Obese Clients: Are You Meeting Their Real Needs?

Do you think obese people are lazy? Weak-willed? Do you get frustrated when they can’t do what you ask because their girth gets in the way? If you think you know obese clients, think again. We talked to obese (and formerly obese) consumers—and the fitness pros who work with them—to find out how they feel, what they think of the fitness industry and how we can better help them become healthy and vibrant.

Do Fitness Professionals Get It?

“[Fitness professionals] may understand how being 5 or 10 pounds overweight may feel, and how you have to stay on top of that, but few understand the powerlessness experienced by those who are more than 50 pounds overweight,” says Lisa Williams of Lawrenceville, Georgia. “I think it’s difficult for them to realize the self-talk that goes on in an overweight person’s mind [and] that constantly keeps them in a defeated, negative mindset.”

Gwenevere Bridge of Asheville, North Carolina, sees a fundamental disconnection between clients and trainers: “I don’t think most fitness pros have the slightest clue,” she says. “Most of them have always been athletic, and their bodies are light and strong. They spend their time either trying to top their own fitness, by tricking out their routines, or just blithely maintaining a [fit] lifestyle, which is where the overweight person would like to go.” Bridge, who is working with a personal trainer, believes fitness professionals should look at obese bodies as “injured” because of “restrictions” caused by excess fat.

Pat Perretta, whose weight loss path led him to a career as a personal trainer in New York City, says that unless a fitness professional has endured years of emotional turmoil because of obesity, the condition is difficult to understand. “The challenge is not exercise programming; it’s developing a trusting, nonjudgmental, understanding rapport,” he says.

Manning says being obese is like “starting at the bottom of the mountain.” “You make slow gains and most likely hit obstacles and have a few setbacks,” he says. “I was always on top of the mountain looking down, and it's so much easier to say, ‘Come up, you're not that far—it's easy’; but it's not.”

The Often-Overlooked Program Component

When asked about their biggest obstacles to adopting a fitness lifestyle, most people we interviewed didn’t cite lack of motivation, will or time. For many, the emotional aspect of facing a life-threatening condition was their greatest challenge.

Susan Robertson of Lawrenceville, Georgia, lost 130 pounds, but it came at a cost. “The hardest thing was giving up the comfort foods that brought me satisfaction and joy,” she says. “I ate my emotions and became numb to the pain of life. To lose the weight, I had to change how I dealt with my emotions. My trainer says, ‘Don’t eat your emotions; move your emotions.’”

“Think Emotions First”

“The most important thing for trainers to understand—whether the person has been out of shape [his or her] whole life or has gained a significant amount of weight after having been fit—is think emotions first,” says Bridge. “[Obese people] have been crushed. Maybe once, maybe repeatedly. They don’t know your world. They know embarrassment, ridicule, sabotage, abuse and pain. They don’t want any more pain. But truly soft, out-of-shape [clients are] going to know pain again as they become fit. It’s unavoidable. They’ve been running to the couch and the cookie to escape pain, and they have become experts at hiding. If you push them too hard, too fast, without enough kind, fun motivation, they will also run from you and their health again.”

Celeste Reeves, a personal trainer and owner of Functional Fitness Personal Training in Lawrenceville, Georgia, agrees that emotions play a major role in programming for obese clientele. “Those emotions cannot be ignored,” she says. “I recommend my clients with depression or deep issues go to a counselor.”

Reeves advises fitness professionals to complement their degrees and certifications with wellness or lifestyle coaching training. “Getting my certification as a wellness and lifestyle coach has helped me take my personal training to the next level,” she says. “I think anyone who wants to work with obese clients should do wellness coaching. It makes you a better listener. You can’t just tell your clients what you want them to do; you have to ask them what they’re willing to do and then create a plan around that. If they aren’t willing, they aren’t going to do it.”

A New Focus

Like Reeves, many fitness professionals have learned through years of experience how to successfully meet obese people where they are. Their best practices may be the fuel you need to help your clients break through barriers, real or otherwise.

For more practical suggestions, please see “Do Fitness Pros Understand Obese Clients?” in the online IDEA Library or in the July 2013 issue of IDEA Fitness Journal.

For the latest research, statistics, sample classes, and more, "Like" IDEA on Facebook here.

Joy Keller

IDEA Author/Presenter
Joy Keller is executive editor of IDEA Fitness Journal and is also a certified personal t... more less
September 2013

© 2013 by IDEA Health & Fitness Inc. All rights reserved. Reproduction without permission is strictly prohibited.

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Article Comments

Marie Powers
On Sep 04, 2013
I am so happy to see this article on IDEA. I lost 150 pounds at the age of 51 and became a trainer and yoga teacher myself. I understand the mindset and the emotions of the obese. That's why in my 50's I have changed my career. It is the very people who need the gym and need the movement that never last very long because they are intimidated and feel their size makes them unworthy. It is so important to address the emotional issues while training. After all, if the change is not made on the inside, the changes on the outside will never be permanent!
Anonymous
On Sep 05, 2013
Great article. From what I have seen through my 25+ years in fitness is that the most prejudiced against obese clients are trainers. They automatically assume that individuals are obese because they eat too much and exercise too little. Nothing could be further from the truth for many clients. Better understanding and more education in the area of obesity is very needed. Sadly, when courses are offered on the topic the trainers who need the most education on the condition are the first ones to choose another workshop.
Ragen Chastain
On Sep 05, 2013
I'm a 300 pound woman who was first certified as a fitness professional in 1996. I am a 3 time national champion dancer and am currently training for my first marathon.

The best thing that fitness professionals working with fat clients can do is to NOT stereotype them. Don't make assumptions about their fitness level, their capabilities, their emotional state, or anything else based on their body size.

Even if you are someone who lost a significant amount of weight remember that all you know is YOUR experience, not the experience of every fat person. The fact that you were fat does not mean that you understand the mindset and emotions of all fat people.

Never motivate a fat client by devaluing their body or fat bodies in general. Remember that we live in a world where the messages that fat bodies are wrong - and proof that we are lazy, emotionally troubled, un-athletic and even immoral - are inescapable. The idea that a fat body should be treated as "injured" is highly problematic and serves to further stigmatize those bodies. Remind fat clients that their bodies are absolutely amazing at any size.

If you want to work effectively with fat people then set aside your preconceived notions and stereotypes and treat them like any other client. Ask what their fitness goals are, determine their baseline fitness, and train them for their goals. If you find that something doesn't work because of their body shape, then do something else. If you want to give your clients role models of fat athletes, check out the Fit Fatties Forum (www.fitfatties.com)

Remember that long term weight loss has an abysmal success rate, but healthy habits lead to greater health regardless of size, so consider training for what the body can do rather than how it looks.

~Ragen Chastain


Anonymous
On Sep 05, 2013
This is a wonderful article but only scratches the surface of a more deeper situation. Mind over body is the key to healthy living and weight loss. An individuals emotional state is just that, individual. To coin the phase, "different strokes for different folks" is best represented in the individual and should be treated as that. Trainers/coaches should be aware of this and make it their starting point for a possible long journey.
Deva Kyle
On Sep 06, 2013
When I saw the title of the article I had some real hope that article was going to address many of the needs of fat people pursuing fitness that are often ignored and can be real barriers to pursuing whatever their next fitness goals may be. Here are the biggest problems that I think fitness professionals need to address for their fat clients.

1. Don't assume that a fat client is just starting out or does not understand how to use equipment. Many many fat people have been working out their whole lives. Many were or currently are serious athletes. When fitness professionals approach serious athletes as if they are new, it is patronizing and alienating. Fat athletes know that most people assume they are not fit and it is frustrating to have to start from a place of proving yourself in a relationship that is supposed to be built on trust.

2. Similarly, don’t assume you know what the fitness goals of a fat client are. Not every fat people who enters a particular gym or meets with a new fitness professional is looking to “get healthy”. Maybe they just moved to the area but have a set fitness routine that they are looking to establish in their new town. Maybe they are looking to ramp up an already demanding workout routine. Maybe they are experienced in one form of athleticism (biking, swimming, etc.) but are looking to learn something new. Individualized fitness goals are important to the relationship with a client so make sure to listen!

3. Not every fat person goes to the gym because they want to lose weight. Many may be very happy with their bodies. Others may be getting there. Some may actually be intentionally or not gaining after an illness or mental health issue including recovering from an eating disorder. Especially for the latter group, assuming that weight loss is their goal is patronizing and potentially triggering. Ask what their goals are before taking out the scale, the measuring tape, or the body fat measuring tools. If they are looking just to learn a new skill, for example, these tools are not only irrelevant but could significantly harm your relationship with your client.

4. Have equipment available for fat clients. If you provide yoga mats, have larger mats available. For those that are charting their weight, have scales that go over 250 lbs. Have exercise equipment that allows for weight over 300lbs. Make sure the space and tools create a welcoming environment for your fat clients.

5. Do not assume excess fat is necessarily an obstacle but do be prepared for the fact that different bodies do have different needs. Just as you would not require a very short client to do pull-ups on a bar that they cannot reach, it is a good idea to be prepared and trained in alternates that take into consideration the way in which fat bodies move. I once had a yogi practically yell at me because, even though I was an experienced yoga student, when I did the cobra my breasts touched the mat. I literally had to have him run his fingers along my back to show him the deep arch I was achieving even though my flesh was not going to leave the ground.

6. Communicate and enforce a non-discrimination policy for both other clients and all trainers/staff. The number one reason I hear from other fat people who avoid fitness is that they hate being in fitness spaces because they feel and are judged. People make fun of their bodies. Others sneer when they sweat. Other clients do this as well as fitness professionals. This is the main way fitness professionals are not meeting fat client needs. If someone feel ostracized in your space you have fail the relationship and failed at your job. Fitness should be enjoyable but it can’t be in space that explicitly discriminates against fat people.

Your article could have done so much. I’m really sorry you missed the boat on this.
Angela Meadows
On Sep 06, 2013
This sounded so promising but I just want to echo what Ragen and Deva have said above. So ditto to all that.

Plus, so as not to be repetitive, I know that many of your readers may be unfamiliar with the work of Steven Blair and colleagues. I studied in nutrition/fitness, qualified at a personal trainer, pilates instructor, kickboxing instructor, and completed a Masters degree in Weight Management, all at around 17 stone (around 240 lbs). Throughout this, I couldn't understand my continued to struggle to lose weight and keep it off, despite all my knowledge. What was I doing wrong? I just wanted to get healthy dammit.

And then, in 2011, I stumbled on a paper (http://www.ncbi.nlm.nih.gov/pubmed/10546694) showing that in an exceptionally well conducted prospective cohort study, while mortality risks were higher with increasing BMI in unfit individuals, for fit individuals, BMI didn't matter!!! Even obese individuals, if they were fit, had the same risk as 'normal weight' fit people, and much better than 'normal weight' unfit people. What shocked me most was that this study was conducted in 26000 men and was published in JAMA in 1999. How had I never heard this before?

I wondered if anybody else had found this or done follow up work, so I started looking. There are dozens and dozens and now, probably hundreds of studies showing that when people have a healthy lifestyle, the risks associated with increased BMI are usually entirely wiped out. If you don't believe me, go look for yourself. In all of my training, I had never heard this, which is an absolute disgrace.

If your clients really want to improve their health (whatever level it is currently at), this does not have to involve weight loss. You (and they) have a much better chance of getting them fit, than you do of getting them thin.

There are healthy and unhealthy people in all BMI categories. Health is not a number of a scale but has more to do with lifestyle. And contrary to popular belief, adopting a healthy lifestyle will not automatically make people thin, particularly if they have a history of weight cycling and disordered eating.

While it is true that as BMI increases, individuals are less likely, on average, to engage in physical activity and maintain good levels of fitness. I would contend however, given that many very heavy individuals do these things, that this difference is due less to the barriers supposedly imposed by their weight, and more to do with the barriers imposed by us. We tell them they're broken, need fixing, we motivate our classes by telling them they need to do this not to become like those fat individuals, they can't buy exercise clothes that fit, or use equipment in gyms, and if they do exercise out in public, they are harrassed and even attacked.

Let's take the stigma out of this and offer fitness and improved health for all of our clients. This is not the same as offering them weight loss.

Angela Meadows
Sarah Young
On Sep 06, 2013
I'm about 50 pounds overweight, and considered obese. I am also physically active--every single day. I am not "injured" or "restricted" by my fat. Please stop stigmatizing and shaming me. It doesn't help you, and it certainly doesn't help me.
Lisa Du Breuil
On Sep 06, 2013
This fat person will give any fitness trainers reading this article the only piece of advice you will ever need when working with a fat person. Ready? Here it is: The only thing you should assume about a fat person who is coming to you for fitness advice or training is that they have had to put up with an enormous amount of prejudice and stigma because they are fat. Got it? That's pretty much it.

So please don't add to their experience of stigma by assuming they are weak, their fat is "injuring" them, they eat to avoid emotions, etc.... or that they don't know their way around a gym. Because your negative assumptions about them is likely what is keeping them out of the fitness arena, not their "love of the couch". Yikes.

Susan Mohlman
On Sep 06, 2013
I'm saddened that stereotyping and stigma are being held up as 'recommendations' for how to treat fat clients in a gym setting. Do not presume every fat person has had the same experience as you. Do not coach other trainers to believe that the 'real' motivation for a fat client is secretly to be thinner. Health does not equal thin. Fat does not equal unhealthy. I've been both very athletic and fit at 300 pound as 6'1" and I've been miserably unhealthy (due to atrophy from inactivity from necessary sedentary time due to NON-WEIGHT related illness. Thin AND fat people get bone infections... And, fat people don't sign up for trainers because they have no knowledge or motivation to work out... they do it for the same reason everyone else does... they was a fresh perspective on working out or maybe a friendly face that enhances the training time to make it less dull. Gee, maybe they just like contributing to the economy in a local venue... rather than working out to dvd's at home. Get a clue... you are continuing the stigma and mistreatment of people.

Susan
Nyree Wadman
On Sep 06, 2013
Well, that's you told! Don't assume fat people are unfit, unhappy, demoralised, or even particularly interested in losing fat/weight to fit in with the cultural stereotype... I think the comments above more than adequately express my opinions of this article, and the well-meaning but sloppy thinking behind it.
Moniqa Aylin
On Sep 06, 2013
Or, you know, instead of assuming that all people who share a random physical trait all have the same feelings, goals, base-level fitness, and abilities, you might have a conversation with your clients about their individual motivations and goals for your sessions . . . like you do for all your other clients. Crazy idea, huh?
Theresa Bakker
On Sep 06, 2013
I'm a fitness trainer (ACSM-CPT) and also happen to be fat. I'm here to remind you that NO, not all fitness trainers are "light and strong." Some of us are very heavy and strong!

Maybe, just maybe, all we trainers need to do in order to be sure we are meeting ANY client's needs is to sit down with them and ASK what their needs and goals are, and then develop a program that gets them there.

Assuming that all fat clients have the same physical and emotional issues is incredibly irresponsible. Assuming that all fat clients want to lose weight is incredibly presumptuous.
Diane Weiman
On Sep 06, 2013

Goodness what comments!! I am an exercise specialist as part of a multidisciplinary team at a hospital for weight loss surgery patients. What I can tell you for since I work exclusively with the obese day by day is that this is a special population indeed. The cause of obesity has different components: genetics, metabolism, environment, stress, economics and spiritual. It has been classified as a disease. There are proper approaches to exercise with anyone with a disease. It is wrong to accuse trainers to approach an obese client in a "special" way. But it is also important is that trainers understand there is a real person under the weight. Know what their desires are like anyone else and guide them in "steps" to get there. I use the word movement instead of exercise because movement is life. And yes, a majority portion of the obese patients I see are not movers in the way they need to be to have long term success of weight loss. In saying all this, I strongly believe no one and I mean no one really wants to be 50, 100 or more pounds overweight. To claim that one can be obese and healthy is dangerous thinking. The body was not created for obesity. Even though one may not have issues with diabetes and hypertension the day will come when that will change and it will be at a cost of health and emotional well being. I wish everyone the best of health.
Jeff Weinacht
On Sep 06, 2013
Everyone saying that all these obese people aren't healthy are crazy!! Maybe 1 out 100 obese people are in good health the other 99% of obese people in this country are notin good health. Why do you think health care costs due to obesity is up to $300 billion dollars a year? Its not because they are so healthy. No matter how healthy you are being obese will break down your joints causing pain.
Sparky TheWondergirl
On Sep 07, 2013
I have to tell you, being a fat person who exercises and having people who can't even lift as much as you, or run as long, or get into the yoga pose, is one of the most aggravating experiences ever. You get these smarmy comments that someone would direct to a beginner exerciser, like people think it's open season to comment and judge what you're doing just because you're a fat person in the gym or exercise class.

If I was paying a trainer that treated me like that, or treated me like I was broken and damaged instead of finding ways to work with me starting where I actually am, that person would be SO FIRED. Whether or not it's healthy to be fat is immaterial to treating people decently and with compassion. If you as a trainer make a client feel broken and damaged that person is not going to want to work with you or come back. The best trainers and instructors I've worked with are completely non-judgmental. They assume everyone wants to get better at what they have to teach (dance, yoga, strength training) and they show modifications FOR EVERYONE (because sometimes thin people also need modifications) without making a big fuss over the poor damaged fatties and trying to psychoanalyze them. If that person came to you they are motivated, and if you make them feel crappy about where they're starting, you will lose them.
Samantha Miles
On Sep 07, 2013
Well, this is strange... I love sitting on the couch and eating cookies, and I never go to the gym, yet I'm 5'4'' and weigh about 100 pounds. Yet people don't seem to think I'm eating my feelings or hiding on the sofa... People tend to either assume I'm in great shape or that I'm malnourished.
If someone can stay as skinny as I do without being particularly athletic and regardless of my eating habits, it stands to reason there must be people who eat quite well and exercise regularly who remain fat. We need to stop making so many assumptions about a person's overall health, fitness level, and lifestyle based on how they look.
@Greg Keoc: how do you know she "struggles" to walk a marathon? Have you seen her do it? Do you train with her? Why would you assume that the "point" of participating in a marathon is the same for everyone?
What really gets me is we have all these people talking about their exercise regimes and/or their careers as trainers WHILE being fat, and yet some people come back at them and try to tell them what they're saying is impossible. "Of course fat people don't exercise, or can't exercise the way thin people can, or be fit. I know this because I feel very physically fit, and I'm thin. Also, I saw a fat person out of breath once. Another time I saw one eating poutine." Everyone's experience is different, and it's not your place to speak for anyone's personal experience but your own.
Rabbi Ruth Adar
On Sep 07, 2013
I'm a 300 lb woman who has been working out happily with a personal trainer for the past three years. Prior to that, I had a long unhappy history of getting hurt in the gym, not because of my weight (it went up and down) but because I have a number of orthopedic issues from old injuries, and the associated arthritis.

The big WIN for me in working with a personal trainer is that my trainer, Brittany Shaddle, took my fitness goal seriously (I want to get strong and build stamina) and has treated me with respect from Day One. There is never a suggestion that I am busted and need to be fixed. She brings her knowledge of exercise physiology and motivation, and I bring my body, and we work out.

This has been a huge success for me. I am stronger and have better stamina (my goals.) Blood pressure, blood sugar, and cholesterol are all good. I have not lost any more exercise time to old injuries.

Respect your clients, motivate them with positives, NEVER trash their bodies, and they'll do well if you know your stuff.
Aaron Alan
On Sep 09, 2013
The comments section of the article has been infiltrated by an obesity advocacy site and its moderator, herself a morbid obese. She tends to be very disrespectful to health and wellness professionals, including doctors, and she has incited her readers, very possibly predominantly obese, to comment here. On that basis, one may disregard those comments.
Samantha Miles
On Sep 09, 2013
@Aaron Alan: Yes, that's right. On an article about how to best serve OBESE clients, it makes sense to disregard comments coming from people who are OBESE. Any other logic problems you'd like to solve for us?
Also, there was nothing disrespectful about Ragen's comment. Assertive, yes. Disrespectful, no.
Joy Keller
On Sep 11, 2013
I'd like to thank everyone for your comments. I wanted to point out that this is just an excerpt. The FULL article actually makes many of the points you all make about not using stereotypes, not presuming that a client needs or wants to lose weight, etc. This is a very important topic from many different angles and I wish you all had access to the complete article so you could create a more informed opinion about it. If you're interested in reading the entire article, please contact me directly.

The bottom line, of course, is that fitness and wellness is for EVERYONE and fitness professionals should never presume anything about the person standing in front of them.

Let's use compassion, sound exercise science and an open mind when dealing with ALL people.
Nancy Brouillette
On Sep 25, 2013
Does anyone have any suggestions for my situation? I am a group exercise instructor and I teach a very energetic and athletic Step Aerobics class. My students range in age from mid 20's to mid 70's and the fitness levels vary. But the class is a big one and many of these folks have been with me for years. Recently three new participants joined and they are very large. I would classify them as obese. I was/am worried that the intensity of this class will ultimately discourage them but so far they have not missed a class and are actually progressing. But I see how difficult it is for them. I constantly suggest (to the whole class - not directed at them specifically) modifications to make the exercises more do-able. I want to talk with them about what their goals are but I'm a little nervous that it will be obvious that they are getting extra attention because of their size. I think this is a good opportunity to make changes in these students' lives but I want to tread carefully. Suggestions anyone?

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