Hey guys, finally after way way too long, I have convinced my dad to go on a diet, and I have appointed myself his personal trainer and dietician. Problem is, sure I know heaps when it comes to bodybuilding for somebody in acceptable or near acceptably normal condition, but my dad is so fat that my scale which goes up to 300 won’t register him. He is 51, about 6 feet tall, and by my best guess, I’d say 310-330lbs. He is in such bad shape he can’t walk from the couch to the fridge without being out of breath (literally). Not to mention the fact he has severe type II insulin dependant diabetes, is bi-polar, asthmatic, hypertensive, has had a heart attack, high cholesterol, is on testosterone injections, has severe back problems and numerous other disorders, probably even some new ones doctors will have to name after him. I don’t want him going to a dietician or a personal trainer for obvious reasons to the T-mag crowd, but it’s almost as if I am scared to recommend anything because of all his conditions and the cupboard full of drugs he uses everyday! Can people with any experience with this please help me?
His diet starts tomorrow and as of now I have him taking 2500cals/day, 6 meals a day, approx 180g of protein a day, healthier fats, lower glycemic carbs. 3 of these meals have carbs/protein, and the other 3 have protein/fat. I will be having him take 15 salmon oil caps a day, vitamins c and e, a multivitamin, vitex, and tribex. Any other supplements I have too much a fear they would interact with his medications or would just be unnecessary at this stage. As for exercise, right now I am clueless… I don’t think he should be doing anything as he can’t even walk, it puts him in severe pain due to his back, and he can’t walk for any more than say 50m without having to sit down and rest. Anybody who has trained people in this condition, or who has trained themselves in this condition, I would very much appreciate any and all of your opinions on all aspects of this. Cheers.
When I began my career as a personal trainer, I had the idea that I would be working with elite athletes and high level bodybuilders. Now I work primarily with the formerly sedentary population. While I don’t have many tips for your dad, I do have a few female clients who were/are over the weight limit. The important thing is to start slow. Someone who is very inactive, just walking a few times a week will improve fitness greatly. I add 10 calories burned each time we walk. Also do not train to failure on weights for a very long time if ever. Just start with a light weight, with a number of reps that is simple. Master technique and each workout add half a pound or a rep. They’ll get there. good luck! Many of your dad’s chronic health conditions will go away if he gets into shape.
I’m not sure that the Vitex or Tribex would be a good idea. It seems like there’s too much of a possibility of drug interaction there, and on top of it he’s already taking testosterone injections.
For now I'd say just worry about getting some weight off of him with diet, and keep his exercise minimal to avoid any strain on his back. When he drops some weight he'll be able to move around easier and can start including some basic calisthenics.
First off, hats off to you and your father for doing this! It’s good to see you helping your father and maybe even more remarkable that he is willing to let you help. (More on this in a second.)
Third, the advice here so far seems sound. You really should check with your father’s doctor before using the supplements, but then again, most doctors will have no idea about these supplements and there is probably little research/information about interactions. Keep looking around until you can find a specialist in weight loss in severe cases like this. It seems like there ought to be someone who really knows what you need.
You might have your father see a physical therapist to design a program that can be done at home, and this should be covered by insurance. Try to find a PT with specialized training or certifications in sports medicine, particularly a certification that the T-mag staff would recommend. (It seems like there is a Chek certification that has been praised here.)
A lot of what I do as a PT is not magic and could be done just as well by a family member with a little training if the patient and family member are motivated (especially if the family dynamics allow the family member to kick the patient in the rear for motivation). Honestly, I have many times thought my main value was to tell a patient a truth he or she would not hear from a family member! (This applies particuarly to situations in which an aging parent lives with a son or daughter and I come in to treat and train the patient in the home.) I think that a PT who really knows his or her stuff could design an exercise program that is relatively painless and protects your father’s back and joints and which you could perform at home. Then every few months you could have a follow up with the PT to modify the program as your father’s condition improves and he can tolerate more vigorous exercise. Being trained in a program to be done at home will minimize the cost both financially and in the inconvenience and wear and tear on your father in making a trip to an outpatient clinic. You might even be able to get a script from the doctor for the PT to do training at your home, but a homehealth PT with the background you need may be hard to find, and I’d take the trouble of going to the right PT even if it entails some trips to an outpatient clinic.
Bottom line: Try to find the best weightloss doctor and sports med PT you can find for this stuff. The right doctor or PT who specializes in what you need is worth a hundered average practitioners. (Notice all the stuff on this site about ART trained chiropractors? Sometimes a very specific competence will set a healthcare provider miles above the rest of the field, so discover what competence your situation demands and then find someone who has it!) Too many people assume that merely having MD or PT (or any other letters) behind your name means you have a certain level of competence, but as in everything, there are bad apples and a great deal of mediocrity even among professionals. Unfortunately, an excellent doctor and a mediocre doctor have exactly the same letters behind their names (though letters designating a specialization or certification may improve your odds of getting a good one). That's not necessarily a slam on certifications and licenses, but a simple recognition of the fact that there is a statistically significant difference in the outcomes of a doctor who has done a given procedure 600 times versus a doctor who has done the procedure only 50 times. (There are studies showing this sort of thing. Unfortunately, six hundred people have to serve as the learning curve for this excellence.)
Just saying thanks for the replies all, especially the detailed one by APT! I’m thinking you are right that I should tell my dad to go to a PT who can devise a program for him to exercise with, as I am pretty much clueless in what he can do right now! Anyways, more suggestions would be welcome from all, Cheers!