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

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  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
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    PAV8888 wrote: »
    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

    Thank you so much for that!
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    edited October 2016
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    daniip_la wrote: »
    I'm 6'0" and weigh 298lbs. I'd rather stay this size than go on an 800kcal/day diet.

    I get lightheaded and dizzy if I have a 1500kcal deficit for a few days, I think a 2000+ kcal deficit for more than a day or two would kill me. Or I would kill someone.

    The 30kcal/lb fat rule of thumb focuses on one aspect only--how much energy one's fat stores can provide. It does not address the multitude of other physiological systems that let you function or feel normal, e.g. hormones that regulate blood sugar to prevent lightheadedness or passing out. I did note above, apologies for the repeat, that just because a big deficit is possible doesn't necessarily make it safe.
  • heybales
    heybales Posts: 18,842 Member
    edited October 2016
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    Here's a study of not obese but the BMI category of overweight, and same effects. Study is link in this post.

    http://www.myfitnesspal.com/blog/heybales/view/reduced-metabolism-tdee-beyond-expected-from-weight-loss-616251

    The other interesting thing about almost every one of those studies - the people tested were NOT any ANY weight loss mode for prior 6-12 months, no attempts to lose weight.

    Many times that's what the Dr is working with too for their extreme diets for short periods.
  • heybales
    heybales Posts: 18,842 Member
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    ahoy_m8 wrote: »
    PAV8888 wrote: »
    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

    Thank you so much for that!

    And if you read the actual "study" - it wasn't. It was a theorizing on other studies (mainly 1) and the results they got from that study - that study wasn't actually after that info of max fat loss. That was obtained by playing with formulas from the results.
  • mangrothian
    mangrothian Posts: 1,351 Member
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    ahoy_m8 wrote: »
    daniip_la wrote: »
    I'm 6'0" and weigh 298lbs. I'd rather stay this size than go on an 800kcal/day diet.

    I get lightheaded and dizzy if I have a 1500kcal deficit for a few days, I think a 2000+ kcal deficit for more than a day or two would kill me. Or I would kill someone.

    The 30kcal/lb fat rule of thumb focuses on one aspect only--how much energy one's fat stores can provide. It does not address the multitude of other physiological systems that let you function or feel normal, e.g. hormones that regulate blood sugar to prevent lightheadedness or passing out. I did note above, apologies for the repeat, that just because a big deficit is possible doesn't necessarily make it safe.

    You're right. Creating a deficit that large isn't safe; or at least doing it without supervision it isn't. Under strict medical supervision, it does make it safe-er (this is part of the reason you're not allowed to promote doing a VLCD on mfp, as it isn't something that should be encouraged by someone who isn't a medical professional). But I think some of the health problems some people with obesity have are much riskier than their doctor helping them with a plan like this.

    My husband was put on one for 4-6 weeks as a way to help reduce chronic knee and back pain from a workplace injury. He's 5'10 and started at 125kg. There was no way I would have every allowed him to even try an 800Cal diet if it wasn't for the fact that he has a GP, nutritionist (the qualifications are a little bit more credible for nutritionists in AUS), psychologist and physiologist all watching over him whilst he does it.

    He's hangry all the time and he's tired. I plan the one non-shake meal he has daily very carefully to make he gets enough protein and fibre, and has something that will fill him up at the end of the day.In my husband's mind, for all that he doesn't want to have to do it, to decrease the pain that he's in on a daily basis, the end justifies the means even if it isn't the safest way to begin losing weight. It's also a hell of a lot safer then his body slowly becoming addicted to opiate-type painkillers.
  • Aaron_K123
    Aaron_K123 Posts: 7,122 Member
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    I believe its a risk assessment. What does more damage. 12 weeks of an overly restricted diet that is likely going to lose you lean muscle and do you some harm or 12 weeks of remaining morbidly obese, given that there is a reason its called "morbidly" obese. I don't think its because it somehow isn't also damaging to them to eat that little, its just less damaging than being that overweight in the estimation of some doctors.
  • PAV8888
    PAV8888 Posts: 13,652 Member
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    heybales wrote: »
    Here's a study of not obese but the BMI category of overweight, and same effects. Study is link in this post.

    http://www.myfitnesspal.com/blog/heybales/view/reduced-metabolism-tdee-beyond-expected-from-weight-loss-616251

    The other interesting thing about almost every one of those studies - the people tested were NOT any ANY weight loss mode for prior 6-12 months, no attempts to lose weight.

    Many times that's what the Dr is working with too for their extreme diets for short periods.

    Yes. But the majority of people on the boards these days don't believe that adaptive thermogenesis is "significant" or of "concern" that should be actively avoided.
  • singingflutelady
    singingflutelady Posts: 8,736 Member
    edited October 2016
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    PAV8888 wrote: »
    heybales wrote: »
    Here's a study of not obese but the BMI category of overweight, and same effects. Study is link in this post.

    http://www.myfitnesspal.com/blog/heybales/view/reduced-metabolism-tdee-beyond-expected-from-weight-loss-616251

    The other interesting thing about almost every one of those studies - the people tested were NOT any ANY weight loss mode for prior 6-12 months, no attempts to lose weight.

    Many times that's what the Dr is working with too for their extreme diets for short periods.

    Yes. But the majority of people on the boards these days don't believe that adaptive thermogenesis is "significant" or of "concern" that should be actively avoided.
    sorry wrong thread
  • Sued0nim
    Sued0nim Posts: 17,456 Member
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    Is "super" morbidly obese a term now?

    Wasn't morbidly obese enough?
  • trigden1991
    trigden1991 Posts: 4,658 Member
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    Because they have a lot of excess fat to lose and are under medical supervision throughout the process to minimise negative side effects.
  • z4oslo
    z4oslo Posts: 229 Member
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    RunRutheeRun wrote: »
    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)

    Actually getting enough nutrients is not really a problem. It just depends on how much vegetables you eat.
    You need to eat ALOT of vegetables though, or have a slowjuice machine.

  • trigden1991
    trigden1991 Posts: 4,658 Member
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    Have a look at studies like the Minesotta Starvation Study. Very interesting regarding VLCD or in this case water fasting for long periods of time.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
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    Sued0nim wrote: »
    Is "super" morbidly obese a term now?

    Wasn't morbidly obese enough?

    Often when classifications of anything get too broad, subcategories are added.


    "BMI categories help evaluate the degree of obesity in a particular person. A person with a BMI of 18.5 to 24.9 is considered to be in the healthy range. An individual with a BMI of 25 to 29.9 is considered overweight, and a person with a BMI of 30 or more is considered obese. A person with a BMI of 40 to 49.9 is morbidly obese and an individual with a BMI of 50 or more has super obesity or super morbid obesity, according to a 2009 article published in "Archives of Surgery."

    http://www.livestrong.com/article/369944-super-morbid-obesity-body-mass-index/
  • amusedmonkey
    amusedmonkey Posts: 10,330 Member
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    Sued0nim wrote: »
    Is "super" morbidly obese a term now?

    Wasn't morbidly obese enough?

    It has always been a term. Class 3 (morbid) obesity starts at 40 BMI, and super obesity starts at 50 I think?
  • ogtmama
    ogtmama Posts: 1,403 Member
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    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?

    I haven't read anything else but my immediate reaction is that an extremely low calorie diet isn't"safe" but it's less dangerous than being morbidly obese.
  • jennifer_417
    jennifer_417 Posts: 12,344 Member
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    I believe it's a couple of things. First, the danger of a VLCD is overridden by the danger of being that overweight, so the goal is to get some weight off as quickly as possible. Second, someone on that category has plenty of fat reserves that the body may feed off of, so malnutrition doesn't necessarily become a problem right away.
  • MsRuffBuffNStuff
    MsRuffBuffNStuff Posts: 363 Member
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    I think its safe because they probably aren't exercising - sedentary fat doesn't burn calories. Yes they would burn more calories if they were moving, because they are heavier, but they probably aren't. Cutting to 1500 or 1200 calories might not do anything for them. They are better off learning to eat lower calorie foods until they are able to move more.
  • StaciMarie1974
    StaciMarie1974 Posts: 4,138 Member
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    Just my theory:

    The health risks of being super morbidly obese may outweigh the health risks of being on a very low calorie diet, and being under a doctor's care could help to spot issues arising from VLCD early in order to offset them.
    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?

  • AlabasterVerve
    AlabasterVerve Posts: 3,171 Member
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    Conventional wisdom is slow, steady and sustainable weight loss. The scientific literature to date shows that the faster weight loss with a protein-sparing modified fast diet results in less hunger and better long term maintenance which I assume is why doctors prescribe "crash diets" for the morbidly obese. There are risks associated with it, of course, the most notable from a paper this year:

    "Attention should be paid, particularly in the early phase of weight loss, to high heart rates in order to reduce the spontaneous risk of atrial arrhythmias." -Drastic Calorie Restriction for the Treatment of Massive Obesity

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