How to Approach Flexible Dieting for Obese Clients

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This blog came about as a result of this:

 

When I got the message through, it really made me stop and think.

 

Most people in the current world of nutrition on social media seem to fall into one of two categories –

 

• All clients need to count and track macros, regardless of where they’re at in their journey.

 

• Calorie and macro counting is overrated, and if you follow healthy habits, or a set of food rules, you’ll fall into a calorie deficit by proxy.

 

If you held a gun to my head, and threatened to blow my freakin’ brains out if I didn’t plump for one side or the other, I’d make my way into group one.

The way I see it, calories matter first and foremost, closely followed by macros, and it is possible to over-eat and get yourself into a deficit even by eating clean.

(I sure managed it – How Clean Eating Made Me Fat.)

 

That said, I’m no stranger to working with clients to develop healthy habits, and it’s something I did a lot more of in my days as an in-person personal trainer, partly because at the time I was in the camp that believed calories didn’t count, but also because I found that people tended to respond better and stick to making habits more than they adhered to writing down or tracking their food intake.

And that’s why I was puzzled by Matthew’s question.

See, while these days I’m a staunch advocate of flexible dieting, counting and tracking, my first response was still initially that obese folk should follow healthy habits before tracking macros.

I’m not sure why, but the answer just seemed to come out, so I thought I’d delve a little deeper, and write up my thoughts on whether flexible dieting works for obese clients. This blog serves as my musings.

 

A Primer on Obesity

Obesity is classed as a BMI of between 30 and 39.9, while a BMI of 40 and above is severely obese. 

It’s easy to judge severely overweight and obese people as lazy.

I’ll admit to having done so myself in the past, but this really isn’t the case.

First up, if you want to learn more about obesity and the psychological and physiological reasonings and processes behind it, go check out Dr. Spencer Nadolsky – he does this stuff for a living day in, day out, and knows far more than me.

 

Still though, from my time in the industry, I’ve worked with a number of obese clients, and have actually found that there isn’t necessarily a right or wrong way to approach nutrition, and it’s rare (actually I can’t think of a single example to the contrary) that I’d use solely a habit-based approach, or solely a macro-tracking one with an obese client.

Let’s look at the pros and cons of each method.

 

A Healthy Habits Approach

 

The BIG argument for using a habits-based approach with an obese client comes from the idea that obesity isn’t simply a case of eating a bit too much, or not knowing when you’re full, rather it’s years and years of bad eating habits that have built up to the point of extreme overeating.

As an obese client likely has many bad habits that are contributing to their weight gain, it makes sense to take the time to reverse these.

While counting macros and calories is a habit in itself, it’s one that requires more time, effort, and knowledge of nutrition than other, much simpler practices.

 

Think of it as picking the low-hanging fruit.

By using simple tactics first to clean up a diet, you’ll be almost assured that your client will fall into a deficit, just with a few small changes – why not do that, and reap the rewards, before looking at the technically more complicated approach of tracking and counting?

Some seriously simple examples would be to cut out or cut down liquid calorie intake by swapping out fizzy drinks/ soda for water, diet drinks or squash/ cordial.

You could look at changing chocolate bars to protein bars, or eating from smaller plates. Even something as simple as eating more protein, or adding a serving of veggies to a couple of meals a day can act as a kick-starter.

By sticking to these goals (despite the fact many of us who’ve been monitoring our diet and nutrition for some time consider them part and parcel of everyday life) an obese client gets a sense of achievement, and they’re inspired and motivated to do more and keep the ball rolling.

 

(For a more in-depth write up on habit-based goals see What Bruce Springsteen Can Teach Us About Fat Loss)

 

 

The Counting and Tracking Approach

 

Most of the time, a habit-based approach works a charm.

In 99% of cases, I’d wager that an obese person would lose weight, improve their health markers and feel so much better just with some simple switches, but that’s not to dismiss flexible dieting.

There are two groups of overweight and obese clients I’ve found this works better with –

 

• Those who are mathematically minded.
• Those who are active – generally powerlifters.

 

For many, it’s simply overwhelm, as they’re not really sure what calories are or why they matter, and worrying about optimal protein, fat or carb intake is just overkill. That doesn’t mean these don’t matter, just that they can usually be addressed enough for what’s needed at the time with some new habits.

Still though, if an overweight or obese client wants to track, has a general understanding of calories and macros, and enjoys looking at data (or, like me, is a numbers geek and considers logging everything in MyFitness Pal as about as fun as a night spent watching Die Hard on repeat while munching on some peanut butter pretzels) then traditional flexible dieting is a great tool.

 

 

How to Modify Macros for Obesity

 

I’ve had close on 100 comments and email questions as a result of my “How to Calculate Macros for Cutting” article, with people saying that they just aren’t progressing with the numbers they worked out for themselves.

9 times out of 10, this has come from a person who’s had over 20 pounds to lose.

Obviously therefore, a standard macro and calorie calculator doesn’t cut it, and while it is possible to work out macros based on lean bodyweight or target bodyweight (Alan Aragon has some cool formulas) I like to simply modify my regular formula.

Here’s how we do it:

 

Multiply bodyweight in pounds by 8-10

 

 These are the calories you should theoretically be able to lose body fat with.

There will of course be some individual difference, and if you find that progress isn’t happening, you’ll need to go lower still. (Or if you’re dropping weight very quickly and feeling run down, tired, lethargic and hungry all the time, they can be increased.)

 

Protein = Bodyweight in pounds x 0.5-0.6

 

I usually go around the typical 1 gram per pound recommendation for most clients, dropping as low as 0.8 grams per pound and going as high as 1.5 grams per pound, for very lean individuals in a more extreme calorie deficit, but this number is simply too high when working with obese clients.

0.5-0.6 grams per pound works just fine, the heavier your client is, the lower you can set the multiplier.

(For future reference, protein has 4 calories per gram.)

 

Fat = 20-30% of total calories

 

Rather than set fat as an amount dependant on bodyweight, just setting it as a percentage of total calorie intake works better.

Let’s say your client weighs 320 pounds for instance, a standard recommendation of 0.5 grams of fat per pound gives a daily intake of 160 grams, which will more than likely be too much.

(Fat has 9 calories per gram – you’ll need to know this in just a moment.)

 

Carbs = The rest

 

Carbs make up the remainder of your client’s calories. We’ll put it all together now.

 

Example 1 –

Dave, who weighs 365 pounds, and is moderately active, training four times a week.

Calories = 365 x 10 = 3,650

Protein = 365 x 0.6 = 219 grams (876 calories)

Fat = 30% of total calories (3,650 x 30% = 1,085 calories = 120g fat)

Protein calories + Fat calories = 876 + 1,085 = 1,961

3,650 – 1,961 = 1,689 (calories left from carbs)

1,689 divided by 4 (There are 4 calories per gram of carbohydrate) = 422g carbs.

 

Rounded, that gives us –

220g protein

120g fat

420g carbs

 

 

Example 2 –

 

Lisa, who weighs 320 pounds, works a sedentary job, but only trains twice per week.

Calories = 320 x 8 = 2,560

Protein = 320 x 0.5 = 160 grams

Fat = 25% of 2,560 = 640 calories = 71g fat

Carbs = 2,560 – ((160×4) + 640) = 1280 calories

1280 divided by 4 = 320 grams carbs

Rounding again, that gives –

160g protein

70g fat

320g carbs

 

Making It More Flexible

 

As I do with every new client, I’d always encourage as much flexibility as possible, which could mean implementing ranges (such as giving Lisa above the targets of 140-160g protein, 65-75g fat and 310-330g carbs) or just aiming for a protein minimum and calorie range.

 

(You can read more about this in “The Idiot’ Guide to Flexible Dieting”)

 

Too Strict? Or Just Dedicated

 

Personally I’d argue that unless your obese client is training hard, and severely performance-based (i.e. they’re a powerlifter, weightlifter or strongman) then the macro counting option is just not needed.

I always promote a flexible dieting/ IIFYM approach, but genuinely believe that when working with a client who has more than 40 to 50 pounds to lose, you’re better off working with healthy habits.

Some guys and girls do leap into tracking and counting with vim, vigour and enthusiasm, and see great results, but the vast majority benefit far more (and have a far more enjoyable, rewarding time) from making small switches to their current diet.

My other reservation is that working out macros for an obese client has too many variables.

For instance, with Dave and Lisa, I actually think Dave’s carbs are too high, and Lisa’s protein is probably  over what it needs to be.

Would these calculations work?

Probably.

Would they be optimal, and would counting macros be the best approach?

I don’t think so.

Obesity: More Than Just Macros

Counting and tracking macros is trendy.

It appears to be what all the cool kids are doing, but that doesn’t mean it’s the best approach.

In fact, unless an obese client also had one eye on performance, personally I’d always go with the healthy habits approach.

I wouldn’t give a crap if they weren’t getting quite enough protein to hit the theoretical level needed for optimal muscle protein synthesis, or if they ate more than 0.6 grams of fat per pound of bodyweight.

What I would care about would be getting them results that they were happy with, that allowed them to diet and feel good, and that created a lifelong fat loss approach.

 

What to do Next

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Tags: flexible dieting for obesity, high bmi, macros for fat loss, macros for obesity, obesity bmi