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“Exercise Considerations for the Bigger Client”… Health and fitness at any size

June 15, 2022
6 minute read

Hey team!

I use the word ‘Bigger’ to describe a particular cohort of clients, rather than the more clinical term of ‘obese’ or even the word ‘fatter’, because that is what they are – bigger. Bigger isn’t about a certain type of measurement or test – it just is – and helps you to evaluate how being bigger may affect your client’s ability to do certain exercises or move in a certain way. 

The word ‘Bigger’ covers a multitude of body types too – it doesn’t label someone quite that way as calling someone fat, overweight or obese does. I don’t use the word bigger to be politically correct... I use it so the client doesn’t feel worse about themselves than they already do, and labels have a habit of doing that! 

Bigger also doesn’t mean people aren’t fit or have lean muscle mass – they might have. Or they are at the other end of the scale being extremely overweight, sedentary, and unfit. I try not to let words define what someone is wanting to achieve or try, but instead I help them set realistic goals and expectations for themselves. ‘Bigger’ can also relate to how people ‘feel’ in their body. They may only be 20kgs above ‘normal’ weight, but for them they might feel big within themselves. 

How you can help your bigger client –

When beginning to train a bigger client, start slowly and let them gain confidence in you, as well as in themselves. It is far easier to increase intensity when you have a better idea of what their limitations are, but it is incredibly difficult to regain their trust and confidence if you have pushed them too hard initially or hurt them. Be aware of all the other factors that may be at play – anxiety, fear, embarrassment, worrying about other people watching or commenting. You want them to come back for their next session! Remember these hints and you can’t go wrong –

  • Never judge. You do not know how they feel in their body – physically, mentally, emotionally. If you’re not sure about something, ask them – and listen to their answer! 
  • Have empathy. Enough said….
  • Teach them to advocate for themselves – for their health and their body. Help them to connect their mind with their body, and to listen to what their body is telling them. What feels good? What doesn’t? Why?
  • Don’t prescribe them unrealistic goals or exercises to achieve – because when they inevitably don’t achieve them or even attempt to try, they will feel like a complete failure – like they have many times before when it comes to their weight, size, and exercise. Remember many bigger clients will have had terrible past experiences with exercise. You don’t want training with you to be another bad experience. Try setting smaller more achievable goals that make them feel like an absolute champion for accomplishing! Then together you can set the next stage of their goals to work towards. We want our people to feel like they are winning! That’s what the best coaches do 😊 

Exercise Prescription for the Bigger Client – 

The three main aspects for you consider when working with a bigger client, and prescribing them an exercise program are -

  1. Health
  2. Physical 
  3. Psychological
  1. Health issues to consider 
  • Type 2 diabetes and insulin resistance
  • Hypertension and CVD
  • COPD/respiratory issues and sleep apnoea
  • High cholesterol, high triglycerides
  • Hypothyroidism
  • Fatty liver disease
  • PCOS and infertility
  • Cancer 
  • Increased CRP – inflammation markers
  • Urinary incontinence
  1. Physical Issues to consider 
  • Osteoarthritis in large joints – mainly knees, hips, ankles
  • Gout (form of arthritis)
  • Plantar fasciitis – can be chronic in overweight people
  • Joint pain – hypermobile joints, particularly knees
  • Core/muscle weakness. Poor balance, stability, mobility, function (see below).
  • Non-specific weight related pain – the body just ‘hurts’
  • ADLs limited
  • Postural considerations – where do they carry their weight?
  1. Psychological Issues to consider

(Please remember your scope of practise with this – unless you are a trained, certified Psychologist, Psychiatrist or Counsellor, you MUST NOT be giving any form of psychological support. However, gaining an understanding of what their mindset around exercise, behavioural change, past experiences with exercise, etc. are, will help give you some information to help support their experience training with you).

  • Barriers to exercise – not just physical. Mental, emotional, confidence, anxiety, depression, where you are exercising (gym, home, bootcamp, group fitness, etc), how many people are around, level of fitness, general comfort in an exercise setting.
  • Previous experiences with exercise – Good? Bad? What happened? I always ask this question to get a better understanding of where potential roadblocks might come from and find out what they have previously enjoyed doing.
  • Any eating behaviours such as restrictive dieting, eating disorders, weight loss (bariatric) surgery, or current dietary behaviours. Again, refer to a dietitian or nutritionist for further support.

When programming, consider the following and how this may affect what exercises you prescribe for your client –

  • Balance – Can they stand on one foot? Do they use a walking aid? Do they have knee or hip joint issues that affect their balance?
  • Mobility – Can they walk? How long for and how far? Do they move assisted with aids or without? Do they need to regularly sit down? Do they require assistance sitting and standing?
  • Flexibility – Potential joint issues – knees, hips, ankles, back. Stiff muscles.
  • Stability – One leg exercises, balance balls, steps, etc. Are these appropriate for where they are currently at?
  • Functionality – What do they need to be able to accomplish in their day? You might need to be focusing more on ADLs (Activities of Daily Life) such as getting up and down off a chair, stepping up unaided, etc
  • Getting up and down off the floor – This is a big one - are they able to get up and down unaided? Do they have knee issues where kneeling might cause pain? Are you able to help them if they can’t get up by themselves? 
  • Getting up and down from a seated position without support – At home they may have a raised seat, or an armrest to support, or something else they use to push themselves up out of the chair/seat, which they don’t have in an exercise situation. Assistance may be required.
  • Stepping up (and down) – Is that platform you are using (box, step, bench) stable? Can it hold their weight? Do they feel stable? Can they see their feet and where they are placing them? Is there something they can hold on to if needed?
  • Fitting into exercise machines – Can they safely enter and exit a machine unaided? 
  • Performing movements correctly – For example – Can a deadlift with a barbell be performed correctly if they have to move the bar forward over a bigger stomach? Keep your exercise choices simple to start with – bodyweight exercises can more than enough when starting out. Be careful of complex lifting movements. 
  • Pressure/compression on their stomach – Be mindful of exercises that may do this – e.g. leg press

Adapt the workout to their capabilities – not yours. Unless you have been a bigger body yourself, it can be difficult to comprehend just how hard moving can be. And remember when I’m describing these scenarios to you, I’m not talking about the client who is 10kgs overweight. I’m talking about the 110-120kg plus client (obviously taking into account height and musculoskeletal structure) who is morbidly obese and potentially has been very sedentary.

Also please listen when your client is telling you how they feel or what their fears about exercise may be. The mentality of ‘just do it, you just need to harden up’ is probably not going to work with these clients! Listen, then talk through the issues together. If you have never been a bigger person yourself, you have just as much to learn from them as they do from you. 

Get curious! This helps you build rapport with your clients and lets them know you actually care about them. 

As the saying goes, “No one cares how much you know until they know how much you care”.

Ask them how things feel for them –

  • what is difficult?
  • what feels okay?
  • what is scary for them with exercise?
  • what is their biggest challenge with exercise?
  • what is their biggest challenge with their size – in life and with exercise?
  • what is something they would love to try or be able to do?
  • what is their biggest fear with their size, health, life?

Rapport!

To learn more about working with the Bigger Client, check out my course, which includes videos on exercising with your bigger client, and examples of how you can alter standard exercises to suit your client’s needs. As always, any questions, hit me up! You got this!

Link to the course here –

You can also listen to the podcast where I have a chat with Jono and Travis about this topic and what is covered in the course on the Fitness Education Online Podcast – The Bootcamp Blueprint. Link here –

https://www.fitnesseducationonline.com.au/ep104-training-the-bigger-clients-with-vanessa-warren/


Related Topics:
To weigh or not to weigh? Should Trainers Ditch The Scales Once and For All?

Post Covid-19 Refocus on Health and Wellness

Ep:104 Training the Bigger Clients with Vanessa Warren

Blue Side BG

Fitness Education Online are one of the leading providers in the world when it comes to the professional development of Personal Trainers. We have over 30 registered AUSactive CEC courses.  Click here to check them out!

 

About The Author: Vannesa Warrren

Vanessa Warren (TWC Wellness Consultant) is a leading Health, Wellness and Activity specialist. She is the premiere Bariatric Exercise Specialist in Australasia currently located in New Zealand, and has spent the past 13 years working exclusively with hundreds of people who have had bariatric weight loss surgery. She has combined her vast experience and knowledge of 30 years working in the health and fitness industry, and has created the TWC Bariatric Programmes covering all stages of the weight loss journey from the pre-surgery phase through to 12 months plus post-surgery.

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