I think it’s also because a lot of them have extreme mobility issues. From trouble walking to being unable to get out of bed/ the house. I hadn’t thought fluid retention. That’s an unreal amount of fluid, though. How much time would you have to devote to eating and drinking to get all that in?
He had gastric sleeve surgery a year or two before this. How far can the pouch and intestines stretch before they just rupture? I can’t wrap my head around how he consumed it all without something blowing out.
It’s not a “Biggest Loser” type game show. Far as I know, the Dr. only gives calorie restrictions. From 600 to 1200 calories a day, depending on starting weight. It’s up to the patient to lose the weight or not most of the time. Sometimes he’ll put them into the hospital/physical rehab facility to limit access to food. I read a couple of articles about the guy and the show this morning. The majority of them fail to meet the goals he sets at first and some never do. Some get their act together and lose enough to qualify weight loss surgery. At first this guy gained instead of losing and got up to 1003lbs. He lost enough to get the surgery then gained back up to 900. The Dr. put him into rehab and got him back into the 400’s. He gained the 278 during 6 unsupervised weeks at home. They put him back in rehab where he died.
My brother ended up in the ER with congestive heart failure. It was the middle of December. At Thanksgiving he was puffy but a couple of weeks later he was so bloated up he could barely walk. In the ER they tapped about 14 liters of fluid out of him. 4 liters is about a gallon. A gallon of water weighs about 8 pounds so that was nearly 30 pounds of fluid right there and then they had him on a lot of diuretics to get rid of more fluid. He was hardly eating or drinking anything before he went to the hospital and he lost maybe 60 pounds overall just of fluid because his heart and kidneys were so bad. for someone who was so much bigger to start with plus eating and drinking whatever he wanted I could see it happening very easily.
I have probably done it especially on holidays but I always feel awful afterwards and don’t want to eat much at all for a few days after that.
On this show they show some of the people eating whole large pizzas in a sitting and a whole large pepperoni pizza from Domino’s is 2,370 calories. Times 3 meals a day that is around 7000. Plus who knows how much else they eat or how many times. One woman had a plate that looked like a whole box of waffles with loads of syrup and butter and maybe 8 sausage patties and strawberries with a whole can of whipped cream. Some have enablers or family memebers who bring them the junk food they want because arguing with them doesn’t work.
By the time someone gets like that, somebody has to bring them all that food, and probably buys it for them as well.
People with morbid obesity often have lymphedema, which is a form of water retention, and they may also have a condition called third spacing, where fluids accumulate outside the cells.
It’s not uncommon for a person to re-stretch their gastric sleeve, or whatever method was done, or they resort to a liquid diet (which not uncommonly includes alcohol). I’ve definitely seen reports of people who successfully lost the weight, but some other addictive behavior took over - substance abuse, gambling, hoarding, etc.
Conversely, I have a friend who used to work at a substance abuse treatment center, and she said that it was very common for people to stop drinking or using drugs, and some other addictive behavior took over; men are more likely to gamble and women are more likely to develop eating disorders.
About 20 years ago, I worked briefly at a hospital that did bariatric surgery. The biggest obstacle was the psychiatric evaluation, and even if they passed that, it was not uncommon for the surgeon to still refuse to do it because he knew the person was not a good candidate for the surgery.
Interesting- medically, why do they restrict them from the outset to so few calories? Someone with that carriage would lose weight at 5000 calories a day, why do they not start off with that? Three large pizzas a day instead of ten, as opposed to fruit and vegetables? A gradual reduction instead of cold turkey(!)?
That calorie restriction is done beforehand so the doctors can see if the person can do it, because the stomach is too small for them to eat any more than that without vomiting (and a surprising number of people won’t mind that, as long as they can eat).
There’s a biggest loser style show on the BBC called Secret Eaters where they videotape the obese and superobese over a period of a few days then sit down and look at the calories they consumed. Most overweight people insist they don’t eat much and don’t snack that much (we would all play down the amount of junk food we consume and talk up all our healthy choices if we self-report) but the video shows them snacking on 2,000 calories several times a day.It’s quite compelling TV actually
Last year, I hosted a childhood friend who was passing through, and she told me that her second pregnancy was very complicated, and among other things, she was put on a 4,000-calorie diet. The only way she could do it was by drinking milkshakes, and by the time she gave birth, she weighed almost 300 pounds.
4,000 calories was the biggest calorie order I ever saw in a chart; it was for a person who weighed over 500 pounds and they wanted him/her to lose weight, but not too rapidly, and this was at least a start.
Their diet is not going to change all that much between training and the race. They usually do 100+ miles/day during training. And those guys are in training pretty much all year; the Tour is hardly the only race they ride in. They’ll be consuming 5000 calories/day all year round.
I really doubt if their calorie consumption is causing any of the problems they have. Doing an extreme amount of exercise is more likely the cause.
I read somewhere that even if you did nothing but breathe it takes 700 calories a day just to exist. For someone so large they can’t get out of bed 600 would guarantee significant weight loss no matter what. The higher counts go to people who are still able to get up and move around.
Most of the people on this show are at a point where they don’t have long to live if they keep going like they are. Not only do they weigh over 600lbs. they have a host of other medical problems. The point is get a large amount of weight off in enough time to save them. According to the Wiki this guy and 3 others died from physical health issues.