Alexis Batrakoulis, MS, CSCS, RCPT*E, ACSM‐CPT, EP‐C and ACE Certified Health Coach, has been involved in the fitness industry since 1995 and currently works as an educator, speaker, author, technical expert and exercise for health specialist throughout Greece and worldwide. He is the personal training education director at the Greek Athletic & Fitness Training School (GRAFTS), which is an accredited vocational training provider and the national leader in fitness certifications in Greece. He holds a BS in physical education and sports science with an emphasis on fitness, and an MS in exercise and health with an emphasis on special populations. He has also earned numerous professional credentials through ACE, ACSM, NASM and NSCA.

Batrakoulis is a subject‐matter expert and master trainer at ACE in Europe and is a member of the Brussels‐based Professional Standards Committee of EuropeActive, which registers exercise professionals and leads development of educational standards for all physical activity occupations in Europe. More specifically, he has respectively led and contributed to the technical experts groups that developed standards for the occupational roles of weight management exercise specialist and pre/diabetes exercise specialist in Europe. His live workshop "Exercise for Overweight and Obesity: Bridging Theory Into Practice" is approved by ACE, ACSM, AFAA, NASM and NSCA as a continuing education course for fitness professionals around the globe.

ACE: How do you see the obesity epidemic affecting our society—families, health care, workplaces—in the United States and internationally?

Alexis Batrakoulis: As a health and fitness professional, I see clearly that obesity is everywhere on our planet and is considered the biggest global public‐
health challenge of the 21st century. Unfortunately, the impact of obesity both nationwide and worldwide is huge and is strongly associated with a variety of other chronic medical conditions that affect people of all ages. According to the latest data, the cost of obesity in the United States ranges from $147 billion to nearly $210 billion per year, while in Europe the cost is approximately €70 billion annually. The Lancet recently published a study showing that obesity is also on the rise in China, Brazil, India and Russia, and the problem will be at its worst by the end of 2025. If we add the fact that nearly one‐third of children aged 10–17 are affected by overweight or obesity in both Europe and the U.S., we can easily see that we are in the midst of a serious health crisis that will have a significant impact on the next generation.

ACE: What do you think positions ACE Certified Health Coaches and other fitness professionals to guide people through the lifestyle change necessary to overcome obesity?

Alexis Batrakoulis: From my perspective as an ACE Health Coach and a practitioner who has been working very closely with members of special populations, especially in terms of supervising individuals with obesity both in clinical settings as a researcher and in commercial settings as an exercise for health specialist, I can affirm that qualified exercise professionals could be the most crucial connecting link among health care, communities and the fitness industry in the fight against the obesity epidemic at a global level. We should not forget that the major barriers for people with obesity who are trying to lose weight are development of positive exercise experiences, improvements in self‐efficacy, adherence to exercise and behavior change. It is quite clear that long‐term weight loss is an approach more like a marathon than a sprint. Therefore, the mental game is the first priority for both clients and fitness professionals.

Unfortunately, many in the general public believe too much in strict diets, extreme workout routines, unhealthy nutritional supplementation or drugs when seeking weight loss, while likely underestimating the most powerful tool—the mindset! The key element of success for people affected by excess weight or obesity is associated not exclusively with exercise programming and in‐session activity, but mostly with progressive and permanent lifestyle changes. With this in mind, the role of certified fitness professionals is absolutely crucial to bridging the gap between primary health care and the general public.

ACE: What elements do you believe a successful behavior‐change program incorporates?

Alexis Batrakoulis: The key elements that should be included in a program of this kind are associated with individualization and expertise from fitness professionals who seek to support their clients' efforts with some very important soft skills, such as adaptability, critical observation, problem solving and empathy. Empathy is considered the most strategic and powerful tool for the development of a process that promotes open communication between client and trainer. It's likely that most of the time our clients are not only affected by overweight or obesity, but are also sedentary and coming to us with some negative past experiences. All of these facts indicate higher barriers and some serious difficulties for trainers. Therefore, communication skills and emotional intelligence are two extremely important elements that every health and fitness professional should incorporate into a successful behavior‐change program. When working with clients with obesity, we should systematically and intensively promote the appropriate message by stating the number‐one priority: health at every size.

ACE: In what ways do you feel health care, corporations and the fitness industry can work together more to provide people who need it most with quality behavior‐change options and exercise programs? Why do you feel that type of collaboration is important?

Alexis Batrakoulis: Evidence shows that physical activity and structured exercise are the two key components of good health, well‐being and quality of life. According to the latest research, it is necessary for individuals with overweight and obesity to add exercise to their daily routines either as preventive care or as an element of the treatment process. I strongly believe that the future of the exercise and health industry is highly associated with the field of medical fitness, which needs qualified exercise specialists who will be able to work with individuals with overweight or obesity. Of course, we must overcome many barriers, including the misconception between healthcare providers and fitness professionals regarding their occupational roles, job descriptions and levels of education, certification and continuing professional development throughout their careers.

Fortunately, the client referral relationship is now a reality in both Australia and the United Kingdom. I am sure that we can learn many things from other geographical regions where local authorities/organizations have already made some very important steps in the right direction by introducing some innovative and promising projects and trying to effectively bridge the gap between fitness and health care.

ACE: Where do you feel people need to be given access to behavior‐change alternatives (workplaces, community centers, healthcare providers)? Why is it essential to meet people in those places?

Alexis Batrakoulis: The pathway for success is the establishment of an exercise and health referral network that will bring together all involved parties under the umbrella of a mutual task. With this approach, the fitness industry and businesses and/or independent organizations could develop supervised exercise training programs, roundtable discussions and small‐group training classes for individuals with overweight and obesity—with the involvement of qualified staff—in many different settings and not exclusively at fitness clubs. Exercise is a vital sign for a better and longer life, and it is up to us to decide how and where we should deliver exercise training or behavior‐change programs to people who seek to improve their body weight, overall health, functional fitness or physical performance.