Why is it safe for a super morbidly obese person to eat 800 cals a day?

AimiAutumn

I'm super confused by this! Usually the heavier/taller you are the more calories you can eat and still lose weight aslong as their is a deficit, but why is it when someone is super morbidly obese its not uncommon or unhealthy according to Doctors to put them on a diet of 800 - 1000 calories?

But if you are just obese its not safe to be on a 1000 calorie diet and they recommend something closer to 1200- 1600 (for a female)

Any thoughts?

justincooper405

Agreed , I see it all the time... my guess ( just a guess) is that the Doc feels they are at a breaking point and need to immediately make changes to prevent serious health issues.

tomteboda

It's not safe. It's dangerous. However, exceptionally heavy individuals are at very high risk and their weight also poses acute danger. So it's a tradeoff... The risk of a crash diet vs the risk of sudden death. Physicians monitor their progress and vitals if they recommend this.

philippakate197

justincooper405 wrote: »

Agreed , I see it all the time... my guess ( just a guess) is that the Doc feels they are at a breaking point and need to immediately make changes to prevent serious health issues.

I suspect this. Although I don't agree that it's a good idea.

I also think that doctors believe it won't be adhered to rigidly, so advise a lower calorie goal to account for the extra calories that the patient will probably consume.

AnthonyX150X

When your "super morbidly obese" your body can handle a larger deficit than even an obese person. The reason doctors put them on 800-1000 calories is because their health seriously depends on it if they don't lose the weight as quick as possible. In some instances, they can die if they don't lose the weight quickly.

AimiAutumn

tomteboda wrote: »

It's not safe. It's dangerous. However, exceptionally heavy individuals are at very high risk and their weight also poses acute danger. So it's a tradeoff... The risk of a crash diet vs the risk of sudden death. Physicians monitor their progress and vitals if they recommend this.

That makes a lot of sense Thanks!

malibu927

Most of the time that amount of calories is closely monitored by the doctor to ensure the patient is getting proper nutrient supplementation.

I'm obese and anything under 1500 calories makes me cranky.

LivingtheLeanDream

It seems extreme.... certainly there's no way anyone would get enough nutrients on so low calories...

Seems like no one could even eat that low for very long without it leading to falling off the wagon which is why I think they'd be better to eat say 2000 cals + and lose a bit slower...
(This figure could be alot higher but without knowing stats it's just an example)

RobD520

justincooper405 wrote: »

Agreed , I see it all the time... my guess ( just a guess) is that the Doc feels they are at a breaking point and need to immediately make changes to prevent serious health issues.

This is basically the reason...

erinc5

I agree with what others have said. When you get to the point of being 500+ lbs you have to weigh the risks of being that big with the risks of going on a low calorie diet. I believe perhaps that the medical community has figured that it is actually safer to get down to a healthier weight faster. The super morbidly obese do lose weight on these diets, but they also suffer other effects. Many people who go on these VLCD (800 cals per day) either through supervision alone or as a result of WLS will experience hair loss, kidney stones, dental issues - all related to the fact that they are nutritionally deficient while on these diets. It's a balancing act the bigger you get.

brb_2013

That's a doctor supervised program, it's not actually safe but is seen as a solution due to the risks of remaining severely overweight. The rules still apply- they're likely to have intense cravings and binge desires and difficulty to stick to the plan. These plans are always shirt term. But given that it's being directed by a doctor (again, this is the ONLY situation where a VLCD is okay- under doctor supervision) the nutrition problems that occur on VLCD can be monitored and corrected when the time comes.

So it's not that it's safe. The drugs used to treat cancer aren't safe either-- literal poison. But the benefits outweigh the risk, same with eating too few calories to become less obese as quickly as possible. It's rough on the body and mind, but side effects are treated and managed until the base problem is handled. By a doctor. Very important to recognize it's not safe, it's just the lesser of two evils.

kommodevaran

I have a follow-up to this: Does a super morbidly obese lose - fat - faster on a 800 calories diet than on - say - a 2000 calories diet? What about that 1% of total body weight per week/31 calories per pound of fat before you start to cannibalize muscle rule of thumb?

MichelleLea122

kommodevaran wrote: »

I have a follow-up to this: Does a super morbidly obese lose - fat - faster on a 800 calories diet than on - say - a 2000 calories diet? What about that 1% of total body weight per week/31 calories per pound of fat before you start to cannibalize muscle rule of thumb?

If you're talking about general fat loss, of course they would lose more fat eating 800 calories vs. 2000. If you're talking about fat to muscle ratio, they would probably maintain more muscle mass on 2000 calories. But when you're morbidly obese you have more serious health issues to worry about than cannibalizing muscle tissue. As someone said above the risks of being morbidly obese often outweigh the risks of a low calorie diet.

kommodevaran

MichelleLei1 wrote: »

kommodevaran wrote: »

I have a follow-up to this: Does a super morbidly obese lose - fat - faster on a 800 calories diet than on - say - a 2000 calories diet? What about that 1% of total body weight per week/31 calories per pound of fat before you start to cannibalize muscle rule of thumb?

If you're talking about general fat loss, of course they would lose more fat eating 800 calories vs. 2000. If you're talking about fat to muscle ratio, they would probably maintain more muscle mass on 2000 calories. But when you're morbidly obese you have more serious health issues to worry about than cannibalizing muscle tissue. As someone said above the risks of being morbidly obese often outweigh the risks of a low calorie diet.

Ah, I see - I took it to mean that the 1% (or whatever) was all the fat that can be lost, not that any loss beyond that will be (just) an increasing muscle:fat ratio. It makes sense. Thank you.

SugarySweetheart

AimiAutumn wrote: »

I'm super confused by this! Usually the heavier/taller you are the more calories you can eat and still lose weight aslong as their is a deficit, but why is it when someone is super morbidly obese its not uncommon or unhealthy according to Doctors to put them on a diet of 800 - 1000 calories?

But if you are just obese its not safe to be on a 1000 calorie diet and they recommend something closer to 1200- 1600 (for a female)

Any thoughts?

Usually a defecit that low (800 - 1000 cal diet) would suggest the person has had Weight Loss Surgery.

yarwell

kommodevaran wrote: »

I have a follow-up to this: Does a super morbidly obese lose - fat - faster on a 800 calories diet than on - say - a 2000 calories diet? What about that 1% of total body weight per week/31 calories per pound of fat before you start to cannibalize muscle rule of thumb?

Yes they lose faster. If they have 100 lbs of fat they can supply 3100 cals a day and 100 lbs of fat would be about 220 lbs woman.

Here's a graph of 25% deficit (CR) vs 800 kcal LCD :-




(PS the VLCD intervention was up to a 15% weight loss then maintenance)

lilltessiiie

yarwell wrote: »

kommodevaran wrote: »

I have a follow-up to this: Does a super morbidly obese lose - fat - faster on a 800 calories diet than on - say - a 2000 calories diet? What about that 1% of total body weight per week/31 calories per pound of fat before you start to cannibalize muscle rule of thumb?

Yes they lose faster. If they have 100 lbs of fat they can supply 3100 cals a day and 100 lbs of fat would be about 220 lbs woman.

Here's a graph of 25% deficit (CR) vs 800 kcal LCD :-




(PS the VLCD intervention was up to a 15% weight loss then maintenance)

I would like to read that study. Yarwell, do you know the title and when and were it was published?

ahoy_m8

Thanks for the chart. I was going to add a general statement that people with large fat reserves can draw more energy from fat daily than someone with little fat. That doesn't say that it's safe, necessarily, but it's possible.

There's a rule of thumb floating around (can't verify but would like to) that fat reserves can supply up to 30 cal per lb of fat daily. To use yarwell's example above, a 200lb person with 100lb fat could handle a 3000 cal deficit, whereas a 120lb person with 20lb fat can handle only a 600 cal deficit without jeopardizing LBM

PAV8888

That would be before Fat Free Mass is affected. I.e. when you're trying to selectively optimise for fat loss only. https://www.ncbi.nlm.nih.gov/pubmed/15615615

BiggDaddy58

My own view is that a morbidly obese person can handle a very low calorie diet for longer than you think without serious damage.

I'd say of course, check with your Doctor first, but in my own case..I was 57 years old, 5' 11" and weighed 308 pounds.

I put myself on a 1200 calorie a day diet. (I stayed between 1200-1300 for a good 3 months) This is way too low for a man, but you can do it. I imagine a woman, needing less calories than a man, could do 800-1000 depending on their stats, safely, for a short period of time.

My Doctor never batted an eye when I told him what I was doing. Everyone is different, as are Doctors.

Zoot_suits

My doctor placed me on a VLCD. It's very similar to SlimFast. It's a high protein shake for breakfast and lunch, and then I have a dinner plan. He only wants me on it for 1 month, and then he is increasing my calorie intake and adding/altering medications. At 5'1" I was classed at Morbidly obese, Pre-diabetic, migraines, joint problems, and Degenerative Disc Disease. I'm only 34. He monitors me weekly, vitals etc. He wanted 10% of the weight gone, by the end of the month, and commented on how this initial weight loss will generally kickstart your body into fat burning vs fat storing. I don't feel that it is a long term sustainable diet, in no way shape or form. But it teaches you portions, and gets you into the habit of exercising. I started off barely walking on the treadmill for 40 minutes, now I can actually jog most of it