Help me fix my brother!
May 16, 2015 3:24 PM   Subscribe

My brother is around 30 years old, 6'2", 286 lbs. He doesn't exercise but he's not a weakling. In fact, people who see him think he's less heavy than he really is. Lately his health has deteriorated big time and I think he's in need of an action plan. Help (and please no cynical answers--just kind and helpful ones please)!

Ever since he started his retail job around 6 months ago (he spent a lot of time looking for a job until he found one for which he is overqualified and underpaid). He can't sit at work so he's on his feet for 8 hours everyday, so his knees have been crackling and hurting much more than before. Since it is an afternoon shift, he comes back at night (which is why he eats at around midnight). He has lower back pain and foot pain (because of the dress shoes). Since he sleeps at around 3 or 4 in the morning, he wakes up at around 11, and spends around 3 hours working on some freelance things until it's time for his job. He spends most of his money on our mother (who lives in another province) and he's saving very little for other things.

He underwent a diet around 2 years ago where he lost 40-50 pounds, but he put back the weight after a failed relationship. Ever since he put the weight back, he's been feeling that his body can't handle the weight anymore. He had an abdominal hernia around six years ago (so he can't do any weight-lifting, push-ups, or sit-ups) and he feels that any kind of exercising or diet plan will cost him the kind of money that he doesn't have. Cheap exercises like walking need time he doesn't have, and his knees hurt way too much (which calls for low-impact exercises like swimming or biking, but he doesn't know where to start with these in Toronto). He hasn't been to his family doctor for months because, to be fair, he is kind of a douche who is in a hurry and who doesn't listen to my brother's problems (so my brother is also looking for a good family doctor in Toronto's downtown as well).

I really want him to start caring about his diet and exercising, but I don't know what he can do with his current schedule or bad mood. I really want to help him because he cares for everybody except for himself--but I feel that I need a feasible plan first.
posted by cyrusw8 to Health & Fitness (23 answers total) 3 users marked this as a favorite
Yoga? There's some dude-focused yoga by ex-wrestlers that friends of mine have liked. It might help with the knees and back thing, and even posture and mood. And from there stuff might hurt less, and he can maybe try other things. But I think the best and most useful thing will be dealing with the pain in some effective way and yoga has been the best thing for me.

And he can do it at 2 in the morning, in his room, by himself.

That said, tread very very carefully - this is a difficult situation and often it can be hard to deal with just in general. Are you able to buy him a massage? That might help as well. If he's been talking to you about this, maybe mention the wrestler yoga thing, buy him a massage, research good shoes and gift him a pair. Making it about weight and exercise I think tends to be unhelpful because it rarely actually in practice is about health/comfort and is all about 'stop being fat, fattie'.
posted by geek anachronism at 3:32 PM on May 16, 2015 [1 favorite]

Decent shoes would help. It's tough being on a hard floor all day. Especially with an extra x number of pounds.
posted by mearls at 3:34 PM on May 16, 2015 [3 favorites]

The thing that changes bodyweight more than anything is diet. Exercise is excellent for you, but to get the weight loss results you're both looking for, I would explore ways he can reduce his intake and make the choices of what he does eat healthier.
posted by xingcat at 3:36 PM on May 16, 2015 [2 favorites]

The best thing he could do is to lose the extra weight. Lots of people, including MeFites, have succeeded in doing so with, which is free (though they were just acquired by Under Armour and have introduced a premium, ad-free version). All he would need is an understanding of nutrition, a food scale, and patience. I also recommend reading John Walker's free ebook The Hacker's Diet; though some of the nutrition information is suspect, Walker does a great job of approaching weight loss as a matter of engineering and management.

You don't need exercise to lose weight, but it helps you retain muscle as you lose fat, and it also makes you feel better. Surely he could fit in 90 minutes (including travel time), three days a week. He could look for the closest YMCA with a pool and exercise bikes, for instance; they're usually relatively inexpensive for gyms, because they're not-for-profit.

As geek anachronism writes, though, you should tread lightly. If he has asked for advice, that's one thing; if he has complained, and you intend to give him advice, make sure you give it in a way that goes over well.
posted by brianogilvie at 3:37 PM on May 16, 2015 [2 favorites]

Building on geek anachronism's suggestion, show him this video.
posted by Thella at 3:41 PM on May 16, 2015

He has to want to get healthy himself, but until then, try getting him a pair of those gel insoles for his shoes. It might make it less painful for him (hips, back, knees, feet) to be on him feet all day.
posted by cecic at 3:43 PM on May 16, 2015 [1 favorite]

2nding cecic's suggestion. You might also want to get him a couple of knee sleeves and some compression socks. The better he feels during/after work the more likely he'll have the energy to focus on other stuff.
posted by mono blanco at 3:47 PM on May 16, 2015 [1 favorite]

I think it's wonderful that you want to help your brother. I would recommend asking him if he wants any help first because there is nothing more annoying than someone trying to inflict help on you that you don't want. The suggestions above seem like a really good way to approach the situation. Hey beloved brother, I can see this job is hard on you. I hear these things may help with your job. How are you feeling? Etc. Please note, I am not being cynical.

In fact, I feel your pain. My partner has big-time knee problems that would improve if he lost about 30 pounds. That is according to him. But I know that saying, "Hey honey, I just checked your BMI and guess what? You are officially obese" would pretty much kill his desire to ever talk to me, never mind sleep with me, again. And I wouldn't blame him. So I wish you all the best and I am really hoping other people answer this great question because I would love to help inspire my guy to become healthier but I have no idea how to do it. (He has no shortage of exercise in his life, btw, he apparently just eats more than his body needs.) I just don't know how to raise the issue without making it a body-shaming thing and I am not up for that, even accidentally. So hive mind, it is possible to do this gracefully? I'd also like to know!
posted by Bella Donna at 4:00 PM on May 16, 2015 [7 favorites]

If your brother lives alone and makes less than $23,861 a year, he's eligible for free gym and pool membership at Toronto community centers via the Welcome Policy. If he's not eligible, they are still reasonably affordable - $120 for six months.

Health Care Connect can help him find deregister from his current family doctor and assign him a new one nearby. It's a roll of the dice whether the new one will be better, but it's better than doing nothing.
posted by Simon! at 5:01 PM on May 16, 2015

All good suggestions above, but one other item jumped out at me. "He spends most of his money on our mother (who lives in another province) and he's saving very little for other things."

If it is possible for you financially, can you have a talk with him about helping to support your mother? Apologies if you are already doing that, or do not have the means to do so. Not everyone does. I don't mean to add to your worries! It might reduce his stress a bit and would free up some cash for better meals or that pool membership.
posted by Gotanda at 5:25 PM on May 16, 2015

Response by poster: Thank you so much for all your advice.
- I like the idea of buying shoes for him. Which stores do you think sell the best shoes for his kind of job?
- I also like the Yoga idea (I don't know which are the best Yoga centres in Toronto, I need to research that).
- I already started looking for a good family doctor for him.
- I really like the idea of the Toronto community centre membership thing. I think their swimming program is wonderful.
posted by cyrusw8 at 6:42 PM on May 16, 2015

I just want to emphasise that I said that specific yoga (and yes it is DDP, thanks Thella) because the men I know have liked it, not just 'yoga' - it is doable at home which removes the performative and exhibitionist elements that can make yoga highly unfriendly for lots of people, and high anxiety. It has a community of dudes doing it at home and supporting each other. It's worked well because of those things which do make it different to a yoga class at a yoga centre.

'Best' is kinda meaningless without his input. Same with shoes, same with doctor.
posted by geek anachronism at 7:06 PM on May 16, 2015

If he ever goes on a diet again, be really careful about it - a lot of people lose muscle, rather than fat, and they really are less able to cope with their weight afterwards.

I'm no expert, but bodybuilders, for all the unhealthy practices associated with it, seem to have this down to a fine art. From my understanding, making sure you are always getting a lot of protein while on a diet, and doing a *little* high intensity weight lifting can help - not long sessions to 'burn fat', but just enough that your body tries to prioritise KEEPING muscle-tone while you are losing weight.
posted by Elysum at 7:06 PM on May 16, 2015

Response by poster: Of course his input is what matters, but he asked for my advice and I intend to research everything before I give it to him.
posted by cyrusw8 at 7:22 PM on May 16, 2015

For his ongoing joint issues, if he's standing in one place for a good amount of time, he definitely needs an adequate anti-fatigue mat. I bought this one for my parents (late 60s, overweight, creaky joints), and they love it. It's expensive, so maybe his employer will help buy him one (if they aren't already doing so).
posted by invisible ink at 7:22 PM on May 16, 2015

If you could get him interested in a future scenario that would require him to be able to walk without help and be mobile, and get him to know he's got more in his favor now than if he loses his abilities, maybe something will click and he'll take an interest. He needs to want it though. It's really difficult, I know that. There is a lot of good food that is great for him that is cheap, but it takes a little planning before the week starts. I certainly hope he improves, I wish you the best.
posted by Shylo at 7:45 PM on May 16, 2015

Glucosamine has really worked for me for my knees, especially that freaky crackling sound when I'm going up or down stairs. You could buy a small bottle for your brother to try out. It's great stuff.
posted by stray thoughts at 8:06 PM on May 16, 2015 [2 favorites]

If you want to "fix" your brother you're going to have to find a way for him to enjoy fixing himself.

Possibilities include:
  • finding him a new activity that he will enjoy doing (for himself: not for you or anyone else)
  • introducing him to new healthy foods or ways of eating / managing food that he enjoys
  • setting him up with someone who inspires him to get healthy for his own reasons
but the bottom line is that the reasons are going to have to be driven by him if you want something that is going to survive more than a season or so.
posted by Nerd of the North at 9:56 PM on May 16, 2015

Mod note: Folks, please note that OP has updated that "he asked for my advice," so it's not necessary to stress that they shouldn't be involved. Helpful answers that might contribute to a fitness/wellness plan to fit the described situation are welcome.
posted by taz (staff) at 12:26 AM on May 17, 2015

I'm 6'2" and my weight has been as low as 180 and as high as 260. I've also had jobs that were entirely standing and killer on my back — enough that I had to talk to a professional about it.

I was going to second the yoga, though there are a bunch of basically physical therapy exercises you can do on your own to deal with back stuff, knees, etc. Doing those (along with some stretches for the back) really can make a sea change in terms of what all else you can do.

For shoes, two bits of advice: First off, if he can, get more than one pair of shoes. They'll last more than twice as long through rotating them, and when he's not at work he doesn't have to wear dress shoes. Even just a second pair of something more comfortable will really help. Second, I've been loving the Merrell zero-drop trail running shoes for my general walking around ones. I used to try to cushion my way out of foot aches, but what I really enjoy about the Merrells (I had New Balance zero-drop ones that were similar until I found out they used the same last for the footbed and cost about $15 more, but the sales where you are may change the calculus) is that they use a very flexible but pretty tough plastic/rubber sole and then put very little cushioning in it, and don't angle the foot forward. It's nominally for "barefoot" running, but because of that it's pretty good at taking big dude weight and also giving a much more "natural" step to the foot (less trying to guide your foot). When I was last ordering them from Amazon, I saw some other guy had posted a really similar review about how these were now his go-to regular kicks and they'd helped with his back pain, so I hope they can also help your brother.
posted by klangklangston at 1:21 AM on May 17, 2015

For me, breakfast and lunch are stressful and rushed, so instead of focusing on trying new interesting dishes I just eat the same food everyday for a week or so at a time. Does your brother have a meal he eats at work? Would he be open to having the same thing every night for dinner if all he had to do was just microwave it?

Maybe you can spend some time either batch cooking with him, or linking him to affordable easy recipes that are healthy and make a lot of food? Some suggestions

baked oatmeal or overnight oats

I use oat milk for oatmeal, it's really low fat compared to other non-dairy milks and obviously the taste works. Skim milk is also good. Healthy oatmeal mix-ins include: chia seed, pepitas/shelled pumpkin seeds, sunflower seeds, PB2 peanut protein powder, dried fruit, raisins, mushed banana, frozen or fresh berries. All those things I just listed also work in yogurt

veggie chili

No sour cream or cheese is hard; a small block of super sharp cheddar goes a long way if he can't give it up entirely. Use it as a side dish for a salad or a sandwich. Make it "meaty" with lots of finely diced mushroom and onion/shallot and use it as a topping for chicken sausages - chili dogs.

Regarding the shoes, maybe wait a week and then ask big/tall men who work on their feet what shoes they recommend? It's not mentioned above the cut and if you don't get specific answers from people in this thread its worth a question on its own.
posted by Juliet Banana at 1:30 AM on May 17, 2015

I find that low carb is the only way to go for me to lose weight and have lots of energy while doing it. Think "primal" or "Paleo." I don't think you have to be super-strict about sticking to paleo-only, but it might help your brother to organize much of his meal planning around a paleo/primal type diet.

Maybe you could round up some paleo/primal resources for your brother - cookbooks, recipes, meal plans? I've found Mark's Daily Apple to be useful. List of best Paleo cookbooks.

Swimming is great exercise for people who can't stress their joints - and it's relaxing, too. If your brother is entitled to free or low-cost gym/pool memberships, even better. And maybe make your brother a present of a FitBit or other fitness tracker next birthday or holiday? I love my FitBit so much - it's helping me set goals for myself and exercise more.
posted by Rosie M. Banks at 5:50 AM on May 17, 2015 [2 favorites]

I'm also pushing thirty, and I do shift work (waitress). That kind of work, and that kind of schedule, can really be hell on your body. I'm a woman and a lot smaller than your brother, so YMMV. But here's the stuff that has made a big difference to me or that I do to keep from feeling like death warmed over:

-- Definitely get those gel insoles. (I get Dr. Scholls, and last time I bought a pair, they even had one that was just for "service work" shoes).

-- I get those rubber-soled "safe step" restaurant shoes from Payless. The rubber sole actually makes a pretty big difference in how tired my feet/legs get over the course of a shift, I guess because it takes less work to be sure-footed when you're wearing a rubber sole? Anyway, they're meant for work, so there are a lot of dressier versions. Last time I looked, they were selling a lot of styles that looked like loafers, styles in "dressy" materials like patent leather, etc.

-- He should try to elevate his feet after work. Not just put them up on a table, but raise them to at least the height of his head. I have a recliner that reclines WAY back so that I'm practically lying flat in it, and it works wonders for this. I got it on sale at Macy's a few years ago and it was about $240 iIrc. So if you have some money to throw at this problem, that's something I'd recommend getting him.

-- He should also try messaging his feet, for example by rolling them over a tennis ball or lacrosse ball.

-- Does he get swollen or stiff ankles after his shifts? If so, I don't think that's a sign of bad or deteriorating health in itself, because I've had that issue since I started shift work at age 16 or 17 (and was healthy as a horse) and still have it. But it can be really uncomfortable. Counter-intuitively, what REALLY helps me with that is exercise. From what I understand, when you're standing for hours and hours, the fluid in your body drains to your feet/ankles/legs, but exercising gets it moving and redistributes it again. Personally, I run, but if he can go on an exercise bike or something, that would probably help. Also, my knees have actually gotten a lot stronger from running (I've ramped up the distance VERY slowly, though. Embarrassingly slowly), but if his doctor says that's a no-go, then it's probably a no-go. It's ideal to be able to exercise after a shift (sounds horrible, I know! But it actually is really helpful in terms of feeling good the next day), but if he can't, he should definitely try to go on his days off, and he can experiment with working out the morning before a shift. I think you're generally OK to exercise before work if you have enough time to rehydrate, rest/shower, and eat before having to go in -- but YMMV.

-- For eating, he should probably be careful about eating salty foods just in general because they'll dehydrate him, which is a real problem if he's got to be on his feet for hours but is unable to drink water for most/all of that time (which I assume is the case for him, if he's working retail?). Personally, the eating schedule that works for me is to try and eat something fairly heavy/filling/fatty before the shift (like today, I had coffee with half-and-half and a scrambled-egg-and-ham sandwich on brioche), then drink a glass of juice near the end of the shift (when there's maybe 1.5-2hrs to go) to get a final burst of energy to finish the work, and then IMMEDIATELY after the shift, to eat something that's light but sustaining (today, I had one of those prepackaged salads that have bits of chicken and croutons and dressing already included), and THEN after taking a shower and unwinding and stuff (maybe exercising), cooking and eating a "real" dinner (for me, usually just a piece of meat or fish and a vegetable, because I'm lazy and that's what I like to cook/eat. Today I had a couple Italian sausages and peas). Dessert can be tricky, because if you're eating very late like that, it's probably not a good idea to have any chocolate (because of the caffeine). But tbh I usually eat dessert myself.

Anyway, eating for physical work is different, because you really are eating for energy/fuel. If you're going to need to be fueled up for a long time, like most of the workday or for the trip home and getting settled for the night, then eat something that won't sit like a rock in your stomach (so nothing too greasy, etc) but that will keep giving you some energy over a long period (so nothing too sugary or that doesn't have any fiber). If you just need a burst of energy and then can/will crash, then something "less healthy" like juice might be the best thing to eat.

-- I notice a big difference in muscle aches/tension and headaches when I take Magnesium. Personally, I take Vitamin D, Magnesium, Fish Oil, and Centrum Multivitamin for Adults. Dunno if that's helpful for him, but thought I'd throw it out there.

-- Shift work is hell on sleep, and that will wear you down SO FAST. I take Melatonin every night, which is really helpful. Also, since I get home very late and go to bed very late -- and wake up very late -- a lot of nights, I LOVE my eye mask. My sleep quality is a million times better when I use it, I guess because with it on, I'm oblivious to the morning light. If he's not interested in wearing one, he might want to look into getting blackout curtains or something instead.
posted by rue72 at 5:28 PM on May 17, 2015

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