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Home » IDEA Answers » How many morbidly obese clients are you working with and what is the number one issue with them?
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Question asked by Jude Forsyth 344 days ago

How many morbidly obese clients are you working with and what is the number one issue with them?

ObesityClients
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Answered by Stephen Landrum 338 days ago
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I currently have 3 morbidly obese and a few on the verge. The most difficult issue I face with them is the intensity levels being too low while they appear to be in major distress. I don't believe they fake it to slow down, they just don't seem to understand the capabilities of their own bodies. A heart rate monitor, pulse oximeter, and good old conversation usually gets them to give more than they ever would have imagined; while showing them that they are safely operating at what they must feel to be insanely intense levels of activity. Its usually just fear; like the first time they did a 3" box jump. ;)
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Answered by Karin Singleton 344 days ago
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I have two clients who would be considered 'morbidly obese'. I have worked with them now for a good number of years.

The number one issue for me was psychological, not physical: making a client feel comfortable and accepted and developing mutual trust. I try to instill a respect for their own bodies who - rightly oor wrongly - they have come to despise.

Fortunately, I have my own studio which I only share with my husband who is also a trainer. More often then not, I am alone with my client. This degree of privacy has helped tremendously because there are awkward situations at times when it is difficult for the client to move in certain ways or even try something new.
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Answered by Lisa L. Taylor 344 days ago
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Hi Jude,
I have about 10 obese clients and 6 who would be considered "morbidly" obese. I basic issue that I find is in finding love and acceptance within themselves. I agree with Karin that psychologically they have to learn to believe in themselves and not let the past or what anyone says negatively to and about them become real.

Part of my responsibility as a Personal Trainer is to make exercise and movement both fun, informative and to give movements that are functional to their everyday activities.

For instance, many people who are overweight (especially my females), don't like doing push-ups. I love challenging them by using the smithbar for push-ups as I can change the height level, they're not on their knees and the wrist and hands are in a comfortable, yet stable position. After they've done about 2-3 the surprised look on their faces are priceless!

One comment that I usually receive it they never could do them before and so after being humiliated in school never tried again. Now...every time we pass the smithbar they ask if they're doing to do push-ups and how many would I "like"!

Having a Personal Trainer at their side increases mental and physical confidence in ability and accountability to exercise and body acceptance.


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Answered by Joanne Duncan-Carnesciali 339 days ago
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I am working with two at present and the number one challenge is behavior change.
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Answered by Danielle Vindez 220 days ago
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Hi Jude
I work with about 30 new clients every 90 days that present as obese or morbidly obese. I do not find any number one issue, besides weight loss. And perhaps weight loss is not something that is distinct to this group. These clients, are like all other clients, they want quality of life. If I was to make any distinction it might be - they are more frightened of impeding disease, although this would be an inference on my part.
Danielle
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I think there is something distinct and that is the mental attitude it takes to consistently sabotage your health and wellness to a point of health issues and cultural uncomfortableness.
For overweight clients there is the issues of time, effort, diet, but when you get to really large people I think there is something else. I think morbid obesity is a cry for health in the emotional arena.
I think that trainers would see so much more success if they can partner with someone who is treating in that area. After establishing a bond with the client, I think asking them about how they are "working out" their mental health would be good and helping them find resources for mental health counseling in the field of obesity would result in more weight loss. What do you think?
Comment by Jude Forsyth 219 days ago
Hi Jude,

Certainly emotions need consideration, but we look at that with every client. Smokers continually sabotage their health, people who do not wear seat belts sabotage their health, people who binge drink, or drink too often, exercise too much, never exercise, eat fast food, etc. All sabotage their health.

Perhaps for many there is an impulse control mechanism that is not kicking in, read more on this here Psychological Review. This is a biological issue and applies to more than emotional eating or being obese.
1984, Vol. 91, No. 3, 295-327 Logan and Cowan
American Psychological Association, Inc.
On the Ability to Inhibit Thought and Action:
A Theory of an Act of Control
There are many studies on a biological impulse control deficit, yet the good news is we can rewire the brain, and there are lots of studies on neuroplasticity. So for those of us that are normal weight, we are fortunate not to have this challenge, and perhaps we have other ones.

Consider also that for some, 40-70%, it may be a genetic predisposition. Find this evidence report- The clinical guidelines for the identification, evaluation and treatment of the overweight or obese adults, National Institute of Health - online.

I will agree with you, obesity is not as simple as, calories in and calories out. It is sociological, psychological and biological. Yet perhaps it is not any more abnormal than the sabotaging I mentioned above.

Danielle



Comment by Danielle Vindez 219 days ago
 
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