600+ Pound Client

[krugerr]

There is no way on Gods green earth that this guy is anywhere near 50% BF. Not a chance.

Exactly my point!

Calstate - Im not trying to be d!ck, but 2500 wouldnt be 'WAY UNDER' maintenance I dont think. Hes not mobile, hes 600lbs, so he hasnt been active for a very long time, I would be surprised to see a 200lb lean man under it. Extreme muscle wastage for these type of obese people, as they're completely inactive except to move their hands to their mouths. I think 2500 cal would be not too far from what his body needs as maintenance. Unless with extremely obese people I am missing something. Im not an expert, Im just applying logic!

[calstate23]

Exactly my point!

Calstate - Im not trying to be d!ck, but 2500 wouldnt be 'WAY UNDER' maintenance I dont think. Hes not mobile, hes 600lbs, so he hasnt been active for a very long time, I would be surprised to see a 200lb lean man under it. Extreme muscle wastage for these type of obese people, as they're completely inactive except to move their hands to their mouths. I think 2500 cal would be not too far from what his body needs as maintenance. Unless with extremely obese people I am missing something. Im not an expert, Im just applying logic!

Well sorry, you're wrong...What is fat?

It NEEDS calories correct? Yes, it does. Not as much as muscle, but it STILL needs CALORIES! Thus, if you have as much fat as this fella calories going to be HIGH...VERY HIGH..

PLUS....Calories are NOT calories!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!

It's WHEN and how body utilizes it! Every little carb you eat (From glucose to fructose) and when you eat it...It's DIFFERENT!

This fella need change in diet and ALSO when he needs certain FOODS!

[tarmyg]

Have a client who came in a wheel chair. He is unable to stand and claims he is over 600 pounds which I would have estimated at well over 700. I gave him two sessions and introduced a brief introduction on nutrition and exercise. I was never trained on such obese clients. Help me pleAse? I really need anything you know, all comments aside. I would like to help this man. 54 yrs old, at least 50% bf, 600+ lbs. please. Anything you know.

Hi Winzololol,

A friend of mine works exclusively with obese clients and I asked her how she approaches this kind of problem.

She starts them on a 90 day powder diet with a combined calorie value of 492/day. Above this they can only drink water, mineral water (with NO ADDITIVES), tea, and coffee. During this time they exercise in any way they can. I can be the smallest weights possible while sitting in a chair, walking around the house, literally anything that will make them move, no matter how small. After the initial 90 days she moves them into a protein diet with lot's of water based vegetables (absolutely no carbs that do not exist naturally in the vegetables) and at this time they generally have lost over 50-90 lbs.

She have proven this to work many times but her dedication to her clients is somewhat extreme (Like showing up at their house and so on) but it works.

Hope it works out for this guy, I can not even imagine what it took for this guy to even show up to a gym!?!

Thanks
~T

[krugerr]

Well sorry, you're wrong...What is fat?

It NEEDS calories correct? Yes, it does. Not as much as muscle, but it STILL needs CALORIES! Thus, if you have as much fat as this fella calories going to be HIGH...VERY HIGH..

PLUS....Calories are NOT calories!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!

It's WHEN and how body utilizes it! Every little carb you eat (From glucose to fructose) and when you eat it...It's DIFFERENT!

This fella need change in diet and ALSO when he needs certain FOODS!

Since when have we ever counted the fat when considering calories? You want to feed his fat cells? Fat cells in themselves are an energy source, they dont need to be fed more energy.

[austinite]

It would not take years at ALL...In fact, it will drop DRAMATICALLY if you can motivate client enough to do it...

They will drop HARD AND FAST..Then it will crash..That's when the ol' motivation come back in.....

Have I seen 700 lbs client? No, I haven't BUT I have seen 500 + MANY MANY TIME and they are basically in SAME situation...

I don't care if someone is 900 lbs they can be 98 lbs....Just google concentration camps..

Alright, well, I'm all for motivation. I think you and I define 'motivation' differently. To me, it's far from magic, which is what I'm hearing. And I can completely understand your position and the need to maintain that level as a personal trainer.

If fat loss did not take years for such a severe case, it would be dangerously unhealthy. We can all agree that too much weight loss, too fast is unhealthy and potentially dangerous. On the other hand, taking years to do it is also a huge risk, as the client remains in a severe position for prolonged periods. With that logic, the only other options remaining are surgery or death. Personally, I'd go with surgery.

I'm sure you're a pro at what you do and I've seen your posts, you most certainly know and understand your business. This is beyond what you or I have ever dealt with. So we could both be wrong, and everything we say is opinions only, not facts, because neither of us have the experience. A 500 lb man is not the same as a 700 lb man. Same goes for a 900 lb man, all different challenges, mainly; mobility challenges but also internal conditions and severity. Has it been done? Possibly. Has to be extremely rare and unusual cases. Even then, I don't think they would ever reach a healthy position. This is a very rare case and needs to be treated as such.

There's nothing wrong with getting help at that stage. As you stated, this client is most likely under some sort of medical/nutritional care. That's not working. Or he would not be making an attempt to go to the gym. Surgery to me in general, is about as weak minded as Synthol users who want to grow. However, whether we like it or not... there are those rare cases where surgery is not 'giving up', it's in fact, in the clients best interest. It betters his chances of survival, if you will.

That said, I respect your opinion and more than anything, appreciate your enthusiasm, because I know that your clients will certainly benefit from your guidance. No doubt in my mind. I'll leave this thread alone for now

[bdos]

If this guy gets to his goal what's the excess skin going to be like?

[AD]

If this guy gets to his goal what's the excess skin going to be like?

Quite an old guy 54yo. Not going to have much elasticity in his skin. Probably will need another surgery to excise the unwanted skin folds.

[bdos]

Quite an old guy 54yo. Not going to have much elasticity in his skin. Probably will need another surgery to excise the unwanted skin folds.

The amount of damage being over weight causes is unreal, really gives you motivation to not go down that path.

[Pittsburgh412]

I don't think anyone is recommending tdee based diet... just pitt who doesn't understand tdee.

I purposely did that because I though the OP was a troll, he would obviously know I was wrong if he was a personal trainer

[AD]

The amount of damage being over weight causes is unreal, really gives you motivation to not go down that path.

When they are over a certain level, it becomes a real medical condition. Not just a fitness problem any more.

[calstate23]

Alright, well, I'm all for motivation. I think you and I define 'motivation' differently. To me, it's far from magic, which is what I'm hearing. And I can completely understand your position and the need to maintain that level as a personal trainer.

If fat loss did not take years for such a severe case, it would be dangerously unhealthy. We can all agree that too much weight loss, too fast is unhealthy and potentially dangerous. On the other hand, taking years to do it is also a huge risk, as the client remains in a severe position for prolonged periods. With that logic, the only other options remaining are surgery or death. Personally, I'd go with surgery.

I'm sure you're a pro at what you do and I've seen your posts, you most certainly know and understand your business. This is beyond what you or I have ever dealt with. So we could both be wrong, and everything we say is opinions only, not facts, because neither of us have the experience. A 500 lb man is not the same as a 700 lb man. Same goes for a 900 lb man, all different challenges, mainly; mobility challenges but also internal conditions and severity. Has it been done? Possibly. Has to be extremely rare and unusual cases. Even then, I don't think they would ever reach a healthy position. This is a very rare case and needs to be treated as such.

There's nothing wrong with getting help at that stage. As you stated, this client is most likely under some sort of medical/nutritional care. That's not working. Or he would not be making an attempt to go to the gym. Surgery to me in general, is about as weak minded as Synthol users who want to grow. However, whether we like it or not... there are those rare cases where surgery is not 'giving up', it's in fact, in the clients best interest. It betters his chances of survival, if you will.

That said, I respect your opinion and more than anything, appreciate your enthusiasm, because I know that your clients will certainly benefit from your guidance. No doubt in my mind. I'll leave this thread alone for now

Well, firstly, as I said before, I would NEVER accept such an out of shape client WITHOUT paper work! And ACTUALLY, it's NOT UNHEALTHY BECAUSE YOU KNOW WHY?

Most 250 lb + clients have DIABETES and/or PRE-DIABETES....I wonder what is WORSE? HIGH BLOOD PRESSURE and DIABETES?

Surgery, LAST OPTION FOR EVERYTHING! Whether it be injury or overweight...

If you read my posts before Im ONLY about ONE THING. Positive vs Negative....Surgery vs DIET....

As I said BEFORE, I don't give a **** if someone weigh 200 or 800 lbs....You can go from from 500 lbs to 90 lbs..

Yes, OBVIOUSLY that is NOT but it's just PROOF ANYONE can do what they want....

Again, Please show me someone fat in a Concentration Camp...Please show me a fat person and prove me wrong!!!

[bdos]

When they are over a certain level, it becomes a real medical condition. Not just a fitness problem any more.

I was going to say that but my spelling is horrible lol

[bdos]

[calstate23]

See..You proved me right...Thanks..LOL

[calstate23]

I was going to say that but my spelling is horrible lol

You're the ONLY one that GOT WHAT I SAID WHICH IS TRUE......

Go back to the beginning and it's all there for you..

(You) Included "Clients" that are over 215 lbs and don't have MEDICAL WORK!

[bdos]

You're the ONLY one that GOT WHAT I SAID WHICH IS TRUE......

Go back to the beginning and it's all there for you..

(You) Included "Clients" that are over 215 lbs and don't have MEDICAL WORK!

I was saying that to AD about the medcal comment cause i cant spell lol im not sure what your refering to as me being the only one who got what you said. I just drift in and out of threads.

[calstate23]

I was saying that to AD about the medcal comment cause i cant spell lol im not sure what your refering to as me being the only one who got what you said. I just drift in and out of threads.

Okay, I like your comment...

I find it funny right now....I give you the protocol if you want it....

Only for you though....Lol

[bdos]

Okay, I like your comment...

I find it funny right now....I give you the protocol if you want it....

Only for you though....Lol

Lol rightio

[austinite]

Well, firstly, as I said before, I would NEVER accept such an out of shape client WITHOUT paper work! And ACTUALLY, it's NOT UNHEALTHY BECAUSE YOU KNOW WHY?

Most 250 lb + clients have DIABETES and/or PRE-DIABETES....I wonder what is WORSE? HIGH BLOOD PRESSURE and DIABETES?

Surgery, LAST OPTION FOR EVERYTHING! Whether it be injury or overweight...

If you read my posts before Im ONLY about ONE THING. Positive vs Negative....Surgery vs DIET....

As I said BEFORE, I don't give a **** if someone weigh 200 or 800 lbs....You can go from from 500 lbs to 90 lbs..

Yes, OBVIOUSLY that is NOT but it's just PROOF ANYONE can do what they want....

Again, Please show me someone fat in a Concentration Camp...Please show me a fat person and prove me wrong!!!

Why do you feel the need to use 'shouting' type text with all the selective caps? I tried to leave you with a pat on the back, I guess that didn't work . It was only an attempt to maintain sanity in the thread without yelling and cussing. anyway...

Cal, you're admittedly not experienced in this scenario. I'm not sure where all this confidence is coming from (although I certainly appreciate it). I don't have to prove anything to you. My option was surgery, I can certainly prove that to be successful. Either way, you're wrong on many points and you're actually putting the client at more risk. Stop thinking of him as a 350 lb man. If you have to require a client to sign a release form... then you're out of your league, even if it's for your own protection. It's no longer your job. Let the medical world handle it from here. You're not qualified to handle such a case. You're not qualified to dissect his blood work, diagnose and treat him. Your knowledge of diabetes and blood pressure is great, but it's not a replacement for a qualified physician. People ask me all the time about different treatments. I give them advice but would never attempt to fix their problems myself, I refer them to the right person. If someone 280 lbs wants to lose weight, I'd refer them to you. A 700 lb man? Not a chance in hell. The last thing he needs is a personal trainer. Once he is safer, after surgery... have at it.

Anyway, once again, I respect your ideas and theories, I just disagree.

[AD]

I went to wiki to look for medical classification of obesity. 3 levels. Severe obesity, morbid obesity, and super obesity. Under super obesity, they gave an example of a 5'10 guy weighing 320lbs. No mention of anything on a 600lbs guy.

[gearbox]

Have a client who came in a wheel chair. He is unable to stand and claims he is over 600 pounds which I would have estimated at well over 700. I gave him two sessions and introduced a brief introduction on nutrition and exercise. I was never trained on such obese clients. Help me pleAse? I really need anything you know, all comments aside. I would like to help this man. 54 yrs old, at least 50% bf, 600+ lbs. please. Anything you know.

Anyway you can focus on his diet more than training. I would focus on his diet for a good 6 months and then when she loses at least a hundred pounds he might be able to stand. You're going to have to coach him and make sure he stays on track so he can lose weight

[--->>405<<---]

Well sorry, you're wrong...What is fat?

It NEEDS calories correct? Yes, it does. Not as much as muscle, but it STILL needs CALORIES! Thus, if you have as much fat as this fella calories going to be HIGH...VERY HIGH..

im failing to follow the logic behind this statement. fat is stored energy. while he may require a certain amount of calories to maintain his level of body fat, he certainly does not need to eat "X" amount of calories in hopes of maintaining this fat. i understand the concept of not dropping cals too low because this guy is prob used to eating a LOT of cals each day, but i disagree with the premise of having to do so for the purpose of maintaining body fat or because body fat "needs" calories.

i think i understand what ur suggesting which is to not drop cals too much too fast, and i agree but the reasoning is not because his fat requires calories. we base caloric requirements on lean tissue because lean tissue is what we desire and we have to protect it. body fat is the opposite, it is the enemy. we want to attack body fat.

[krugerr]

im failing to follow the logic behind this statement. fat is stored energy. while he may require a certain amount of calories to maintain his level of body fat, he certainly does not need to eat "X" amount of calories in hopes of maintaining this fat. i understand the concept of not dropping cals too low because this guy is prob used to eating a LOT of cals each day, but i disagree with the premise of having to do so for the purpose of maintaining body fat or because body fat "needs" calories.

i think i understand what ur suggesting which is to not drop cals too much too fast, and i agree but the reasoning is not because his fat requires calories. we base caloric requirements on lean tissue because lean tissue is what we desire and we have to protect it. body fat is the opposite, it is the enemy. we want to attack body fat.

You explained it much better than I. Lol.
I also understand his point slightly now that you re-worded it. I guess dropping calories too fast to a 'normal' range could has consequences, he's probably spent many years eating way too much. A normal diet might shock him too much in one move.

[austinite]

^ We don't know that. There are conditions that prevent the common diets from working. He could have been eating moderately all his life and gained this weight because he was never treated. There are people that eat 6000 calories a day, everyday... they don't grow to 700 lbs.

[--->>405<<---]

^^ yeh saying he probably eats a lot is def an assumption but the odds are in favor of it IMO. the 600+ lb people ive seen were eating in the neighborhood of 10000 cals per day and it was a female. this was on TV

[AD]

Has anyone heard from op yet. He seems to have disappeared after making this thread. His very first post.

[austinite]

Has anyone heard from op yet. He seems to have disappeared after making this thread. His very first post.

He left when he found out that he won't be given "secrets".

[krugerr]

True Aust, I have made a large assumption - But given the information provided, which is very little, its a good guess as to the cause. You dont see many people over 400lbs that just have a medical condition and no food addiction.

My problem is, in the cases of people with eating disorders, who buys the damn food? I was watching a show just last night about the 500lb teenagers from Texas, John Wayne and Billy something. Both of these kids pretty much are fed by their parents. The kids arent active enough to have a choice what they're fed, so why are they still getting fatter? The mother of Billy was sneaking him McDonalds in whilst he was in the hospital. If I were the carer for a bedridden 500lb+ human, I would not be bringing them damn fast food, thats for sure!


On topic, at 600lbs, if his problem is eating. Who is bringing him the food? If he isnt bedridden, he will be very severly limited as to mobility. Someone is basically helping him eat to death.

[austinite]

Ohhhhhhh I agree and you and 405 are most likely right. I just had to throw in another possibility. Either family/friends buy food or they're in a health facility under care

[krugerr]

Ohhhhhhh I agree and you and 405 are most likely right. I just had to throw in another possibility. Either family/friends buy food or they're in a health facility under care

You mean you just wanted to complicate matters!

[Lunk1]

Perhaps the guy suffers from the same medical condition Yannick does. Testosterone makes him fat!

[tigerspawn]

Have a client who came in a wheel chair. He is unable to stand and claims he is over 600 pounds which I would have estimated at well over 700.

Your client probably does exceed 600lbs. While working in the medical field I have noticed that obese individuals at a certain point refuse to weigh themselves. I have taken care of multiple individuals that weighed at least 50lbs more then what they claimed.

[calstate23]

All he needed was my first two posts...

That's why he never responded again...he knows what I said was SPOT ON....That's all he needed...Lol...But really, it's true....

And yes, OBVIOUSLY caloric intake matters..But NOT with this fella...that's not what he needs...Just SUPPORT and ENCOURAGEMENT..To have someone say, "It's POSSIBLE"....

Which it is...

[SexySweetheart]

when someone this obese seeks a medically supervised weight loss program they are most always required to have a psyc eval and attended a min requirement of therapy during the process. medically induced or not, there is most always a psychological aspect involved that is underlining in the patient that aided in the mass weight gain and will sabotage any success if not dealt with ( including weight loss surgery patients, a mass majority regain the weight lost after several year of post procedure).

so i guess as a trainer, your looking at the extra challenge of self serious sabotage behaviors when unsupervised ... i think the rest has all been covered by the group

[calstate23]

im failing to follow the logic behind this statement. fat is stored energy. while he may require a certain amount of calories to maintain his level of body fat, he certainly does not need to eat "X" amount of calories in hopes of maintaining this fat. i understand the concept of not dropping cals too low because this guy is prob used to eating a LOT of cals each day, but i disagree with the premise of having to do so for the purpose of maintaining body fat or because body fat "needs" calories.

i think i understand what ur suggesting which is to not drop cals too much too fast, and i agree but the reasoning is not because his fat requires calories. we base caloric requirements on lean tissue because lean tissue is what we desire and we have to protect it. body fat is the opposite, it is the enemy. we want to attack body fat.

Well it DOES matter in this fellas case....He is used to eating a TREMENDOUS amount of food...It is not only mental but physical as well...

His body WANTS those calories...Whether he like it or not....

For someone this overweight they can EASILY drop weight fast..They get excited and then it stalls....

They need MORE then that....A real plan that isn't just based off caloric intake

Furthermore, body adapts to ALL diets, correct? His body is ADAPTED to MASSIVE FAT STORAGE! That is what his body wants him to do and is PROGRAMED to do...

It's so SLOW steps with these folks...

[951thompson]

So his TDEE (600x15) is 9000 so I guess have him eat like 8500,then 8000, then 7500, and then taper down? If your a personal trainer, how do you train someone incapable of moving?

I agree with this guy, these obese people eat a ridiculous amount of food, too drastic of a cut could do more harm them good. Been that obese is already putting a tremendous amount of stress on the organs. Too drastic of a cut could be too much of a shock too the body, too much of a stress. You know its not only muscle that burns calories, fat cells burn calories also. So 15x LBM isnt going to work here. The shock of going from 7000cal per day to 2500 could kill the guy, I would seek medical advice.

I would find his TDEE then start him off around 1000cal below. A rough estimate I would say his TDEE IS around 6000 cal per day. But I think you should consult a doctor or a obesity expert.

[calstate23]

I agree with this guy, these obese people eat a ridiculous amount of food, too drastic of a cut could do more harm them good. Been that obese is already putting a tremendous amount of stress on the organs. Too drastic of a cut could be too much of a shock too the body, too much of a stress. You know its not only muscle that burns calories, fat cells burn calories also. So 15x LBM isnt going to work here. The shock of going from 7000cal per day to 2500 could kill the guy, I would seek medical advice.

I would find his TDEE then start him off around 1000cal below. A rough estimate I would say his TDEE IS around 6000 cal per day. But I think you should consult a doctor or a obesity expert.

The focus SHOUD NOT be TDEE with this fella...But more about the food he eats and WHEN he eats it...That will make HUGE difference...

You have to CHANGE their habits or NOTHING is going to work...Even if they lose weight they will gain it RIGHT BACK...Encourage and change habits...It has to be BEATEN into their head

And it all starts from my first two posts...Follow that and client on way to success

[--->>405<<---]

All he needed was my first two posts...

That's why he never responded again...he knows what I said was SPOT ON....That's all he needed...Lol...But really, it's true....

And yes, OBVIOUSLY caloric intake matters..But NOT with this fella...that's not what he needs...Just SUPPORT and ENCOURAGEMENT..To have someone say, "It's POSSIBLE"....

Which it is...

boy its a good thing u were here cal!

[calstate23]

boy its a good thing u were here cal!

SARCASM at it's best! On both sides...

Well, Obviously I was trying to be funny (Sarcastic), yet at the same time it is true......So you're welcome

[--->>405<<---]

^^LOL.. yeh sometimes it goes unnoticed on the screen