Body Weight Case Study

Methods commonly used to calculate body weight goals involve ideal body weight (IBW) and being in the “normal” range for BMI. If IBW was used to calculate a weight goal for Mr. McKinley, then his weight goal would be 166 lbs. If BMI was used, this would require Mr. McKinley to lose over 230 lbs. However, both of these methods are highly unreasonable, given Mr. McKinley’s current body weight, BMI, UBW, and considering that he has weighed over 250 lbs. for over 20 years now. Therefore, both of these methods are unacceptable for determining an appropriate weight goal for Mr. McKinley. A 5-10% loss in body weight in obese persons is likely to improve blood glucose, blood pressure and cholesterol levels.1 Since Mr. McKinley has already lost a little

McKinley’s energy needs would be calculated using the Mifflin St. Jeor equation. In this case, Mr. McKinley’s estimated energy needs would be about 3,350 kcal/day ((10 x 186.36 kg)) + (6.25 x 177.8 cm) – (5 x 37) + 5 = 2794.85 kcal/day) x 1.2). However, this estimated energy requirement will be too high for Mr. McKinley following his bariatric procedure in which he will be experiencing rapid weight loss. According to ASMBS, low calorie diets are advised for post-bariatric surgery in the regular diet phase, which is 800-1200 kcal/day.3 After taking into account potential energy expended from adapting a physical activity plan following bariatric surgery, Mr. McKinley should aim for 1100 kcal/day once he has progressed to a regular diet. Protein intakes of 60-80 g/day, or 1.0-1.5 g/kg of ideal body weight (IBW) are recommended by many bariatric surgery programs, according to ASMBS.3 Using 1.5 g of protein/kg IBW, Mr. McKinley’s estimated protein needs would be about 113 g/day, or 453 kcal from protein. This would be too high for Mr. McKinley, when considering that nearly 50% of his energy intake would be from protein (he is already volumetrically restricted, and carbohydrate and fat intake needs to be considered, as well). Using 1.0 g of protein/kg of ideal body weight, Mr. McKinley’s estimated protein requirements are 75 g of protein/day (1.0 g x 75.45 kg