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Establishing Standards

Brian Biagioli is the executive director for the National Council on Strength & Fitness (NCSF) and a founding member of the Coalition on Registration for Exercise Professionals (CREP). A longtime leader in the health and fitness industry, Brian also serves as the graduate program director for strength and conditioning in the department of kinesiology and sport sciences at the University of Miami. Throughout his career, his expertise has led to leadership positions on several executive committees, including the Commission on Accreditation for Exercise Sciences (CoAES), the National Coalition for Promoting Physical Activity (NCPPA), the National Commission for Certifying Agencies (NCCA) and the European Health & Fitness Association Standards Council. An international presenter and author, Brian is an authority on training and conditioning.

ACE: How do you see the obesity epidemic affecting society—from health care to relationships within families?

Brian Biagioli: The obesity epidemic is a complicated and systemic problem, meaning it creates systemwide issues among those impacted by it. While the associated low-grade inflammation affects cells throughout the body (promoting cardiometabolic disease), hormones become disrupted and create negative feedback loops that further promote weight gain and associated issues. Collectively, this affects a person’s well-being by negatively impacting the physical, emotional and, eventually, psychological aspects of health.

Many people are surprised to hear that obesity actually feeds itself by changing a person’s functional systems
into a chronically dysfunctional health problem. An unhealthy person then experiences a reduction in life quality, which extends to family and friends, impacting work, relationships and personal self-worth. When you consider the high number of obese and morbidly obese individuals in the country and the number of people they directly affect, you come to the daunting realization that we have to get our arms around this with a high level of urgency.

ACE: Why do you feel that establishing standards for health and fitness professionals is essential to combating the obesity epidemic?

Brian Biagioli: Obesity and its comorbidities are serious medical conditions. Additionally, the drivers to cardiometabolic disorders are multifactorial, suggesting that we need competent and appropriately prepared professionals to address the critical issues. It starts with understanding the underlying causes, which oftentimes are more than simply eating [too much] and moving [too little]. Professionals must be well versed in the causal and direct relationships associated with the disorders; they must fully understand what the individual is experiencing and be cognizant of overall well-being, including both psychological and emotional states. Any qualified fitness professional can recognize the seriousness of conditions associated with obesity and prolonged physical inactivity, the procedures for getting clients psychologically and physically ready to combat them, and the ongoing plan and support system necessary to succeed.

It may sound very medical in theory, and that’s because it is. You may ask, shouldn’t an allied health professional manage the situation? I say yes, in the form of a qualified fitness professional who can provide screening, evaluation, proper program design and instruction, behavior modification tools and implementation strategies.

ACE: How do you feel a registry of fitness professionals who hold accredited certifications in the United States will make an impact on the obesity epidemic?

Brian Biagioli: Many people call themselves ‘trainer,’ ‘coach’ and even ‘fitness expert,’ and currently they can do so without any real qualifications. Likewise, there are no repercussions for doing so, even if the individual lacks professional competence, which is truly sad. A registry sets the bar and says to the public that we ensure you a quality of care consistent with our duties as health professionals.

We demonstrate no less than the minimally accepted competency to practice in the United States, and we promise to continue our education to provide safe and effective services at a discernibly different level of quality due to our validly measured higher competency. Without establishing a standard, health and fitness professionals will never enjoy the respect and recognition necessary to be part of the healthcare continuum.

ACE: Why do you feel it is important for fitness professionals who work with overweight and obese individuals to hold a certification accredited by the NCCA or similarly respected organization?

Brian Biagioli: Why do lawyers take the bar exam? Why do physical therapists and physicians take boards? All of them hold advanced degrees and, yet, graduating from an accredited school does not ensure adequate competency to protect the public from possible harm—at least that is what state regulators suggest. It is important to recognize that a certification is an instrument of measurement; that’s all it is and all it should be.

Education is a means for knowledge enhancement and establishes the foundations for professional capabilities. Mentoring influences our philosophies and aids in our methodology. Experience hones a professional’s skills and directs his or her future path, and an NCCA-accredited certification validates a level of competency. If I am impacted by obesity, I want a level of assurance that the person providing solutions is both qualified and capable to help. I believe everyone deserves that as a minimum. Everyone must understand that while fitness enthusiasm and regular participation in physical activity are great, they do not qualify a person to work in a role that makes him or her responsible for someone else’s well-being.

ACE: As a professor, what information do you feel we need to start communicating to aspiring health and fitness professionals so they are effectively prepared to address the obesity epidemic?

Brian Biagioli: I wholeheartedly believe that education and training are necessary to resolve many of the health care–related issues we are facing today. Finding solutions means we must first recognize the problems—all of them. If we see obesity as a “fat” issue, we have failed because of the multiple elements that affect the disorder. It clearly is not simply a calorie issue, but rather a social issue, an economic issue and a psychophysiological issue. Therefore, we must address the problems with real, sustainable, evidence-based solutions that scale.

If we try to provide personal training (in a one-on-one manner) as the solution, we again fail. With just over 250,000 personal trainers working in the United States, according to the Department of Labor, professionals are vastly outnumbered by the number of adults and children impacted by obesity. I would suggest we stop thinking “one client” or “one health club member” at a time and challenge ourselves and aspiring health and fitness professionals to think bigger.

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