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Thread: Help for a Morbidly Obese Friend page

  1. #1
    CoachJames's Avatar
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    Help for a Morbidly Obese Friend

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    Hello all,

    I have been a semi-lurker here for a while and I wanted to reach out to the forum because there are people on here much smarter than I regarding the subject matter below.

    I have a friend who is in his mid-40's who weighs approximately 450 pounds, and he has been asking me for advice on how to shed the extreme amount of extra weight he has accumulated.

    He is currently seeing a specialist who has prescribed an extreme caloric restriction diet with no fat and protein drinks as his only source of protein (The doctor does give him periodic shots of vit. b6 + b12) to jump start his weight loss program.

    The doctor has allowed him to eat small amounts fruits and vegetables. But, I have advised him to stay away from fruit due to the fructose and recommended raw vegetables for some sort of insulin control.

    I do not have his blood work, but from what he has told me he has somehow avoided being diagnosed by his doc. with t2 diabetes

    Do you guys have any advice/ articles to send my way?


    Thanks!!!

  2. #2
    loafingcactus's Avatar
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    You can go to the National Weight Control Registry for a lot of good research, but what both they and Consumer Reports research found was that success was very individual- it is what works for you. He is trying to do something that is highly unlikely- less than 1% of the tiny amount of people who successfully lose 65 lbs or more keep it off for five years or more. So with that in mind, I think there is a sort of split advice-

    First, don't get down on yourself. You did not cause this to happen. It isn't because you have bad self control, or bad habits or all the other crap that gets thrown out there. Your body is, for whatever reason, different and requires intensive management. As part of that, I would say set reasonable goals. If you can land at 350 and maintain, that's a huge win over 450. Half of excess weigh is how "success" is defined in weight loss research.

    Second, if you are going to succeed you are doing something rare and heroic and extreme, which means going all in. This is going to take time and dedication and effort and it may mean scaling back other activities and hobbies.

    People with a support system are far more likely to succeed. NC has an extensive OA network, some meetings better than others. Or Weight Watchers, which few here are going to like suggested, but the in person meetings and continued support about double the chances of success and they are extremely available. You can find leaders who have lost more than 100 pounds and if you go that direction I would seek them out since IMHO the newer WWer systems are better suited to people with less to lose and an experienced large loser can help navigate the differences. if in the triangle Rex Hospital has an obesity treatment team with a Primal physician that is supposed to be very good. Duke of course has the Rice Diet Center. Both of these provide long term support which is effective for some people.
    “In God we trust; all others must bring data.” W. Edwards Deming
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  3. #3
    eats.meats.west's Avatar
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    Did you read the Primal Blueprint or similar books? Have him eat a primal diet, skip the fruit and keep carbs low.

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    I dislike those kind of lopsided prescriptions because they don't teach maintenance so the only modes are draconian deprivation and SAD-as-usual.

    Purely unqualified advice but:
    In his shoes I would completely forget the total weight and just try to live as a person at his goal weight would. That means a weekly routine of shopping and cooking for complete nourishment--put another way, don't try to "lose 200#" or even "lose 10#" just cultivate a routine one can be proud of and reinforce permanent behaviors. IMO most obesity is at root a culture deficiency and things like refined protein shakes are just a daily reminder that he's defective--I'd rather see him rejoin the human race with our lovely soups, salads, steaks, and (small) desserts and let the energy balance shake itself out.
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    I think just a standard paleo/primal diet would work very well. Even including moderate amounts of fruit or tubers would probably be fine - just giving up all processed foods will go a long way towards improving his health.

    I believe you should never do anything to lose weight that you aren't willing to do forever. Eating nutrient dense paleo foods with plenty of fat and protein, lots of veggies, some fruits and tubers is sustainable forever and will almost undoubtedly bring your friends weight down dramatically.
    Using low lectin/nightshade free primal to control autoimmune arthritis. (And lost 50 lbs along the way )

    http://www.krispin.com/lectin.html

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    Ripped's Avatar
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    Quote Originally Posted by CoachJames View Post
    Hello all,

    I have been a semi-lurker here for a while and I wanted to reach out to the forum because there are people on here much smarter than I regarding the subject matter below.

    I have a friend who is in his mid-40's who weighs approximately 450 pounds, and he has been asking me for advice on how to shed the extreme amount of extra weight he has accumulated.

    He is currently seeing a specialist who has prescribed an extreme caloric restriction diet with no fat and protein drinks as his only source of protein (The doctor does give him periodic shots of vit. b6 + b12) to jump start his weight loss program.

    The doctor has allowed him to eat small amounts fruits and vegetables. But, I have advised him to stay away from fruit due to the fructose and recommended raw vegetables for some sort of insulin control.

    I do not have his blood work, but from what he has told me he has somehow avoided being diagnosed by his doc. with t2 diabetes

    Do you guys have any advice/ articles to send my way?


    Thanks!!!
    1. (To your friend.)First and most importantly, he eventually has to learn a flexible plan for long term success. Primal is the way to go with that. 80/20 and intermittent fasting goes a long way to insure flexibility. No need to be afraid of food, and no need to put anything on a 100% off limits list.

    2. (To you.) There is no need to eliminate fruit. Notice it's at the bottom of the PB food pyramid. You can't eat enough of it to get fat or cause any problems. Sugar is only a real issue when eaten in extreme cases such as with soda, cakes, candy, etc..

    3. (To your friend.) I think it's good what the doctor has prescribed. He needs an extreme approach just to get the fat to come off. Tweaks to PB can be made to help with such results such as with the "Dukan diet". So essentially I'm saying that yes, I do agree with an extreme/aggressive approach in such a case in order to reach a descent goal weight. BUT, a long term plan must eventually be learned and employed.

    450 lbs down to a normal healthy weight sounds like it can be a long and uncomfortable road. And because of that, one can flip flop between cutting and comfortable maintenance depending on the aggressiveness of the attitude of the individual. The great thing about this option is it gives one the ability to pause on the weight loss for a while and relax, enjoy, and resume later on. It can make the entire process much more comfortable. And most important of all, it gives one the ability to learn successful maintenance techniques gradually on their way down. This is opposed to losing the weight quickly all at once, reaching the goal, only to walk out not knowing how to maintain. Either way, I still recommend the most aggressive approach mentally possible.

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    Huarache Gal's Avatar
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    You might want to point him in the direction of Jimmy Moore's blog. He used to be 410 pounds. There's some good stuff here:

    Meet Jimmy « Jimmy Moore's Livin' La Vida Low Carb Blog

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    picklepete's Avatar
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    Quote Originally Posted by jammies View Post
    I believe you should never do anything to lose weight that you aren't willing to do forever.
    Co-sign x100
    Having an "end date" to look forward to is like built-in failure.
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  9. #9
    Ripped's Avatar
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    I think the others have all made good comments.

    I actually like the idea of the Dukan diet for the fat loss part and Primal for the maintenance part. Let me explain.

    The Dukan diet mainly consists of Primal foods, but it has it's own specifications. It's high in protein and you can eat as much as you want, so it's highly satisfying. It provides enough fat from foods such as meat and eggs, but not too much. And it provides a lot of vegetables. And because of the food choices, the calories can't be high enough and weight loss is definite, comfortable, and effortless. As long as you spice up your meals to make them flavorful, you can't go wrong.

    Also, if understood how it works, the Dukan diet teaches the importance of food choices in terms of high satisfaction and low calories.

    The only problem I have with Dukan is it isn't flexible enough for the long term. If I'm out with my friends and I want to have a burger, I want to have a burger. And if I'm traveling and all is available is what's on the plane, I'm going to have what's on the plane. It isn't going to kill me. And at least I have IF to help me pick up the pieces and balance things out.

    Primal on the other hand offers A LOT of flexibility and is ideal for the long term. There truly is no food that is off limits on Primal because of 80/20. Most of the recommended food choices of primal are good anyways and won't make you fat. Meal times are non-specific. And we have IF. It all helps a lot to make a balanced flexible plan.

    For that reason, if understood correctly and IMHO, primal is actually impossible to not be able to adhere to. Why? Because you can still eat what ever you want on it. There are foods that are more ideal and recommended that you should aim for. But it isn't strict. If you can't stick to the recommended foods, you still have IF and that helps A LOT. You can still try to eat the ideal foods, even if you can't do it all the time. It's all about 80/20. As soon as you start making up more rules you're doing it wrong.

    So as discussed in the last post, I think flip flopping between Dukan and Primal would be the ideal way to go. Why? Dukan works perfectly to shed the fat comfortably and fast. But primal offers the flexibility. So when your friend feels ambitious, he has the option of doing it Dukan style, which actually is a variation of primal. And when not, he can go back to less strict rules that primal allows such as eating fruit, potatoes, and other/all foods allowed because of 80/20.

    I hope that's not too complicated. Because all I'm recommending is to do the Dukan diet, and learn how and why it works. But eventually learn the whole PB and how to make your own style that's flexible and suitable to you for the long term.

  10. #10
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    It sounds like your friend is in a rough situation. Now, I was never that heavy, but I was almost 300 pounds at one point and have managed to get down to the low 240's without it feeling like it was a chore. Not that there isn't a huge decision factor involved- whatever your friend decides to do, he is going to have to own it and wrap his head around it. That is just about the most important thing he can do and it is the only real way to continued success, I believe.

    Generally speaking, it is a good idea to focus on proteins, but try not to add too much fat in, I think. Good fats are fine, but adding more just doesn't make sense in your friend's situation. Also, it might be easier (it was for me) to take eliminating things in stages so that your friend doesn't feel so overwhelmed and can focus on the baby steps (they add up after a while). First cut out the processed foods (boxes, etc) and white flour and white sugar. Do that for three months or so (maybe six) with the whole grains keeping total carbs to between 100 and 150 grams with fruit and vegetables, and then cut out the grains altogether. Eventually he should be able lower his carb intake to 50 to 100 grams to help him lose even more weight. That was my path and it really helped me deal with the stress of avoiding things I had been eating mostly because I didn't have to do it all at once. Cutting it all out at once was simply unrealistic for me and to help encourage the long-term habit, it might be helpful for your friend to go that route.

    Hope that helps! I am looking forward to see what way your friend decides to go! I really do believe in the end it has to be a choice he is comfortable with regardless of what he chooses to do. Good luck!
    Stephanie
    "The only person you are destined to become is the person you decide to be."- Ralph Waldo Emerson

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