Help with stepdads situation

Hello, I’ve been running your programs and taking your advice for 1.5 years now. I value your opinions and I would like to see if you could help me improve my stepdads situation.

My stepdad is a 57 years old, 5’9" and about 235 lbs. He was diagnosed with type 2 diabetes 3 years ago and has been taking statins/metformin since. He was also diagnosed with Hepatitis B a few years ago so he has regular check ups with his doctor now. The doctor has brought to his attention that he has fatty liver disease (hence all the check ups) and has to undergo a livery biopsy soon. He was told that he is close to having cirrohcis. He is currently on meds for his fatty liver disease and they surpress his appetite greatly. Also, his PCP wants him to get down to 180 lbs.

I looked at a dexascan that was done on him and he has 40% body fat. Recently, he ended up having to take insulin but in the last few weeks he has gotten his blood sugar regulated because he is definitely scared of what will happen if he doesn’t get his act together. He told me the last 2 weeks his A1C has been 95 or lower when he wakes up. I believe he has stopped taking the insulin now. My question is, what should he be doing to lose as much weight as possible immediately? He doesn’t have too much gym experience, although I have showed him how to do all of the compound movements in your programs. I was thinking of having him run the bridge, but I didn’t know if what I would have him do would be any detriment to his condition. I have not given him diet advice other than steer clear of refined/simple carbohydrates because of his diabetes.

I am definitely not qualified to suggest any sort of medical intervention, so I was wondering what I could do to help him as far as training goes. He wants to live longer and he is worried now that if he doesn’t get his health in order that he won’t have too much time left and a poor quality of life. Thanks for your future answers.

Hi there,

Sorry to hear about this situation. I agree that fat loss needs to be his primary concern a move all else. As I’m sure you’re aware, this will require establishing a (likely substantial) calorie deficit, and while exercise (both strength & conditioning-based activities most days out of the week) can certainly help and is recommended, it does not replace the need for a calorie deficit. He may benefit from seeking consultation with a registered dietician or getting some individualized coaching (we have a dietician on our staff, for example).

Finally, it may be worth asking about whether certain medications like liraglutide (or other medications in the GLP-1 agonist class) or an SGLT2 inhibitor like dapagliflozin may be beneficial/appropriate for him, since these are known to improve control of diabetes, cause weight loss, and reduce cardiovascular risk.

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Thanks for the quick response! Sunday he will be coming with me to the gym so I can refresh him and he will be starting the bridge. I left out that he is consulting a nutritonist at the moment. He is going to be hungry but he is definitely going to be happy he took control of his health. Thanks again.