You want to help overweight or obese clients adopt healthy lifestyle behaviors they can maintain. But how do you do it?
Within the context of exercise, the American Council on Exercise defines self-efficacy “as the beliefs in one’s own capabilities to successfully engage in a physical activity program” (ACE 2010). In other words, self-efficacy is the perception we have of our ability to change or perform behaviors such as physical activity or dietary habits.
Past experience is a good predictor of a client’s current self-efficacy state. A history of failed attempts typically leads to low self-efficacy and negative self-esteem—which overweight and obese clients tend to attribute to their physical appearance. With their expectations not met, they feel frustrated and confused. That vulnerable state of mind drives them to attempt more quick fixes, such as the “Lose 10 pounds in 2 weeks” workout or diet plan—but when they gain the weight back with interest, their self-efficacy drops to a new low. They decide that diet and exercise do not work for them. The more they believe this, the harder it becomes for them to make positive and lasting lifestyle changes. They may even lose interest in trying.
If you have the opportunity to work with these clients, begin by learning what their large goals truly mean to them; reorienting them toward smaller goals; and demystifying their many perceptions about health, fitness and diet.
Some of the biggest gains come from the smallest changes. Obese and overweight clients often have big goals, which often include looking better for a specific event (such as a wedding or vacation). The timeline for a long-term goal, such as losing 100 pounds, is a macrocycle, but accomplishing that overall goal requires many lifestyle-progression steps. These steps, or microcycles, involve short-term goals. Microcycles usually last 1–4 weeks.
The purpose of having microcycles, with short-term goals, is to establish changes that the client finds achievable—and thereby increase self-efficacy. It is common when assessing traditional clients to state up front the change(s) they will need to make in order to progress. Don’t bombard obese clients with a list full of changes to do all at once. Trying to attempt too much will not increase their self-efficacy. They will perceive that being healthy is too challenging and may give up if they fail to meet your expectations.
Get on the client’s level to see what is achievable. Small goals are easy to find: drinking more water, incorporating more vegetables into the diet, establishing a weekend family walk with the dog. To find the true meaning behind a client’s goals and set achievable objectives in his or her present-day life, “dig deep” by doing a thorough assessment and asking open-ended questions.
Use your judgment and expertise when deciding how to progress clients, as some obese people are self-motivated and others require much more coaching. The overall principle is to create a positive experience and increase self-efficacy in order to facilitate lifestyle changes.
Ways to Increase Self-Efficacy
There are various ways to boost self-efficacy on and off the gym floor. Partner games, client conversations and achievement reinforcement are three effective ways to break through negative barriers.
Partner games and exercises place the theme on play and emphasize that exercise is fun rather than repetitious “work.” It is common to see clients smile and laugh, which makes it more likely they will associate exercise with a positive experience. Try these simple and achievable partner games and exercises:
- Simon Says
- Medicine Ball Squat and Toss
- Bounce Passes With Reaction Ball
One-on-one conversation with a client can help you identify his or her true goals and let you determine the best way to proceed. Ask open-ended questions, and take your cues from the client’s responses. For example:
Trainer: Can you explain to me what you are looking for in an exercise program?
Client: I would like a program that will help me lose weight and gain muscle.
Trainer: So I understand that you want to lose weight. What in your life would be different if you lost weight?
Client: I’d be able to travel again.
Trainer: Could you further elaborate?
Client: I took a flight recently, and it was hard to walk down the aisle and the seat was so uncomfortable that it made me realize I need to lose weight. I love traveling, but I have avoided it because traveling is uncomfortable.
Trainer: Thank you. I see you have a busy schedule. When do you think you can fit exercise in?
Client: My goal is to work with you 2 days per week and to work out on my own 2 or 3 other days for about 1 hour. It depends on the week, as I work on call for the overnight shift.
Trainer: Yes, job commitments are very understandable, and together we’ll work around the demands of your schedule. I see you have listed some dietary concerns and requests. I think it is best to proceed by meeting next week, as we planned, and discussing your dietary concerns then. In the meantime, please think about one habit you would like to change and how it has affected your health.
For more ways to help obese and overweight clients build self-efficacy, please see “ Building Exercise Self-Efficacy in Overweight and Obese Clients” in the online IDEA Library or in the January 2014 issue of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at (800) 999-4332, ext. 7.