TLC had a show on this 1100 lb lady. She confessed to killing her sister’s kid by rolling on them. Ever wonder how much food it must require to get that huge? Are they basically eating non-stop every waking moment? She was bedridden so everything she ate had to be purchased, cooked, and given to her by someone else. AA and NA talk about enablers. It takes an enabler to reach 1100 lbs. Thankfully she got a gastric bypass and lost most of that weight.
I can understand how the wrong diet can easily push someone to 400 or even 500 lbs. I saw a lady at the grocery store check out lane yesterday. She had to be pushing 400lbs. Still walking for now. But I can easily see her bedridden in a few more years.
Dietary fat provides about 9 calories per gram - or about 4000 calories per pound. In terms o energy content, fat is fat, so if she’s got 950 pounds of excess fat on her body, a really coarse first-pass estimate would suggest that she’s eaten 950x4000 = 3.8 million excess calories to get there.
If you assume she took 20 years to put that weight on, that’s 520 excess calories per day, each and every day. A Big Mag is 550 calories, so imagine she eats what an average person eats…and then at the end of every single day, she eats an extra Big Mac.
The reality is certainly more complex than that, including the fact that at some point her weight made it extremely difficult to be anything but very sedentary, facilitating even more rapid weight gain.
I had a co-worker who was morbidly obese - probably around 500 lbs. He would eat at all-you-can-eat buffets. I’d go to lunch with him and could keep up plate for plate. At 210 lbs, I’m not all that skinny myself.
However he would also eat at a buffet for supper or order a big supper at a regular restaurant. He’d also often pick up some donuts for breakfast. I, on the other hand, would eat near normally at other meals plus exercise about an hour a day.
On a happy note, my friend decided to lose weight and over the course of a couple of years got down to 250 lbs. He even completed some half marathons. No surgery. Just diet and exercise. He followed Weight Watchers. He’s over 300 lbs now, but is 6’6" and carried it better than 500 lbs.
I would think an extra Big Mac a day would only make you gain a certain amount and then you would be maintaining your weight after that. Wouldn’t you have to eat more to get over that level, and then more and more to keep going up?
You’re moving past my really-coarse first-pass estimate, and yes, I’d agree that the metabolic effort required to maintain those 950 pounds of excess fat probably increases her daily caloric excess requirement to something well beyond that daily Big Mac. I wasn’t going to delve into that because I have no idea how to begin estimating that; this is where I think it would be interesting to hear from a bariatric physician, if we happen to have one in the house.
I imagine the common formulas for calculating calorie needs with basal metabolic rates and activity levels start to break down at some point, and don’t work for the massively obese. There was probably a point where an extra Bigmac per day was sustainable, but thats when you get an extra super size fries along with it, and keep gaining weight.
I am quite fat. I have always been around 240-260, but increased to 280-300 a few years ago. It came with unexpected problems, like constant sore feet, and the inability to tie my own shoe laces! That was when I realized I had gone too far, and I needed to change my lifestyle. Its not easy, and I continue to struggle with it, but I am trying. An 1100 pound person has to experience lots of these moments, like suddenly squeezing through doorways, or not fitting on the toilet, or not being able to get out of bed without assistance. I NEVER want to experience that foot pain again. Even if I never make it to my weight-loss goal, I vow to never reach 300 again. It was agony. I can’t imagine how bigger people make it past all these warning signs.
Actually from a first order thermodynamics perspective it takes less calories for a fat person to maintain weight than a skinny person because their surface area to volume ratio is smaller (they more closely approximate a spherical cow, erm sphere). A skinny person has all kinds of spindly extremities acting like cooling fins and the metabolic rate is increased to maintain a constant temperature.
This is not accurate. There’s a lot more to human metabolism than simply maintaining core body temperature. The reality is that obese people typically have much higher basal metabolic rates than thin people:
That’s your cite? An on-line calculator? That claims to calculate total metabolic rate not BMR? For shame! You usually do much better!
Of course you are right, there is a lot more to it. It increases and is not linear by body weight. A good place to start. The factors involved include that fat is much less metabolically active than is muscle, that it takes more muscle to carry around more fat so fat free mass increases even as percent body fat increases more, and that it takes more energy to carry around that increased mass for any given amount of physical activities of living (PAL) and the amount of activity only seems to decrease at the highest levels. The net result is that while calories expended goes up with increased obesity the amount of total calories per unit body weight goes down.
Here’s another source just for resting metabolic rate. The Mifflin-St Jeor equation seems to work best. It’s:
BMR = 10 * weight(kg) + 6.25 * height(cm) - 5 * age(y) + 5 (man)
BMR = 10 * weight(kg) + 6.25 * height(cm) - 5 * age(y) - 161 (woman)
There are other formulae that use lean body mass as the input which may be better yet for figuring out the Resting Metabolic Rate. Here’s a calculator that uses one of those but you need to know your percent body fat.
The TLC channel, which has gone to freak-appeal programming in a big way, ran a show called “I Eat 33,000 Calories A Day,” which featured four severely obese people who habitually ate the stated amount. (The program seems to have been largely scrubbed from the internet, but here’s a link to TWOP). IIRC, for one of these people, the producers assembled a groaning table-load of food to show the person very clearly how huge that daily intake really was. The person said that the amount did surprise him when displayed that way (although he also confessed that it made him hungry).
One of the other people claimed to get food by lowering a bucket out of his fifth-floor bedroom window down to street level, where delivery people (presumably waiting in line) would deposit his order.
There is also Susanne Eman, a 750-pound woman in Arizona who at one point publicized that she was on a quest to become the world’s fattest person. First, though, she was engaged (to a chef!) and hoping to hit 800 pounds by her wedding day. She said that she was eating 22-30,000 calories a day, and the link sets forth a sample day’s consumption for her. Since then, she has announced that with the help of Dr. Phil, she dumped her enabler fiancé and has become bringing her weight back down toward a more manageable 300.