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How to Turn Your Fitness Facility into a Health and Wellness Facility and WHY!

2020 came and went with a pandemic and the resulting crash of our fitness industry as we knew. It seemed like time stopped. Fitness facility doors closed. Staff were furloughed and separated. Fitness delivery models changed overnight – hybrid models of live streaming and on-demand services. Business plans were re-done for a budget year that evaporated.  

The OPPORTUNITY… there has been an increased awareness of the value of good health and the importance of exercise. Much of the research shared post-COVID clearly demonstrated that the sickest were at the highest risk with COVID and that those who were mostly healthy fared much better when diagnosed with COVID.

CDC reported that obesity worsens outcomes from COVID-19. Obesity increases the risk of severe illness, tripled the likelihood of being hospitalized, and is linked to impaired immune function, decreased lung capacity and many other risks. Obesity is forecasted to exceed 50% in Americans by 2030.

How do we go forward as business owners to capitalize on a perfect storm of individuals now realizing and valuing their health as an asset? How do we go forward to create environments in which our facilities feel like a home away from home for new exercisers, de-conditioned, COVID recoveries, overweight, out of shape and scared individuals who now wish to exercise?

American Psychological Association reported recently that Americans’ Physical Health has taken a back seat since the start of the pandemic. It was reported that 47% delayed or canceled healthcare services and that 53% have been less active than they wanted.

How do we fill the gap to provide services and welcome all ages, stages, shapes, sizes into our facilities to capitalize the business opportunity and to support those who need us most to get healthier?

  1. Bring communities together by offering health and wellness programs to non-members that teach good health and prevention. Some examples:
    • Post-hab COVID health program: 30 days to reset your health
    • 8-week weight loss programs/challenges, 8-week pre-diabetes classes, 8-week cardiovascular health and wellness programs.
    • Any program that can target a COVID risk factor that targets a certain element of health: cardiovascular, flexibility, strength, stress management, sleep, etc… or certain disease states such as asthma, obesity, diabetes, hypertension etc. all can be made into health and wellness programs for potential new members.
  2. Consider offering these health and wellness programs (with a nominal registration fee) without requiring a membership to your facility. So, include a membership to your facility for the duration of the program, offer a discounted sign-up fee to convert them to members at the completion of the program, and perhaps a friends and family rate to enroll. Leave a trail of financial incentive crumbs with some skin in the game to get them to value your facility and programs to stay long-term. Show them the value-added they experience by having you at your facility. Let them “try before they buy” — but in the wellness space first.  Not “gym and swim” first…that is too much for some.
  3. Offer intro level and disease-specific type group classes that may group like-minded individuals with common goals. Example: Beginner cardio class, where you clearly accommodate beginners, new exercisers, those who are low-level fitness and who need a shorter duration of work. 
  4. Offer personal training programs that clearly measure pre and post-health metrics to show improvement to give individuals confidence in their improving health and an appreciation of the value of the services they pay for. This also allows for your trainers and your facility to connect their improved health outcomes to their primary care providers so you can get future referrals as a credible source for a patient who needs exercise.
  5. Offer healthier food choices and nutrition education as part of your centers’ offerings. Consider adding a Dietitian to your team.
  6. Partner with local health departments, health care systems to host health checks to promote good health awareness and to get more foot traffic into your center.

THINK “A GYM without WALLS” and offer wellness to all – become the health hub of your community!! It makes good business sense for all!

Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer.  Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies.

Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.


Immunity in Question

When I was in graduate school, cardiac rehab was THE big issue in exercise science. Most graduates who wanted to work in clinical chose cardiac rehab as their mainstay. However, much of the discussion about the medical benefits of exercise changed in the late 1980s when Dr. David Nieman from Appalachian State University published the first in a series of reports on exercise and the immune system. In my opinion, Dr. Nieman changed the conversation on exercise as his research looked at one of the first biological mechanisms for change in the body due to acute and chronic exercise.

The State of Immunity

Why are we discussing exercise and the immune system? Because thirty years and hundreds of papers on the effects of exercise on immune enhancement, we are still as a nation not educated (let alone convinced) that exercise should be a mainstay of maintaining and improving overall health – especially in persons with infectious disease.

Let’s look at some of Nieman’s work. First, Dave was a marathon runner, who noticed that after long races he and his friends felt “drained” and some came down with colds. He took blood samples pre- and post-marathon race and found on numerous occasions that specific immune cells such as lymphocytes dropped dramatically after races – leaving persons (himself as well) more likely to come down with colds. So, his response was to train accordingly and get plenty of rest in days after races.

His second area of research looked at the chronic effects of exercise on the immune system, such as white cells, natural killer cells, and other specific immune groups. His conclusion after his research is that exercise does stimulate immune cell function, and this may help in persons with cancer (immune damage due to chemotherapy), and other metabolic diseases.

Today’s Immunity

Over this same 30 years the nation has gotten fatter, lazier and sicker. To the point where many people have no idea that their diet and exercise regimens can actually improve their immune function – so they resort to medications.

Today we are faced with a COVID infectious disease, where many people literally fear for their lives. The crux of this report isn’t to cherry-pick statistics, or to point fingers, but the bottom line is that persons who are physically fit suffer much less severe symptoms of COVID, the flu or other infectious diseases than sedentary counterparts.

The immune system is one of the strongest areas of biology that cement the strength of regular exercise. Along with changes in blood chemistry and telomere length, immune changes represent one of the foundations of clinical exercise benefits for young and old. Especially old.

Why Americans Should Start Exercising

Physical fitness has been left out of the discussion relating to COVID. This, along with proper nutrition and supplementation are not only NOT mentioned in the media, but many are disregarding the basics in favor of specific medical therapies.

Exercise should be touted if not for just ONE area of concern – and that is obesity. As one of the main comorbidities for severe COVID, losing weight would reduce severity in many people. This alone would reduce the burden of the disease from a death, healthcare expense and severity aspect. Of course, there are other complications relating to COVID, but in general, exercise has many positive effects, with few side effects. Its contribution to enhancing immunity is one of the biggest attributes.

Using proper assessment and outcome metrics, trainers and coaches can correlate the effects of their programs with other health and medical scores (such as a change in blood sugar or blood pressure each session, or loss of body fat over a one-month period). These are important because they will correlate to changes in overall blood labs, which will have both an acute effect (reduction in the risk of heart attack, stroke, or asthma attack), or long-term effects, such as reduction in diabetic complications, risks of falls, and peripheral vascular disease. Trainers may not understand just how powerful regular exercise can be for specific medical populations, but since the 1970s, the data is clear that exercise has an effect on almost every type of medical condition – even relatively new conditions to exercise training such as autism and Ehlers-Danlos Syndrome.

If we understand that just a moderate amount of exercise will improve circulation enough to enhance the immune system, then we should be detailing it to new members as they come into the health club setting.

Why Health Clubs Need to Open – and Stay Open

Even mom and pop clubs can play a role in improving health.  The first is to have a member tracking system that can keep people coming to the club, at least twice a week. For health’s sake, perhaps 3-4 days per week would be preferable.  The “essential” label is a bit misleading because there are no true metrics for what an “essential” business may be (outside of trash collection, medical triage, and grocery stores). Clubs can position themselves through medical fitness and in the near future, have the technology and assessments necessary to look at health outcomes as persons who normally would not be in a health club see the benefits of a medically based program that will cater to their needs while improving their health along the way.

Eric Durak is the President of MedHealthFit, and founding partner in the Fitness Is Medicine Initiative. He is a 35- year veteran of the health industry. He has worked for health clubs, medical research centers, and continuing education. He has been at the forefront of the medical fitness movement and appreciates the opportunity to work with MedFit Network to move medical fitness to the forefront of health care.  Email him at edurak@medhealthfit.com




Safely Returning to Exercise Post-COVID-19 Illness

The world of exercise and fitness was struck hard by the COVID-19 pandemic, taking access to gyms and fitness centers away for a period of time. With these facilities returning to their open availability, many individuals who personally experienced having COVID-19 have been posed with the question of when is it safe and okay for them to return to exercising again. Factors to consider include, of course, not wanting to spread the virus. But from a medical perspective, when is the body ready to safely return to exercising?

Internally, the immune system has just been through warfare depending on the strain and severity of the contracted virus, so the first consideration is feeling confident that symptoms have been eradicated during normal daily living activities, before venturing on to performing more strenuous or even mild/moderate forms of physical activity. COVID-19 affects the lungs (respiratory system), causing severe inflammation. Normal functioning of taking in oxygen and releasing carbon dioxide becomes impaired when the virus impedes by increasing fluid in the lungs and inflammation. Therefore, breathing becomes the common exercise inhibitor when first getting back into movement patterns. In fact, the CDC estimates that 3-17% of COVID-19 patients develop a complication known as Acute Respiratory Distress Syndrome (ARDS). A simple test for readiness is trying to walk quickly for 500 meters without feeling breathless or fatigue. From this self-assessment, endurance and intensity can progressively improve.

Returning to strength training can be challenging when considering cardiac output and fatigue depending upon resistance training goals and modalities. Therefore, it is best to work in the endurance phase for 2-4 weeks prior to strength or power training. This will help prepare the body for more intense training as well as let the body adjust to feelings of fatigue and breathlessness that might occur. A negative COVID test does not equate to the body returning to its normal workload capacity right away. Patience is key and although this can be a frustrating feat for athletes and avid gym-goers alike — movement is medicine but overtraining in sub-optimal conditions only prolongs the perceived setback.

There is no exact timeline upon returning to exercise post-COVID, but one way fitness professionals and individuals can gradually and safely do so is to utilize the “Rate of Perceived Exertion” to modify and accommodate for any potential risks. An example of this is the Borg Rating of Perceived Exertion (RPE), using a scale of 6-20 with 6 being no exertion and 20 being maximal exertion. Realistically working between 6 and 11 to start and pacing oneself to 12-15 and above is a good road map. Wearing a heart rate monitor can also be helpful with the understanding that if you are working at a higher level than what your lungs currently want to or can even do, taking resting breaks before returning the exercise is recommended. Exercising over time will help repair the body’s systems to again function as efficiently as before.

Megan Johnson McCullough is the owner of Every BODY’s Fit in Oceanside CA. She is a NASM Master trainer, holds an MA in Physical Education & Health Science, and is a current candidate for her Doctorate in Health and Human Performance. Megan also holds specializations in Corrective Exercise, Senior Fitness, Fitness Nutrition, Drug and Alcohol Recovery, and is an AFAA Group Exercise Instructor. She’s also a fitness model, professional natural bodybuilder, and published author.



  • Salman, D., Vishnubala, D., Le Feuvre, P., Beaney, T., Korgaonkar, J., Majeed. A. et al. (2021). Returning to physical activity after covid-19. BMJ, 372:m4721. doi:10.1136/bmj.m4721
  • Yale School of Medicine (2021). Challenge 5: How does covid-19 affect the respiratory system? https://medicine.yale.edu/coved/modules/virus/respiratory/



Pandemic Proofing our Muscles

My first published article as a medical fitness pro (30+ years ago) was “Muscles…our True BFF (Best Friend Forever) in Life.” Fast forward over 30 years later in a global health pandemic, this is even more critical. Alas, our  muscles have not prospered as Netflix and liquor sales.

We all know that muscles exemplify  “use it our lose it.“ Fascinating study  August 2020:
“Exercise Induces Different Molecular Responses in Trained and Untrained Human Muscle”

Conclusion: “…several key regulatory genes and proteins involved in muscular adaptations to resistance exercise are influenced by previous training history. Although the relevance and mechanistic explanation for these findings need further investigation, they support the view of a molecular muscle memory in response to training.”   

Our “muscle memory” speeds the process by which we regain our former muscular strength and size. This merits the word “awesome”.

What an evolutionary advantage to regain muscle mass, for both physical and mental health.  Survival of the fittest in action.

Before the pandemic, studies showed 60% of US adults do not strength train. We are our own worst enemies.

During the COVID pandemic: Working from home, not getting up and going out to work — various factors have made us more sedentary. A study from eMarketer said TV viewing dramatically increased this year, ending a 9-year steady decrease in television viewership.  Studies show there’s been a 32% reduction in physical activity this year, and not surprisingly, another poll says 53% of people struggle with mental health issues due to the pandemic. 

Sitting truly is the new smoking.

I think gyms were closed more in 2020 than they were open. Many of us love the gym — a real adrenaline rush. Many people are dependant on the gym for exercise, whether it’s to see their trainer, attend a class, discipline, motivation. The fallout: this pandemic has been more of a sit down than a lock down!

If there is ONE thing, COVID has taught us: Adaptation, the ability to change to our environment, is truly paramount to survival. 

Exercising and working our muscles is a vital part of preventative health, even more so now. Muscle wasting is a product of aging, too much tush time and many diseases, including COVID.

Pop exercise advice always mentions get 10k steps per day”. And yes, “strength train 2-3 times per week”. Sadly, the perception of strength training is that it must be with heavy barbells and machinery at the gym. No gym, no strength.

May I suggest we encourage muscle mindfulness? Working our muscles is not just for “exercise time”. We can encourage muscle work in many forms, multiple times per day. Just like we eat, use the washroom, have screen time… let’s help people anchor some muscle time to daily activities. 

Example: cooking in the kitchen –  hang on to the counter and give me 10 squats.

Muscles are a key factor in our metabolic equation. Increasing our muscle mass boosts our resting metabolic rate,  burning more calories at rest, not just during exercise. Muscles help balance hormones such as leptin, insulin, estrogens, androgens and growth hormones. These are all imperative for appetite control, cravings, metabolism and body fat distribution and management. At the ripe old age of 30, we start to lose muscle mass (sarcopenia) unless we are mindful to nurture it. And yes, people over 90 can still build muscle mass. 

Amongst the many functions of our muscles is utilizing the glucose in our blood, therefore reducing blood glucose levels, irrelevant of the presence of insulin. 

Diabetes is an inflammatory disease. Type 2 diabetes causes the body to become less sensitive to insulin, and the insulin resistance leads to inflammation. A vicious cycle.

  • 1 in 3 people in the US are pre-diabetic
  • Most people are unaware of their diabetes
  • 13% of the population has diabetes
  • 42% of the population are obese

Diabetes is a gateway disease. It is a red flag for the potential to develop other diseases such as heart disease, cancers, kidney disease, eye issues. As I mentioned before, insulin resistance leads to greater levels of chronic inflammation, which greatly increases the risk of all of our plaguing chronic diseases. 

Lowering chronic inflammation has been the focus of my medical fitness journey, research, coaching and published work. Getting people to move “chronic inflammation” into their daily vernacular, permanently affix it to the top of their health wish list has been my professional raison d’être.

My last article here on MFN was all about chronic inflammation, how it is at the root of all of our chronic illnesses, mental & physical: diabetes, many cancers, mental health challenges, heart disease, arthritis, prostate issues, Alzheimer’s, neurodegenerative disorders… and yes, COVID-19. One line here: Please don’t get caught up in pop anti-inflammatory diets causing people to eliminate vital food groups.

The inflammatory response of COVID-19: The severe reactions to the virus happen more in seniors, and those with diabetes or obesity, or other preexisting inflammatory issues. No coincidence. COVID provokes an exaggerated immune response, excessive inflammation and inflammatory products called cytokines – the infamous cytokine storm. Exercise is a crucial factor in controlling inflammation – moderate cardio (NOT long high-intensity cardio, which actually can increase chronic inflammation) and preserving muscle. 

So just how important is it for us to encourage our clients to build muscle? Obviously, it is HUGE, and unfortunately, most people do not focus on muscle work.  It is our job as MedFit pros, friends and family, to demonstrate how to creatively and seamlessly incorporate muscle mania into their daily lives — yoga, Pilates, resistance bands, dancing…

The COVID pandemic is going to have far-reaching complications for many years to come. Adaptation is key. Integrating muscle work throughout the day along with other activity bodes well for lowering our levels of inflammation — helping to pandemic proof our bodies. Don’t just depend on a vaccine, we could have a new normal for a while. Preventative health is more important now than ever.  Our muscles are truly our BFF. 

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public. She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation. Shira is now a product specialist with a major COVID-19 test kit supplier, working with epidemiologists educating people on COVID testing, and setting up and designing protocol for COVID testing clinics


Deliberate Wellness at Home

In the daily grind of life, it can be challenging – between doctors appointments, grocery shopping, meal prepping, upkeeping your home – to prioritize what benefits your wellness and wellbeing. Things like enjoying healthy meals, making the time to go out for a walk, maybe even taking an art class – these activities take deliberate effort, planning and determination to find, coordinate and attend.


Marching Forward in 2021

Everyone in the industry knows how tough 2020 was regarding work, planning, staffing, and getting by. While many in the industry look to digital and video health programs, the integrity and growth of the fitness industry by no means will mean that health clubs will be a thing of the past (Segran – 2021). On the contrary – clubs will play a critical role in changing the face of healthcare in the United States – which is also on life support. The recent article by Elizabeth Segran in Fast Company states that many Americans will forego health clubs in favor of other types of exercise. She states that 59% of Americans won’t return to health clubs. This may be 59% of current health club members, and not the 65% of Americans who don’t belong to health clubs.


Pregnancy and Childbirth During Unprecedented Times

Being pregnant and having a baby is stressful on its own. Now imagine being pregnant and delivering a baby during a global pandemic. Being a mother myself and treating pregnant women and new mothers, I recognize this population struggles with support, proper healthcare (especially postpartum), isolation and they may have limited resources at their disposal. It is important to understand that for many of these women the unexpected turn of events, has left them disappointed and it has affected the entire pregnancy and postpartum experience affecting both their mental and physical health. 

Adult woman indoor at home smart working using computer

Regaining Physical Fitness in a Post-Pandemic World

Yes, I know we’re still dealing with a life-changing pandemic around the world and especially in most areas of the United States, but it is still worth thinking ahead to what comes next. Despite a current focus on non-gym fitness trends (see an article in Time [1]), it is more than likely that many of us have experienced a change (most often a decrease) in our daily physical activities and, subsequently, in our aerobic and muscular fitness levels.