Determining BMR for the morbidly obese

[bullseye]

Hey folks,
This winter I want to help two friends that are dangerously over weight lose some pounds and start moving. Both are big guys, one is probably 5' 11", the other may be as tall as 6' 2", both are well over 100lbs over weight, with no significant athletic background.

All the BMR calculation stuff on the web seems to assume 'average' body composition, but I know I can't stick these guys on a 2k diet and expect them to do well, I'd like to be able to get a better idea of their caloric needs. Anyway, any help or advice would be appreciated.

thanks

[mc]

It's super great that you want to help your pals, and forgive me if everything i say here is what you know and have already checked out, but just in case you're seeing BMR as your first step, It's not clear to me why calculating BMR is important for folks who have fundamentally a poor relationship with and knowledge of food to begin with

Thinking about obesity in terms of a calorie focus has not been proven to be too successful - there are a number of complex issues at play.

The first is motivation. There's been some very compelling research on this area, and it kinda makes sense: commitment to change has to be there. If they haven't determined for themselves that this shift is a priority and that they're ready to act, you're stuffed.

If they have made that commitment, the second thing is how to support change: it means understanding what they eat now and working with that to introduce NEW habits - cuz that's what change is about: new habits: are they ready for fundamental habit change? or only small changes in amount of stuff rather than kind? or?

Are they keen to learn at all about better eating patterns? to learn about nutrition? so that they'll get a handle on what some of the issues are with what they're eating now, vs what they need to eat? or do they just want a menu to follow? or - my favorite - some new habits to learn as heuristics they can rely on.

Do you have a nutrition approach ready for them? Prep for a lifetime change?

So, you can see, BMR/calories is so so so far down the list of things to check for folks who are morbidly obese. It's desire to change, motivation to change and knowledge of how to change, and a PLAN to support that change over at least a four month to two year window that needs to be in play. In other words, one of the key attributes of ongoing success, shown in a recent study tracking obese women over two years, was ongoing support. If these parts aren't in play, the best laid plans gang aft aglee in a heart beat.

If you want to test the waters around food change, you can ask them: do you want to lose weight? check ok, do you want to change your approach to eating? maybe at some point, in the next month or so, within the coming two weeks, now - that will help you gate if they're really up for it. if they're not at at least the change in the coming two weeks, they're not there.

This is not just my opinion - it's a whack of studies since the 90's on habits like smoking, drinking and weight loss, as well as studies looking at approaches to weight loss for the obese.

good luck on your mission.

mc

[bullseye]

MC,
Thanks for the reply.

Let me provide a little more background. I'm going to start working with this friend starting in the next week. They have expressed their desire to lose weight and get in to better shape, and I've explained some of the basic considerations behind that. They know they are in for a long journey, they understand that they are going to have to make some fundamental life style changes, and I have expressed that I am committed to helping them understand and accomplish this with what knowledge and experience I have.

At a very fundamental level, they do not know how to eat. A general guide line of "eat when you are hungry" is pointless with this individual, as all indications have them so out of whack with their body that they have no idea when that may be.

I've read the PN material, and some of it is very interesting, but I don't feel that taking someone who is currently only eating one to two meals a day at a great caloric surplus to a multi meal plan with no caloric guidelines is neccesarily the best idea.

The request for a BMR calculation for the morbidly obese is so that I can put my head around their basic calorie calculations. I fully understand that calories are not the be all end all of this situation, but initially I will have to provide them with a very thorough set of eating guidelines, probably including examples of what a normal days eating should look like.

I know how to eat to make myself lose weight, but I weigh over a hundred lbs less than this friend, and my physical activity level is miles beyond theirs....so the rough guidelines by which I prepare my own food would seem to be inadequite for my friend.

My current plan is roughly as follows.

The first step is to get them away from a diet consisting largely of sugar, alcohol and processed meat to one that includes more fruit, vegetables and unprocessed animal products.

At the same time I want to get them moving in a concerted manner, my current thinking has activity progressing as follows: 1) walking on a level path,focusing on breath and movement with coordination 2) walking on an uneven path (light - moderate trail climbing) 3) rudimentary body weight exercises 4) weight lifting

I'm going to try to structure their training around 6 to 8 week blocks in which we will build on the diet and exercise principles I'll be teaching them.

My long term plan is to leave them with a skill set to make their own dietary decisions, and push themselves in regards to exercise, but it's going to have to happen in many many small steps over a long period of time...so I feel that the more information I have in my arsenal, the better.

[Semonides]

Here is my reaction which is more of a gut reaction than anything that is researched and validated: it seems that you are over-complicating the whole BMR thing. At one point in my life I was about 75 pounds overweight. I looked up how many kcals were generally needed to maintain a person with my frame, I ate a little bit less than that number and put myself in a calorie-deficit situation, and then Bob's your uncle.

Therefore, I agree with mc that BMR is a rather low priority but once you do consider it, it really is not that difficult. Your Kcal maintenence amount is the same whether you have 20 pounds of blubber or 200.

Again, that is my unlearned take on the situation.