of being so heavy, but she has some horrible habits that she needs to change. Since starting to track calories she is eating mostly vegetables but is still eating pasta and rice and not getting enough protien.

Her nutritionist has her only concerned with hitting 50g of protien per day and not even tracking carbs or fat. What is a good range for her to try and hit? Is her nutritionist right with the 1400-1600 calorie recomendation? I'll be sure to let her know that the tooth loss and gaining the weight back is a possability. I agree that if I was 400 lbs I would eat anything if I thought it would help, but for her even trying a new foods is a big deal.

I think she is excited about the surgery idea because she is so far gone she feels hopeless and has seen 2 examples of great results from the surgery. I just really want her to give it an honest shot first before resorting to the surgery. If she does continue to lose weight it might encourage her to listen more and try more new foods. I'll get her to start walking at least once per day and to try the ezikiel bread.

Once she gets on track with the exercise I'll update on weight loss and to see how else we can tweak her diet. Thanks a lot for the advice.


#6

Congrats Bird. You've uncovered something where others have failed, truly the holy grail of this forum: [u]construction of the "perfect diet"[/u]

All except for that (minor) detail called sustainability.

And according to the OP, it's looking a bit idealistic.


#7

Listen buddy,
I do what I can do to help. Ofcourse it will be difficult to follow this diet strictly, but I can only offer guidelines. Unfortunatley I cant follow this lady around everyday making sure she is exercising and eating right.

OP, at the moment its about taking baby steps. Its about education. Its about getting her mind ready for the "transition". I beleive we can do this.

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#8

heh no doubt Bird, good posts

(don't think I've seen that single tweet before either)


#9

I would say that if you are going to do a bypass then get a good doctor.
Spare no expense in the surgeon on this one and do your research.

As for losing weight I would get her up and have her go on walks like someone already mentioned. I have a weighted vest that goes up to 80 pounds that I walk with and I can only do 2 miles with the full weight. It is a hard workout so go slow with your sister. I could not imagine what it is like to strap on 200 pounds and do anything.

For non meat protein sources...
Cottage cheese is my favorite.
Eggs come to mind too.


#10

You do realize that what you suggested in your first post is literally the polar opposite of baby steps, right? You suggested doing 12 workouts a week and getting her right onto an idealized diet plan, regardless of what she's currently eating.

Baby steps are already in place, and have nothing to do with what you suggested. She's working with a nutritionist, she's keeping a food log, she's eating more vegetables. What we're dealing with here is third or fourth hand info (some guys help a guy helping his sister).

This can be pretty common with the obese. You should take it as a glaring reminder that her issue is primarily psychological, like most disordered eating. If that isn't addressed (let alone "resolved"), the gastric bypass is going to be a band-aid solution at best.

Consider looking into overeater's anonymous, but don't directly approach your sis with this info. Maybe you could try calling them yourself and talk to someone for info.
http://www.oa.org/meetings/find-a-meeting-online.php

It'd be better if you, or maybe your mom, walked with her to make it a team effort. However, start off aiming for just once a day, not "at least" once a day. No point in going from zero to 100% when going from zero to 10% will be just as effective.

Like BBB said, don't think of it as exercise. It's activity. There should be a distinct difference in how her gradually increasing her activity isn't similar to you increasing your own training.


#11

Chirs Colucci- like I said buddy, I can only offer guidelines. Dont take my word as gospel. For example when I say take a walk twice a day, this may be taken as go for a walk in the morning and in the afternoon spend some time hoola-hooping or shooting some hoops. I dont know anything else about this lady. Does she have the time to exercise/"increase activity"? Is she motivated to lose this weight? Is she depressed? There are lots of variable factor here, but all I can do is offer guidelines. And yes we need to take baby steps, but if she wants results before the end of next century, then she will have to get realistic. We are only trying to help her.

Do it like a bird.

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#12

lol at baby steps....

Why does this guy still feel the need to give out specific training advice to people on these forums when he himself has very little to show for it?

Not to mention ive never seen him give out advice that didnt sound like he just cooked it up as he was typing a reply... rattling off diets for 400 lb women is somehow a specialty of his?


#13

Have you seen my quads?

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#14

OP have you considered the psychological aspect of her weight?

Cognitive behavioral therapists can do a world of wonders when it comes to these sorts of things. Any nutritionist or anyone for that matter can write up a meal plan, but it takes a lot of therapy to overcome something like an eating disorder.


#15

Surgery is just a temporary fix. Without changing diet and physical activity she will be just as unhealthy and still fat a few years after the surgery. Unlike most threads pretty much what everyone else said is good advice. Protein intake needs to be at least 100g I would start there since it seems to be the biggest problem. Experiment with different meat recipes, if shes willing to eat it I think it just needs to be cooked better.


#16

I dont really understand why a nutritionist has started your sister off on a 1400 calorie diet when she would almost certainly lose weight on double that. Dropping calories that quickly will just result in her metabolism getting screwed and/or her feeling constantly hungry (which will lead to snacking). Is she struggling on the diet? Do you think she is still secretly snacking on high calorie foods?

It has already been mentioned but the majority of people who get that big have done so because of an underlying Psychological disorder. Is this side of things being addressed?

As far as nutrition and exercise go I would concentrate on keeping things extremely simple. If your sister is genuinely eating below maintenance (1400 kcal is far too low IMO) with calories coming from clean sources then there's no reason the weight shouldnt fall off. As far as exercise goes, she shouldnt need any to start with. Just increase her daily activity level (i'e. taking the stairs rather than the elevator).

Exercise and extreme calorie restriction will come into play once weight loss has stalled. This will be a lot easier for her once she has seen a good amount of progress.


#17

The quads of the same guy who posted a video squatting 275 for 5?

And how does developed quads make you an authority for advice on how to get this woman into shape?


#18

Yep, thats me in the video. :slightly_smiling:

Buddy, this dude has come to T-Nation and asked for some advice for his obese sister. And I offered him advice. Im sorry I dont have a "licence to give advice for obese people", but I do what i can do.
And I do it good.

Do it like a bird.

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#19

lol


#20

Your occupation is listed as "health proffesional"[sic], so I hope you certainly don't have a license to offer health/fitness advice to obese clients.

No, you don't do it good at all. Your advice is, at best, useless, and, at worst, generalized to the point of doing harm.

That you'd even think "shooting some hoops" is appropriate for a morbidly obese client speaks to how little advice you should actually be offering others, especially in extreme populations like this case.

I'll never understand why you and a handful of other guys on here insist on using "characters". It's a weight training discussion forum, not an AOL chatroom circa 1995. It's not cute or clever. It's bothersome, but you already knew that. Congrats on getting attention by any means necessary.

Anyhow, I'm done sidetracking this thread. It'd be great if the OP kept us in the loop as to how things are progressing.