Why is it safe for a super morbidly obese person to eat 800 cals a day?
AimiAutumn
Posts: 22 Member
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?
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?
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Replies
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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.28
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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.64
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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.
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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.
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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! 1 -
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.9 -
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)5 -
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...0 -
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.3
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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.
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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?3
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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.8 -
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.0 -
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.0 -
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)5 -
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?0 -
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 LBM6 -
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/156156151
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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.
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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
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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!1 -
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.8 -
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.2 -
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.0 -
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.1 -
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.3 -
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.3
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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.
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.0 -
sorry wrong threadHere'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.0 -
Is "super" morbidly obese a term now?
Wasn't morbidly obese enough?0
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