How to lose weight when morbidly obese

Question

I am a very overweight man at 400lbs (181 kg). I've been told by several doctors that I need to lose weight or else my health will get worse and worse.

What exercises are safe for a large person? For weight training I'm wary of doing squats since every time I've tried I end up with sore knees and have problems walking. I've also found that most cardio programs have the same effect.

For losing weight should I be concentrating on cardio or weight training? Is it better to exercise or should I just change my eating habits?

What are some good websites for teaching myself proper nutritional information? I've heard the old adage "eat less", but considering that most of my meals are from fast food restaurants, I have no idea of what kinds or proportions of foods I should be eating.

Answer 1

Ok... for your situation, unless you're good at doing things cold turkey, read on...

Forget weight training (and definitely squats) for the moment. At 400lbs, your body weight is doing plenty for your legs and body as you move around.

First thing is changing what you eat. It's easy to say eat veggies, oatmeal, etc., but that's a difficult change for someone eating fast food most of the time. You have to start adjusting gradually.

Why do you eat fast food? Taste? No time to cook? Can't bring lunch?

Like hamburgers/cheesesteaks? Buy whole wheat bread, turkey/chicken burgers, and low-fat cheese with a little mayo.

Like fried chicken? Buy rotisserie chicken at the market, make mashed potatoes at home (with low-fat milk and smart balance butter).

Like sodas? Mix ginger ale with sparkling water or unsweetened tea with agave.

Follow those lines of slowly shifting out of fast food and slowly into homemade meals, by mimicking what you eat out with making it at home. It doesn't always save money, but saves calories and adds nutrition.

If you have to eat out, find places like Chipotle (chicken w/ brown rice, beans, lots of veggies), Pot Belly's (turkey or roast beef on whole grain), Kebab joints (grilled meats on rice, hold the butter). Go light on mayo/dressing/cheese.

Second thing is movement. Start slowly, with walking, no stairs yet. Do you have a treadmill or a park? Either way, start at a nice walking pace. Do 5 minutes first day, even if you could do 10. Add 30 seconds each day. It will add up faster than you'd think. Once you get up to 60 minutes at that pace, stay at 60 and up your pace (.1 on a treadmill) each week. If you don't have time for 60 minutes, at least max out at 30.

After a month or two, you can adjust your meals to be more healthy and add a little weight training to your routine.

Slow and steady is key to maintaining a major change in lifestyle both physically and mentally.

Answer 2

1. Diet - Unless you get your diet under control, exercise alone will not make enough of a difference on its own. Craig Ballantyne does a great diet versus exercise video that will stick in your mind when you are considering calories going in and just how hard it is to work them off with exercise.

   The best resource for a specific diet for you is to meet with a registered dietician that specializes in obesity. This will save you a lot of wasted time trying to learn how to eat well, with proper portion sizes and with specific calorie amounts so that you have a viable eating and weight loss plan. Your doctor will be happy to set you up with a good dietician. With morbid obesity, you need a pro helping you handle your diet. And you will need to get away from fast foods as they generally have poor nutritive values and a lot sodium and artery clogging fats.

2. Keeping Track - Discuss with your doctor the measurements that are most important for you to keep track of to measure your progress: Waist Circumference, BMI, Body Fat Percentage etc. Ask your doctor for advice on using a Heart Rate monitor and what your safe target heart rate is during exercise. Keep a chart or graph of your diet, exercise and progress to help motivate you when the going gets tough.

3. Exercise - Finding the right exercise(s) for you is key to exercising successfully. Low or no impact exercises are easiest on the joints. Water aerobics, swimming, running in water, water resistance exercises etc. will allow you to get a good workout without as much strain. Stationary cycles, elliptical trainers and Nordic walking poles are also good options for delicate knees.

   Join a gym and set up a regular schedule that works for you. Meet with their trainer and have them set up a routine for you that includes resistance training as well as cardio and stretching. Then have them upgrade it periodically.

   Ask for a program that includes resistance training for large muscle groups. They can show you alternatives to the squat that are easier on your knees. You may need to use a machine and/or limit your range. For example, you can target your glutes with the hip extension machine and this won't affect your knees.

4. Get Support - Losing the amount of weight that you want to lose involves a lifestyly change - increasing your overall activity and decreasing your sedentary time. Find a sport or physical activity that you enjoy.

   You will need support along the way. Enlist as many friends, family, trainers, work out buddies etc. as you can to help you stick with the program. You can also get support online. However, given just how important losing weight safely is to your health, it is wise to set up your plan with your own health professionals.

Answer 3

First of all, you must change your diet. Eating fast food all the time is bad for you in multiple ways, including your pocketbook. Switch to unprocessed food as much as possible. Regular oatmeal in the morning as opposed to quick oatmeal or cold cereal is much better for you and doesn't take more than a few minutes to prepare. Add some cinnamon, nutmeg and some raisins.

Second, drink lots of water. Not only will it reduce cravings, it will help in step three.

Third, no elevators, take the stairs. And, if you work in a multi-story building, do not use the bathroom on the floor you work on.

Finally, change is hard. Don't beat yourself up when you slip up. Try to find a friend or coworker that is also trying to make a change so you can support each other.

Good luck.

Answer 4

Weight training best effect comes from the training of large muscle groups using a high range of motion. (Moving a weight over a distance = doing "work"). Ideally you wat to do as much work as possible in smaller amounts of time do that you expend energy without building up tons of fatigue. For example. Shoulder-shrugging 110-lb dumbbells is HARD, but the dumbbells only move a few inches up and down. In contrast doing arm raises from flat at your side to perpendicular involves a greater distance, and if you used appropriate weight, you'd do more WORK than with he other exercise within a few sets.

Also, from what you described, you should look for exercise that would be ok for someone with patellar-tendinitis to do. Why? Because you'd like to go easy on the knee impact. One thing you may consider to being with is plain old walking. If you have an pulse/hear-rate monitoring instrument (like a watch) take you resting heart-rate and then walk for even 200 meters and take your rate again. The difference will be significant. So walking 1 mile a day would help. I suggest a REAL mile, not an elliptical machine mile, as it requires much more energy to walk on the ground than on machines designed for lower knee impact, and more weight support (handles). Until your knees become stronger, walking and body squats are your limit. You can ice your knees after each session to keep inflammation away.

"Cardio" is somewhat overplayed. Everything is cardio, and your heart-rate should fluctuate with interval style workouts rather than even-keel stuff like jogging. They do not run treadmills all-day on Biggest-Loser. You should download the show, or buy it on DVD and do your best to incorporate what they do in your own fashion.There is a website for Biggest Loser also, with a community for people at home who also wish to change the the shape they are in. It has diet/eating information and recipes also.

As you are in touch with your doctor, you can run every exercise you wish to do by him/her - but remember his/her job is to err on the side of caution, and if everything you want to do it "too much" you will never do anything and stay as is.

You should start preparing immediately, but also set a date in the future say 3 weeks when you will be ready to cal it your first day prepared. Cold turkey diet change it hard. Setting a routine to exercise everyday is harder. So start today "trying" to change so that in 3 weeks you have had a chance to implement different things more easily. Then you'll be good to go.

Answer 5

Even if you don't plan on counting calories consistently, just doing it for a week or so will increase your awareness of how many calories foods contain. For example, one whole walnut contains 28 calories - so eating a handful results in quite a calorie intake! I use FitDay for counting calories - it's free and easy to use.

A good alternative to fast food is to carry a cooler with you in your car and/or to work. Stock it with healthy but satisfying foods and ice packs. Light cheese, whole grain crackers, tomato juice, veggies and hummus, etc. I also do this with leftover meals - another incentive not to clean my plate at dinner - I'll have 'free' lunch tomorrow.

If you drink soda, just cutting that out alone will probably result in some weight loss within a few weeks. Make the switch to water or unsweetened iced tea and your body will be very happy.

Also, if you have food cravings, seek out healthy substitutes. I love chocolate ice cream, but luckily I discovered mixing cocoa powder with 0% Greek yogurt and a small amount of maple syrup satisfies my craving.

Go in small steps and don't deprive yourself of all the foods you love. Just reduce the amounts and savor them as you eat.

As for exercise, juggling is great no-impact cardio activity and perfect for people just getting started with exercise. You can even do it while sitting down in an armless chair. For a detailed how-to, check out the post I did on the Fitness Stack Exchange Blog.

Answer 6

This is my personal experience, but I'm sure you can find many other people who have experienced similar results. I have a massive appetite and consume the same amount of food as I did when I was 13 years old and playing basketball everyday.

Adopt a whole-foods plant-based diet like that suggested by Dr. McDougall. I used to be morbidly obese - topping in at around 300lbs. It was a real struggle to lose any weight - though I suffered and struggled my way down to about 200lbs.

I then discovered the vegan diet and adopted a whole-food vegan diet - I now weigh 150lbs and no longer have to deprive myself of food - I just eat whole-vegan foods as much as possible to maintain my weight. To clarify, I used to weigh 2x as much as I do now and now I don't have to deprive myself to get reasonable results.

Of course, your results may vary, but you're highly likely to make significant headway. One of the great things that happened to me is that after losing the weight, I started to WANT to exercise because I had energy again! This will further help you on your health and fitness goals.

I really feel for you - I didn't realize how miserable and crappy I felt when I was at 300lbs until I lost the weight and regained my health.

There may be fast food or food delivery services in your area that have vegan options that are primarily whole-foods based - this will help you transition away from fast-food and give you the initial success you need to stay motivated to carry out some of the suggestions in the other answers here.

Answer 7

Many would suggest that your energy is better spent focusing on your diet than focusing on exercise. An essential aspect is simply eating less. Sure, eating better foods is better, but the most important thing is to eat less. You have to find techniques that work for you, but here are some ideas.

• Try using a plate that is smaller than normal and filling it only once.
• Give yourself a half hour before going back for more. You might not be hungry.
• Stop when you are satisfied, not full. There's a difference.
• A serving is roughly the size of one fist. Think about that when you portion out meals.
• Eat as many green vegetables as you want. Everything else in moderation.

Answer 8

Changing your eating habits is the most important.

The following may seem like common sense to some people, but I thought it should be said.

Eat one bowl (under 2 cups) of yogurt mixed with granola for breakfast.

When you eat fast-food (it happens) don't order a combo-just the sandwitch/burger (and only one of them per meal). Try to eat at subway; be sure to load up on the vegetables and get wheat bread. A foot long with vegetables is better for you than a 6 inch combo.

Don't eat or buy candy, ice-cream, chips, or French fries... ever! The same goes for fruit juices and soft drinks. 2 cups of milk per week is fine but drink water almost exclusively.

At least 3-4 times per week buy frozen vegetables (cheap!), boil them, and find a spice/salt mix that tastes good without butter or oil on them. Don't eat vegetables exclusively but make them replace things like French fries.

If you are dying for a snack occasionally eat a handful (and only a handful) of nuts such as peanuts, cashews, almonds, or macadamia nuts. They are high in fat content, but they can prevent larger snacking.

Eat lots of watermelon! It is packed with fiber and water, which bloats the stomach and makes you feel full. Also it tastes delicious when refrigerated. Skinny people occasionally win food-eating contests if they have stretched their stomaches with watermelon.

Recognize that it is OK to feel hungry-especially at bed time. I time it so that I eat 4-5 hours before I go to bed, which is important since if the time is any longer I get hungry and want to eat right before bed (bad!).

Exercise is important but I think others have covered that topic well enough.

If dieting and exercise fails, consider gastric bypass surgery- my aunt got it and she lost weight so fast!

Answer 9

That's strange, but no one focused on the most important "exercise" -- walking.

A) Set clear goals

1. Walk 30 minutes every day in the morning.
2. Walk 30 minutes every morning and evening.
3. Walk 30 minutes every morning and 1 hour every evening.
4. Walk 1 hour every morning and 1 hour every evening.
5. etc.

B) Buy a cardio monitor

Try to keep HR at 120-130 for non-stop for 30-60 minutes. Not less, not more.

C) Buy tracking device (or pedometer) and forget about logging your activities

You can check FitBit or use any similar solution. It doesn't really matter. Choose based on price and easy to use functions.

D) Increase difficulty of walking every month

Select routes with elevations like hills, sand, etc.

E) Use poles

It will decrease pressure on your ankles and gives additional upper body training.

F) Walk sometimes in company or with a dog

A good mood will really help you to achieve results! Explore new places, routes, etc.

G) Don't stop during walking session.

Always keep moving! Think about having a good route in advance.

H) Walk EVERY day

I really stress it. Enjoy your walk. On weekends walk with your family or friends. Park your car far away from your destination (when you don't required to carry something heavy).

And some diet points:

• Do not eat "quick" carbohydrates before and after walking
• Drink more especially when walking for longer than 30 minutes

Remember, walking is the most valuable activity! You can combine it with any other ones, as gym, swimming, diet. Especially, diet. This is simple and very, very effective. Do not expect quick results, they will be slow, but stable.

Good luck!

Answer 10

First, it is great that you have decided to do someting for your health and are asking for advice.

I'll just go through in a couple more ideas about diet, which is definitly where to start.

Diet

A "Diet" is something you have, not something you go on. At present your diet is unhealthy and you need to transition to something healthy, don't think of a diet as a temporary thing otherwise you will end up yoyoing and will probably end up back where you are now. Progressively change to a healthy diet.

Motivation

Keeping yourself motivated can be hard work. Set goals, but don't consider them as pass / fail. If you don't make a goal, how much of it did you make 10%? 50%? 90%? Then ask what it was that worked against you making the 100% and see if you can change something to remove the obstacle. Or are your goals over ambitious, it can be helpful to get advice on this.

Also, remember to reward yourself, if you have "been good" say you made your goal then give yourself a treat. Ideally I'd say non-food treats are best, but if you have saved say 3000 calories in a week, spend a couple of hundred on a favourite.

Be kind to yourself, you're worth it.

Answer 11

First of all, congratulations on starting a new life. Trying to lose weight is hard, take it from someone that has not cared about anything she eats as long as she has been alive. I too have started on the same road you are on to a healthier life at 278lbs 5'4" and 29yrs old not a good look for me, not only that, but at this weight I am destroying my life.

The advice I have gotten from many people and what I have gotten from personal experience, is to start only with cardio for the first couple of months. I've only been exercising for a little over 3 weeks now and already I feel better. Take it slowly, you don't want to hurt yourself. The first day I could not do over 5 mins in any machine, 3 weeks in and I can do over an hour in the elliptical machine, then start working weight training into it. Also, have an exercise plan, don't just go in doing things like crazy, you wont get anywhere that way. I'm lucky enough to have a sister who used to work in the industry and has given me some advice on the matter.

Also something I have learned is very important, drink water, more when you are exercising. Not drinking enough water can actually lower your metabolism.

Anyhow, keep the good work and good luck on this new adventure, hope for the best.

Brenda

Answer 12

Being overweight and starting to exercise for the first time, you will find pressure build up especially on your knees. Start by making some life style modifications. Park your car further away from the shopping centre, go for a walk everyday for no less then 20 minutes. Along with diet these small changes will be the first Step. Look at your current eating an try to eliminate process foods. The more raw and organic the better! Try to buy your fruit and veggies when you'll use them as the longer they stay packed away in your fridge, the less nutrient they'll have, also peel away the outer layer and wash before consuming as this helps to ride of the chemicals the outer layer contains. Try limit the amount of "other" liquids other then water. You should be consuming atleast 8 glasses a day. This does not include "diet" or "sugar free" drinks. These contain harmfull chemicals which will actually go against your weight loss.

Now as for exercise, I'm a personal trainer with a client similar, we started by going for nice easy walks with a heart rate monitor. It's important to ease into exercise and be prepared for your muscles to feel a bit stiff or sore the next day due to delayed onset muscle soreness. Don't he alarmed by this it's completely normal and you'll find by doing a nice walking warm up before exercise will help reduce this stiffness felt usually the day after exercise. I would recommend also bikes and rower especially, this will raise the heart rate but be easy on your knees and take the strain off the body weight you are carrying. Squats using a fit ball are great not to deep, nice slow repetitions. Side raises and resistance bands and boxing are all great options ! If you have the use of a pool is a great form of exercise as due to the buoyancy takes the pressure of Your weight off. Try treading water for a few Minutes, high knees or even side stepping.