Training clients impacted by obesity can be tremendously rewarding, particularly because this population can experience significant health benefits and reduce their risk of many chronic diseases by starting a program of regular physical activity. It is important to remember, however, that these clients may have both emotional and physical reasons for resisting exercise, which makes it especially important that you take the time to find activities that are both safe and enjoyable.  

Of course, it all begins with developing rapport and displaying the kindness and compassion necessary to build a trusting and supportive relationship with your clients. Furthermore, there are specific physical considerations you must take into account when designing exercise programs for clients impacted by obesity. Realistic, customized and sensitive exercise programs will set your clients up for long-term success.

Start Out Right

Your first step in working with a new client is to obtain a completed health history, medical clearance and a clarification of his or her goals. Don’t assume that weight loss is the client’s primary goal—he or she may be more concerned with lowering blood pressure or moving without pain, for example.

Start out slowly and allow the client to get used to the new movements and activities. It may take a few sessions to develop a vocabulary and visual understanding of when to push your client and when to lighten up, but the rate of perceived exercise scale (RPE) is a good starting place in finding that balance. Develop metrics to measure client exercise outside of training sessions—step counters, heart-rate monitors and RPE are all useful tools. Progress should be slow and steady, but it’s important to emphasize that a weekly session won’t be enough—developing a habit of moving regularly should be a primary goal.

Know The Limits

Avoid putting clients in any awkward or embarrassing situations by asking them to use equipment that might not accommodate their body size. For example, it might not be possible to fit into certain weight machines or they might be over the weight limit of some cardio machines.

Instead of using machines, focus on exercises that utilize things resistance bands or straps, balls and free weights. Clients might feel most comfortable doing a cardio workout outdoors, as it tends to be more private than the gym setting. If this isn’t feasible, make sure you know the weight limitations of cardio machines you might be using ahead of time.

Build Strength and Form

Focus on resistance training when starting out with new clients. Even those who have been previously sedentary are likely to be strong due to carrying substantial body weight in the activities of daily living. This will also provide a basis of success and create additional (calorie-burning) lean muscle. Here are a few simple guidelines for strength training:

Do:

• Use a bench or work from a standing position.
• Start with strength exercises that use large muscle groups and mimic activities of daily living, such as squats, lunges, and upper-body pushes and pulls.
• Incorporate bands, straps and balls to keep workouts challenging and fun
• Provide manual resistance or have the client use a wall to help develop strength and muscle awareness.

Don’t:

• Don’t use machines, exercises or foam rollers that have your client getting up and down from a lying position. The awkwardness and discomfort that this causes isn’t worth the effort.
• Don’t suggest single-leg strength exercises. Concentrate on managing body weight equally on both legs and develop better balance through exercises such as squats and lunges.
• Don’t overdo core work. Sit-ups and planks may be especially difficult for these clients, creating a recipe for failure and misery. Initial core work can be incorporated into other exercises; you can add more direct core work when your clients are more confident, experienced, and strong.

Emphasize Low-impact Cardio

Carrying more body weight can make cardio work uncomfortable—both physically and emotionally. Furthermore, because obesity is often associated with joint problems, high-impact work may be inappropriate for your client’s safety.

The cardio goals of your sessions should include raising the heart rate, finding endurance exercises that clients can (and will!) do on their own, and staying injury-free. Lower-impact cardio activities, such as walking, hiking, boxing, stationary cycling and rowing, are all great options. Avoid jumping, running and plyometrics. Better options include jumping-jack arm movements (no jumping), marching in place (instead of high knees) and walking lunges (instead of jump switches).

Moderate All Goals Except Enjoyment

Clients impacted by obesity might have a long road ahead when it comes to fitness. Don’t feel a need to jam everything into your initial sessions, but instead work slowly, methodically and deliberately toward increased endurance and strength. One of the best things you can do for your clients is to help bolster their confidence and enjoyment of physical activity, which requires the right attitude and choosing the exercises and activities that are both safe and fun.