Alright. First, it seems counter intuitive, but for now he needs to stay low on activity for his legs. Extra activity will just cause inflammation and will not help the healing process yet.
I get nothing else might be pressing, but it's important to know his health problems to understand his possible metabolic problems. Things like diabetes and thyroid conditions can drastically alter metabolism. If he is diabetic, it's important to know if he is Type 1 or Type 2. And if he uses insulin, if he's on a sliding scale or fixed unit.
Right now a large part of his problem is the swelling and the lysing of his cells. It's not hard to turn back, but it does take time. Worst case I helped was a 6 ft 660lb man. But now his cellulitis is gone, along with the pain.
He needs to start counting his calories. Get any app, Lose It, my fitness pal, doesn't matter. Don't bother telling the app you wanna lose weight or anything, their calcs tend to be shit.
For the first week have him just eat how he normally does and track everything. See what he comes out to at the end of the week. This is mostly so he can see what he takes in.
The next week he needs to start at staying at or below 2000 calories. His TDEE at the moment is right around 2500 so this will put him at a 3500 cal deficit for the week. He just needs to stick to that for now. If he has high blood pressure problems tell him to track his sodium too and keep it to less than or equal to 1200mg a day.
If he doesn't take a multivitamin have him start, with food, at the start of his day. Be sure it has iodine, zinc, magnesium and selenium. Believe it or not, GNC makes a pretty decent one for the money you can get on Amazon.
If he drinks a lot of soda or tea he needs to stop. None if possible, one a day if not. He needs to up his water consumption. Minimum six 8oz glasses a day. More if possible.
Tell him to buy compression socks.. The first day he should wear them for an hour and then take them off. By the end of 7 days he should be trying to wear them for 8 to 10 hours, more really shouldn't be needed.
For at least an hour a day, while wearing the socks, he needs to lay flat on his back with his legs elevated higher than his heart. To do this have him lay on the floor, or if he has back problems, on a bed and place pillows under his legs. Not straight up, just higher than his body, as if his feet were the start of a slide and his pelvis the end.
Don't worry about checking weight or any of that bullshit. Stick to the 2000 calories or less for about 16 weeks or so. Along with the water and socks and position during that time.
Any weeping his legs do should stop in the first two weeks, if not, there is something more serious going on or he's not following what the fuck you told him. After about 6 weeks you should notice a marked change in swelling.
At the end of 16 weeks there should be very noticeable change. If the pain has gone to a 0 on the 0 to 10 scale he can add walking to his routine, with the socks on, for about 25 minutes a day. At this point you should start weighing him every 4 weeks, first thing in the morning and decreasing the calories about 25 calories a week for another 16 weeks, more if his weight loss doesn't continue. If he had blood pressure problems before and they have gone away he can start to increase his sodium again, but never more than 2500mg a day. If he still ha problems, keep the sodium low.
At the end of that 32 weeks total, from start of this to finish, he should be damn good. Maybe some scaring.
Literally best advice for any fatty, not just ones with this problem
A+, that was informative as fuck.
thank you for all that great information. I have read it to him, i been telling him to do it. I appreciate you taking the time to type all that out for me. thanks again!
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