Do Fitness Pros Understand Clients With Obesity?

In 1988, Joan Darragh tipped the scales at 288 pounds. During a trip to Japan, she had a defining moment. “I was in a bar, and I sat on a stool built for the slighter Asian frame,” says the New York City resident. “Suddenly, the bolts on my metal stool started to pop.” She tried to pretend it wasn’t her stool making that noise, but she still kept one foot on the floor.

Pat Perretta’s moment of clarity about his obesity came when he ran into an old friend from college. “After saying hello, I realized she hadn’t recognized me at first,” says Perretta, who went on to become a personal trainer in New York City. “I went home, looked in the mirror with sadness, thought to myself, ‘My God, how did I get here?’ and began to cry.”

Darragh and Perretta—and everyone else interviewed for this article—succeeded in losing weight and keeping it off, but not without a lot of work and a high tolerance for physical and emotional pain. Can you put yourself in Darragh’s and Perretta’s shoes? Unless you have been obese—defined for our purposes as having a body mass index of 30 or higher (World Health Organization 2013)—then perhaps you can’t. 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? Maybe it’s time to put on a fat suit and get real so you can help them get real results.

Drew Manning, a fit and healthy personal trainer from Eagle Mountain, Utah, gained national attention in 2012 for purposely gaining more than 60 pounds to draw attention to healthy living and to learn firsthand what it was like to be in an obese body. What the personal trainer didn’t bargain for, however, was how hard it would be, not just on his body, but also on his mind.

“The biggest thing I learned was that losing weight and becoming healthy isn’t as black-and-white as I had thought,” he said. “Once I became addicted to these processed foods, it wasn’t as easy to give them up. Being overweight, and trying to lose [the weight], is much more of a mental and emotional struggle than it is a physical one.”

You don’t have to gain 60 pounds to become more empathetic. However, 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?

As Manning learned from his personal obesity experiment, his clients were not simply “lazy”; they longed to change, but a plethora of obstacles were making that very difficult. Yet many obese people have had negative experiences with personal trainers and group fitness instructors who lacked empathy and compassion.

“[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 Dacula, 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 Black Mountain, 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. “They may have hurt their knees and ankles just stepping down wrong at a curb or perhaps they strained their back while getting up from hours of sitting,” says Bridge. “They’re carrying around a weight set they can’t put down. They don’t get a break from fat. Fit people know the strain of weight training, but when they’re done, they can leave the gym and take a load off.”

Darragh at times feared that personal training would do her more harm than good. “[One] trainer was invested in turning my bulk into the physique of a bodybuilder,” says Darragh. “Carrying around all this extra weight makes your legs very strong. I could easily do 600- to 700-pound leg presses. He would jump on the equipment and add his body weight to push me along [in my training]. All this killed my arthritic knees and back. I’m 67 years old and have had several personal trainers. Some tried to kill me, and others seemed disinterested. [At] New York City gyms . . . the 5-foot 3-inch morbidly obese woman is not made to feel that her personal fitness is on their agenda.”

Suzette Banzo of New York City thinks fitness professionals need sensitivity training and ought to let go of the preconception that all obese people need or want to lose weight. Instead, she suggests, health and happiness should be the primary goals. “My blood pressure is fine, my cholesterol is 180, and my thyroid is normal,” she says. “You can’t assume an overweight person is unhealthy. I feel personal trainers need to be very sensitive to this fact and [must] listen to what clients’ needs and desires are. Encourage a healthy lifestyle at any size.

“I’ve been fortunate to work with wonderful trainers who were aware that not all overweight people were unhealthy,” she says. “Some people are fit even in a larger body and can run a marathon at size 16. Meanwhile, there are some slim people who have high cholesterol [and] diabetes, and who get winded running down the block.”

Perretta, whose weight loss path led him to a career as a personal trainer, 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.’”

Kelly Webb of Alpena, Michigan, says her emotional struggle overshadowed all the other obstacles in her life, including work, kids, college and the fact that her husband’s job took him out of state. “Sure I could change my eating habits, and I could work out like crazy, but if I hadn’t learned to change my mindset, I don’t think I would have been nearly as successful.”

“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.”

Social anxiety imposes an emotional toll on the obese. Don’t underestimate it. “I have always had a problem with the fear of feeling or looking stupid when exercising,” says Kim Fernandez of Hercules, California. “This stems from school bullying, both by other students and by instructors. The Presidential Fitness Tests from the ’60s and ’70s were always an embarrassing ordeal for me. I was shamed by my instructors for ‘not trying’ and for being too slow and uncoordinated. It didn’t help that my mother was fit and used to jog to work across the athletic field during my PE time, saying, ‘Hi Kimmie,’ while I struggled to keep up with the others.”

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. The best practices of these veterans may be the fuel you need to help your clients break through barriers, real or otherwise:

Make Them Feel Safe

With obese people facing discrimination and ridicule every day, make your facility or studio a safe haven where they feel fully accepted and supported. “If my client doesn’t feel safe and comfortable and gets in the ‘compare-and-despair’ mode, it triggers feelings of being judged and not measuring up,” says Perretta. “I try to keep clients in the moment and locked into one workout at a time. I put them in surroundings and situations that breed success and feelings of accomplishment.”

Kishan Shah of Chicago and New York City is a former Wall Street private-equity investor who lost 200 pounds and became a “fitness evangelist.” He has made it his life’s mission to help obese people feel relevant and accepted.

Shah was recently named president of Downsize Fitness, which is designed exclusively for the morbidly obese population. The company has gyms in Chicago and Dallas and boot camps in Naperville, Illinois, and New York City. “If there’s one piece of any secret sauce in this business, it’s a sense of community,” Shah says, “whether that’s the relationships people have with each other, with the staff or with family. This is a long-term commitment and journey, and you want to have people around you who are invested in your success.”

Focus on What They Can Do,
Not on What They Can’t

Modify moves whenever it’s necessary. This may seem obvious when you’re working with clients who have severe restrictions, but personal trainers don’t always realize just how much they need to modify.

“My clients would rather be successful at doing a modified exercise for a couple of reps than not be able to do the move at all,” says Reeves. “Set them up for success, not failure. Modification is thrown out there as the buzzword, but with obese clients, you may have to try a few different modifications and be willing to say that’s ‘it’s okay to move on.’ Sometimes the simplest thing is very difficult. There’s a balance between pushing and motivating a client and knowing when to back down.”

Rochelle Rice, president of In Fitness & In Health, in New York City, tells her clients to “borrow my faith” (or “fake it until you make it”) and initially recommends 1 hour of “organized movement” per week for 6 weeks. “[Typically], a client’s initial response is, ‘That’s it?’ But I’ve found that after 6 weeks, the body wants to show up to the sessions to move and breathe. It’s not just the head beating the client into guilt and submission.”

As a client, Bridge has experienced more than once how disheartening it can be when a fitness professional isn’t fully present. “I love my trainer—he is wiser than most, as he respects the boundaries of my pain and understands (to a degree) what I need to be truly healthy. But sometimes even he doesn’t quite get it. He will disregard the fact that my extremely large breasts might be in the way or might throw off my balance. He’ll tell me to do a move that if I had no chest would be easy, and then he’ll get frustrated that I did it with bad form. I will speak up and explain that I could do the move closer in if my own body was not obstructing me.

“It’s at moments like this that I know he has forgotten that my physical shape, not my lack of ‘proper’ form, is causing me to do something wrong. I get irritated when he doesn’t pay attention to that and simply switches me to something else. I think, ‘Can’t you just introduce this to me [after I’ve lost another] 40 pounds?’ Don’t waste my time trying to get me to do something I can’t. Let me do something I can!”

Listen, Listen, Listen

Approach obese clients with an open mind, put down the whistle and stopwatch, and listen to what the clients want and need. “Don’t overwhelm them when you first meet them,” says Sue D’Alonzo, owner of SueDFit Workout in Pinole, California. “Don’t do body assessments. They know they’re overweight. Listen to them—don’t judge and don’t lecture. Hear their frustrations.”

Rice says she has seen health professionals “overstuff” obese clients with so much information that they leave overwhelmed and never return. “Talk to your clients and ask them what they need,” she says. “Don’t presume you understand how they feel. Know anatomy, and assist each client in connecting with his or her body. Be patient with progress and don’t get frustrated if clients don’t lose weight. Focus on movement, an active lifestyle and improvements in activities of daily living, including sleep, sex and social engagement.”

Webb echoes D’Alonzo’s and Rice’s sentiments from a client’s perspective. “I understand most fitness professionals want to push their clients, but it’s also important for each client to be allowed to listen to his or her own body and do what works without causing injury,” she says. “We all need to be pushed past our comfort zone, but there is such a thing as pushing too much, too far and too fast. I am a person, not a number or a dollar sign.”

Offer Rewards and Accountability

Look for creative ways to motivate clients who are obese. Mac Dodds, owner of Good Life Fitness in Lafayette, California, includes strength test challenges to boost self-esteem. D’Alonzo and Reeves use software to help clients track progress. “I set realistic goals,” says D’Alonzo. “[My clients and I are] in constant communication, and I’m always fine-tuning their programs. I send them educational materials and my IDEAFitnessConnect newsletter, and we have check-in emails and phone calls.”

Get clients started on a dietary diary, says Reeves. “Food journaling works. Ninety percent of my clients who lost 50 pounds or more and have kept it off wrote in their food journals daily and brought them in each week for me to review. I’m not a nutritionist, so I can’t do a food plan for them, but what I can do is educate clients and make them aware.”

Reeves believes in facts, not in guessing or fads, so she uses a piece of medical equipment that measures basal metabolic rate and tells people how many calories they can consume if they need to lose or maintain weight. “They have to accurately know how many calories they need and not [rely on] a generic math equation.”

Robertson, one of Reeves’s clients, says the smallest reward goes a long way. “Every time I lost 5 pounds, my trainer would give me a foot rub. It absolutely made my day.”

Small Steps, Big Changes

Reeves and Perretta acknowledge that when obese clients can’t reach their weight loss goals, it can be difficult for the fitness professionals as well as the clients, given that weight loss often means a reduction in medication and perhaps even a reversal of some diseases. However, small steps can lead to big rewards, which is why patience is so important. “Celebrate every accomplishment,” says Reeves. “Set reasonable, baby-step goals you know clients can reach within a short amount of time. Make them a part of goal-setting so they have ownership.”

Perretta says he lets go of the thought that he can succeed with everyone. “I can only do so much. [Clients are] at different stages of acceptance, and having gone through the process myself, I know that unless you have the willingness, the motivation and the right support system, it’s an uphill battle. Nevertheless, you can win!”

Bridge says “the celebration must start immediately” when obese clients choose to trust you. “Celebrate their courage and resolve, because they’re afraid they have failed before they even begin, and they need only the tiniest excuse to run back to the cookie or couch. Be fun, be kind and be a best friend. Seduce them with something easy. If they feel like they accomplished nothing [in a session] because you didn’t praise and encourage them, they’ll retreat. Make them feel like kids at play instead of adults at work on the chain gang being punished for their fatness. You’ll get much farther with baby steps than you will by hitting them hard. It takes awhile to get into the enjoyment of the body after you have divorced the flesh.”