Help 400 pounder teenager - BUILT!!! or anybody else

[GreenManalishi]

I teach/coach at a high school and have a 400 pound sophomore that has been working out with me (P90x). He plays football and basketball is very athletic for a kid his size. I think if he can change body composition and get to a strong 300? he may be a college athlete.

Anyway we started P90x the beginning of March. Right away he lost 15 pounds and 2 pant sizes. The scale has not moved the past 4 weeks (I know the scale isn't the tell all). He eliminated soda and late night raman noodles from his diet and has tried to eat "right" but doesn't have alot of knowledge.

I guessed, from his stall and in talking with him, he doesn't eat enough, often enough etc. I asked him to journal a few days worth of food and he was around 2000 Kcal on 3 days and 3000 Kcal on another. Using the Harris-Benedict BMR formula his maintenance should be around 5200 Kcal and at a loss of 2 pounds a week he should be on a diet of 4200 KCal. He obviously is not close and I don't know where he was before but I would guess his calories were much higher but full of junk and alot of late night food.

I have decent knowledge but I don't know where he should start. How fast should we ramp his calories up from 2000 to 4200 (probably the problem right?). What do you think his macros should be? (1g [1.5]protein + .45 g fat per lb, etc).

I don't want to make this complicated for him but he needs some education. I put his info into myfitnesspal and printed it out and as well as mine and will show him I eat more at 160 pounds than he does. I can show him several mistakes he is making. His family doesn't have a great amount of money so and he will not eat a vegetable so its not like we have a open field at the grocery store either.

I have rambled enough. I track my diet religiously and am great shape and for the most part know what to do for me but this is an extreme case and don't want to be too aggressive/do something very wrong.

 

[Built]

It's nice of you to help him.

How tall is he?

I teach/coach at a high school and have a 400 pound sophomore that has been working out with me (P90x). He plays football and basketball is very athletic for a kid his size. I think if he can change body composition and get to a strong 300? he may be a college athlete.

Anyway we started P90x the beginning of March. Right away he lost 15 pounds and 2 pant sizes. The scale has not moved the past 4 weeks (I know the scale isn't the tell all). He eliminated soda and late night raman noodles from his diet and has tried to eat "right" but doesn't have alot of knowledge.

I guessed, from his stall and in talking with him, he doesn't eat enough, often enough etc.

He's eating too much or he would drop weight. Why do you think he should eat more frequently?

I asked him to journal a few days worth of food and he was around 2000 Kcal on 3 days and 3000 Kcal on another.

He's lying.

Using the Harris-Benedict BMR formula his maintenance should be around 5200 Kcal and at a loss of 2 pounds a week he should be on a diet of 4200 KCal. He obviously is not close and I don't know where he was before but I would guess his calories were much higher but full of junk and alot of late night food.

I have decent knowledge but I don't know where he should start. How fast should we ramp his calories up from 2000 to 4200 (probably the problem right?). What do you think his macros should be? (1g [1.5]protein + .45 g fat per lb, etc).

I don't want to make this complicated for him but he needs some education. I put his info into myfitnesspal and printed it out and as well as mine and will show him I eat more at 160 pounds than he does. I can show him several mistakes he is making. His family doesn't have a great amount of money so and he will not eat a vegetable so its not like we have a open field at the grocery store either.

I have rambled enough. I track my diet religiously and am great shape and for the most part know what to do for me but this is an extreme case and don't want to be too aggressive/do something very wrong.

He's eating more than he says.

It's really tough with a kid, because you really need to put the whole family on a diet.

Have you spoken with his family?

 

[GreenManalishi]

He is 6'4. I really don't think he is lying. He seemed like he thought having 3 chicken strips at prom was going at add 10 pounds. Haven't spoke to whole family but I know mom has tried to cook a few things differently. He makes alot of his own meals. Starting from scatch -- How many calories should I start him off at and what macros?

 

[tubbednova]

He might not be eating to much.
If you don't eat enough even on a diet your body will start to hold on to fat as to have a fuel source.
You'll lose weight at first fat/muscle then stall.
Best bet is to zig-zag cals. and find the sweet spot.
Im eating 3300cals and losing fat.Getting ready to up cals again to get rid of fatigue during day.

 

[tubbednova]

Also do you have body-fat calilpers?He might be losing fat but building alittle muscle.
Which would be the weight stall.
I only use i scale to see if im losing muscle and for my b/f meter.

 

[GearsMcGilf]

Not eating enough? Are you trying to get him to 500lbs or 300? He's not eating 2000 calories per day or he wouldn't weigh 400lbs. He needs a good simple and clean 3000 cals/day diet. If he can keep his cals "up" to 3000/day, along with his athletic program, he should lose weight. If he doesn't, he's lying about his diet and he's still eating junk food. Another good idea would be to threaten to kick him off of the team if he hasn't lost x amount of lbs by a certain deadline.

 

[Built]

^ That.

Make him up a 3000 calorie diet; if we assume he's got at least 200 lbs lean mass, I'd set protein at no lower than 300g and fats no lower than 100g. Fill him up with protein and fibre - find a few veggies he WILL eat and load those into his food. tubbednova's concern is premature - a 400 lb kid won't go catabolic if he runs a deficit.

Try 300g protein, 200g carb and 100g fat. First meal of the day should have at least 100g protein; I'd suggest he gets in a sugar-free whey shake followed by something like an omelette and any veggies he'll eat. This will set him up to feel full right off the bat and the research shows that people who eat a very high protein first meal will tend to undereat for the rest of the day. The whey shake is a very important part of this formula, because it normalizes the insulin response and loads him up with ghrelin-suppressing protein. He COULD blend in thawed unsweetened frozen raspberries if he wants; they're very low carb and full of fibre. Not banana, not pineapple - stick to unsweetened berries for this one, or forget it.

Do NOT try eggwhites without the yolks on this kid; eggwhites don't suppress hunger in humans, but whole eggs do. He could try cottage cheese on the side of his omelette with celery, cucumber chopped into it. A 400 lb kid needs to eat - that's why he's this big. We need to reconnect his metabolism to his appetite.

No fruit juice, no pop, no dried fruit, fruit smoothies etc. They will screw with his appetite and load him up with sugar he does not need.

Does this help?

 

[GreenManalishi]

Thanks Built! The macros make sense - even if the carbs aren't that low another 100 are only 400 calories and keep him to 3300. 4000 Kcal seemed like too much.

We workout before school - how would you alter morning? Because we are at school it makes some things tough - not cooking up omelettes. Probably have to live with him eating school lunch as well. We are not going to get this perfect but trying to work around some things. Hoping to get him a calorie range. Macro range. Clean up his evening meals. Get rid of awful things and replace them with decent things. Get him eating 5-6 meals rather than 2 or 3 (I know you aren't as big on that Built). Finances are an issue. I can't even afford raspberries. Strawberries more affordable so that should work. Bananas cheap, apples not too bad but too sugary.

Remember I am working with a 15 year old kid. Not going to have the complete discipline needed. I bring a grocery store to school with me every morning but I don't think that is going to happen. Trying to shape and steer - baby steps.

 

[GreenManalishi]

General reply to others.

We know how he got to 400. Question is why the stall? Understand there may be a shift from fat to muscle that causes scale not to move but at this size I would think scale would still go down. I don't think he is lying but he could be. His friends have even commented how he doesn't eat like he used to. He has expressed frustration about the stall. Another possible contributing problem is for the days he journaled he may have underestimated some portion sizes. I need to get him to measure food. REMEMBER - HE IS 15.

He is working very hard. 7 weeks ago he could not do a sit-up and now he can crank out 25 of them. He really is very athletic for his size. He does look better. It has only been 13 pounds but you can tell and others have commented as well.

If he lived with me it would be much easier to get him squared away. Trying to guide. I appreciate the help.

 

[REDDOG309]

General reply to others.

We know how he got to 400. Question is why the stall? Understand there may be a shift from fat to muscle that causes scale not to move but at this size I would think scale would still go down. I don't think he is lying but he could be. His friends have even commented how he doesn't eat like he used to. He has expressed frustration about the stall. Another possible contributing problem is for the days he journaled he may have underestimated some portion sizes. I need to get him to measure food. REMEMBER - HE IS 15.

He is working very hard. 7 weeks ago he could not do a sit-up and now he can crank out 25 of them. He really is very athletic for his size. He does look better. It has only been 13 pounds but you can tell and others have commented as well.

If he lived with me it would be much easier to get him squared away. Trying to guide. I appreciate the help.

Good for you. This kid is lucky to have someone looking out and helping him out. Good Job Coach.

 

[Built]

Please do not encourage him to eat more frequently - it'll just help set him up for lifelong weight gain. I speak from experience here. Three might be too few, but four meals ought to be plenty.

How about hardboiled eggs - they're cheap. Could that work?

And I cannot stress the whey shakes more strongly. Get a flavour of no carb whey he can stand, and have him knock back a shake before every meal. It'll fill him up for cheap and it'll normalize his insulin response - which will ensure he gets a normal satiety response and stays feeling "fed".

 

[GreenManalishi]

Definitely gonna do the eggs. He should do normal post workout nutrition - correct? Mainly gonna add a mid-afternoon snack. So one scoop whey with every meal - That should be good. Stick with whey or whey casein blend (Dymatize)?

 

[Built]

Whey is ideal. Whatever's cheap and tastes good, no sugar. Normal PWO not necessary; no need to go heavy on the carbs anyway.

 

[sassy69]

I'm watching this thread -- its great the kid has great athletic potential and he sounds like a damn big build. This is someone I would hope & pray finds a diet and lifestyle that will get him there - sounds like his body is just aching to get going and run efficiently - particularly at that age. Figuring out the diet and then establishing the habits at that age can be challenging given he's a kid and should live a kid's life and not DIE w/ a T (that's a joke on "DIET" btw). He will also learn a great deal about his body and how it responds, and also the importance of just doing the diet and letting it work vs cheating and lying about it. Frankly if he were eating 2000 cals, I think he'd be passed out on the floor from lethargy - I'm a 5'7" slightly musclebound chica w/ the joys of estrogen on my side, and I cut on 1800 cals - so yea, he needs a little more. But my guess is he's lying.

I don't know how he's building his meal plan - if he's counting calories after the fact or if he's pre-planning. I think maybe over a weekend would be a good time to have him do a pre-planned meal schedule to illustrate what that total amount looks like and how it would be to digest it all instead of maybe gettign hung up over the perception of a written diet or approximating (aka eyeballing w/ a skewed eye) total cals day by day, w/ the limitations of eating what mom cooks for the family & what he can get from school lunch. At least having that baseline will give him a better idea of what will get him there.

The other thought that is coming to my mind is my own cousin - granted we're now in older years (he's 2 days older than I am), but he's been heavy his whole life and has successively been adding weight over the years - he's been holding steady around 475 lb at 6' tall and it really agonizes me to see how this has affected his life. I know the situation that got him established in that lifestyle (kinda screwy home life), but he's never really gotten control of it and where's at now is probably where he'll be until his body decides its just done playing the game.

Very much sending positive vibes & good results to you for your interest and attention for said Future Heisman winner, and for him dive in and get things in order to fulfill that potential!

 

[Kathybird]

And I cannot stress the whey shakes more strongly. Get a flavour of no carb whey he can stand, and have him knock back a shake before every meal. It'll fill him up for cheap and it'll normalize his insulin response - which will ensure he gets a normal satiety response and stays feeling "fed".

Hey Built - I"m throwing in some splenda occasionally (some flavors SUCK) and that helps. COuld he do that?

 

[atlas114]

Nice

 

[Catalyst]

He is 6'4. I really don't think he is lying. He seemed like he thought having 3 chicken strips at prom was going at add 10 pounds. Haven't spoke to whole family but I know mom has tried to cook a few things differently. He makes alot of his own meals. Starting from scatch -- How many calories should I start him off at and what macros?

Sounds like he is having some severe guilt association with food from the chicken strips comment. But, when he is on his own, and slips up, your the last person he wants to disappoint by telling you he ate 4K + calories a day.

I weighed 330 at 5"10 when I was 15. When I eventually got tired of being obese I cut down to 1000 cals/day and pounds were flying off. At these weights, sub optimum caloric intake will not cause a stall.

Just trying to give you perspective on why his log count may be off as I was in a very similar situation in highschool and understand the mentality a bit.

 

[Built]

Hey Built - I"m throwing in some splenda occasionally (some flavors SUCK) and that helps. COuld he do that?

Yep, he sure could.

Sounds like he is having some severe guilt association with food from the chicken strips comment. But, when he is on his own, and slips up, your the last person he wants to disappoint by telling you he ate 4K + calories a day.

I weighed 330 at 5"10 when I was 15. When I eventually got tired of being obese I cut down to 1000 cals/day and pounds were flying off. At these weights, sub optimum caloric intake will not cause a stall.

Just trying to give you perspective on why his log count may be off as I was in a very similar situation in highschool and understand the mentality a bit.

Nice first post, Catalyst.

I'm glad you got your weight under control, and absolutely, no risk of catabolism when you're still juicy.

 

[FitnessBlogger]

First I want to say kudos to you for helping this kid out, you're doing a great thing. Most people don't write down everything they eat when they keep a journal. I really doubt the problem he's having is not eating enough. Most likely he didn't change his diet much at all, and has hit a plateau. This is the point where he needs to make a choice whether hes serious (and change his diet) or he wants to give up (stick to old habits). You're gonna need to guide him through it, cuz this is the toughest part of his journey. Good luck.

 

[Merkaba]

He might not be eating to much.
If you don't eat enough even on a diet your body will start to hold on to fat as to have a fuel source.
You'll lose weight at first fat/muscle then stall.
Best bet is to zig-zag cals. and find the sweet spot.
Im eating 3300cals and losing fat.Getting ready to up cals again to get rid of fatigue during day.

Also do you have body-fat calilpers?He might be losing fat but building alittle muscle.
Which would be the weight stall.
I only use i scale to see if im losing muscle and for my b/f meter.

You lost me at "He"

 

[leei515]

I am writing this as someone who has struggled my whole life with my weight. There is times that I "logged everything", but still was at a plateau. I was forgetting the little things that added up to a lot. Enough 15 calories here; 25 calories there...adds up to several hundred. The small amounts (even though they happened often) rarely made it to the log. I've also had times where I rationalized things like "eggs are good, so its ok to eat a dozen of them...". I definately know what the kid is going through...

 

[Built]

Leei, thank you for the post. When you log, you log EVERYTHING.

 

[tubbednova]

You lost me at "He"

How did i lose ya??
If your maintence cals are say 3000 a day and you start to eat 2000cal.Which is a thou less.You will lose fat.
After a week or two your thyroid is going to start to slow which means your body is going to slow along with it.
So if you eat 500cals once a day above maint one x a week your thyroid gets aboost and has little effect on diet.

At his lb he uses alot of cals running around.Top that with mod. exercise he needs more then you think.

My gooodness im 182lb eating 3100cals and losing fat like crazy with out doing alot during day but training hard morning/night.

 

[GreenManalishi]

Update

Just wanted to update you all on the progress of the "big-kid" I'm helping. After the advice given here we sat down and had a "come to me Jesus" meeting. Showed him some diet math and talked about some of the things he should do. We then took a couple of hours and went grocery shopping together and got some basic foods to build around and read some labels and did some comparing of items. By the end he was starting to understand some things (this was a pretty good time). Anyway we got the scale moving again. He dropped from 387 to 378 and then stalled again but came clean that he wasn't doing as well with the eating. Got rededicated and we finished P90x on May 31. He weighed in at 367! We indulged together on some eating (maybe shouldn't have but we had fun and he actually felt like crap and is even more focused now) He weighed in today at 362. We found out that in January he was 408.

We now are beginning a 5x5 lifting program and trying to get this kid strong. His goal is 349 by the beginning of football practice on Aug 11. He should make this pretty easy and is actually targeting 339. Sidenote: We are a small school and not many of the kids have lifted much but I have 12 lifting with me 3 times per week. The kids couldn't believe it when the big kid was killing them during ab work - he couldn't do a sit-up on March 1 and now cranks out 25 like they are nothing.

He is doing much better on the carbs. He still needs to get more protein in him. (Still dealing with a 16 year old kid). On his "good" eating days I doesn't get to 3000 calories. But habits are getting better and you can tell he is making an eating lifestyle shift by some of the things he says.

Thank you all for "calling him out" and giving me the courage that there was nothing wrong with him. I appreciate all the help and any other advice that can keep us pointed in the right direction.

 

[GreenManalishi]

Special thnaks to built!!!!!

 

[myCATpowerlifts]

You got him on protein shakes yet?

Have him replace a meal or 2 with some whey isolate.

Show him how to cook eggs/meat.

 

[feinburgrl]

Get him on a weight training program and drop the P90X. Is the teenager weight his food? ALso if he is eating at fast food places then using the calorie on the chart can be up to 20% more then what he is eating. Tell him to stop in taking high-fructose corn syrup like soda or juices. They most likely what's keeping him at stand still.

 

[Justinbro]

Had the same problem with a kid on my team. Eventually he started eating a ton of cheese and I guess the constipation slowed his intake lol

 

[sassy69]

Special thnaks to built!!!!!

Thanks to you & Built! I love hearing stories like this..... Just love it!

 

[MDR]

This is a great thread. I really enjoyed reading through it and I admire all the folks who are really trying to help out. Stuff like this keeps me coming back to this site. The overall tone and tenor of the thread is very positive, and a lot of folks chipped in to help. The coach came here looking for genuine help and answers, and got it, and the young kid is making real progress as a result. Lot of good people who are genuinely interested in helping others in this thread. Very, very cool.