Currently, health clubs offer a variety of cardio and strength options. They offer a plethora of equipment and classes yet attrition remains high. By combining the science of cardio and strength training with a motivated and energetic instructor new programming combining….
Each year for the past several decades, the health & fitness industry has served approximately 20% of the population, primarily helping the fit get fitter. Eighty percent of the population joined a health & fitness center but did not stay, or never joined because they decided it was not the right fit for them. A movement is gaining momentum to change that, and to make the health & fitness industry more inclusive and welcoming of people of all different ages, shapes, sizes and abilities.
Worldwide, rates of obesity have tripled in the past 45 years. More than 42% of Americans have obesity, with the prevalence in the United States rising over 12% in the last 18 years. This presents an untapped opportunity for fitness professionals with specialized knowledge and expertise in working with clients with obesity.
Dr. Rachele Pojednic and I have developed a MedFit Classroom Specialist Course. Presented in 10 modules and requiring 10 hours to complete, the Obesity Fitness Specialist course defines obesity and weight bias and identifies the biological, developmental, environmental and lifestyle factors that contribute to obesity. It explores solutions to obesity using the Socioecological model and empowers fitness professionals to be a part of individual-level, as well as institutional- and community-level, solutions.
Learners will be able to position themselves as obesity fitness specialists separate and distinct from weight management and weight loss specialists. They will be able to create safe and effective programming for clients with obesity and inclusive environments that can lead to sustained client behavior change and health outcomes. The course culminates in a 10-step roadmap with one end goal—obesity fitness specialists who can help their clients reduce their risk of obesity-related risk factors and associated disease, discover the joy of movement, and reap the many health benefits of physical activity.
People with obesity who find health & fitness environments where they feel welcome and included are likely to stay. Fitness specialists who are able to lead with empathy and build trust are likely to make their clients feel understood and heard. Obesity Fitness Specialists have an important role to play in helping their clients with obesity achieve their health & fitness goals.
Dr. Amy Bantham, DrPH, MS, MPP, is the CEO/Founder of Move to Live More, a research and consulting firm addressing physical inactivity, chronic disease and social determinants of health through cross-sector collaboration and innovation. A certified health and wellness coach, personal trainer, and group exercise instructor, Amy holds a Doctor of Public Health from the Harvard School of Public Health. She can be reached at movetolivemore.com or @MovetoLiveMore
Heart rate variability (HRV) is a measurement of the variation in time between successive heartbeats.
HRV is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, which work in opposition to regulate our body’s functions. The sympathetic nervous system is responsible for our “fight or flight” response, while the parasympathetic nervous system is responsible for our “rest and digest” response.
A higher HRV indicates that the parasympathetic nervous system is dominant, which means that the body is in a state of relaxation and recovery. A lower HRV indicates that the sympathetic nervous system is dominant, which means that the body is in a state of stress and exertion.
HRV is a valuable tool in assessing overall health and identifying potential health risks. It is affected by various factors, including age, fitness level, stress levels, and sleep quality. As we age, our HRV tends to decrease, and this decrease is associated with an increased risk of developing chronic health conditions.
Research has shown that a low HRV is associated with an increased risk of mortality from various health conditions, including heart disease, diabetes, and cancer. Monitoring HRV regularly can help identify potential health risks and enable us to take steps to address them.
A “good” HRV varies depending on a person’s age, fitness level, and overall health. Generally, a good HRV falls between 60 and 100 ms. This range varies depending on age:
| AGE GROUP | AVERAGE HRV |
| 18-25 | 62-85 ms |
| 26-35 | 55-75 ms |
| 36-45 | 50-70 ms |
| 46-55 | 45-65 ms |
| 55-65 | 42-62 ms |
| 66+ | 40-60 ms |
HRV tends to decrease with age, and this decrease is attributed to a decrease in parasympathetic nervous system activity. This decrease can be more pronounced in individuals with chronic health conditions or who lead sedentary lifestyles.
Chronic health conditions, such as heart disease and diabetes, can negatively impact HRV. Furthermore, lifestyle habits such as smoking, excessive alcohol consumption, and a poor diet can also have a negative impact on HRV.
Stress, whether physical or emotional, can decrease HRV. Poor sleep quality or sleep deprivation can lead to a decrease in HRV, as the body is unable to fully recover and recharge.
Certain medications, including beta-blockers used to treat high blood pressure and heart conditions, can significantly decrease HRV. (If you are taking medication and are concerned about its impact on HRV, we recommend speaking with your healthcare provider.)
Regular exercise has been shown to increase HRV, especially high-intensity interval training. Engaging in regular physical activity improves heart health and can positively impact HRV. It is important to note that overtraining can have the opposite effect on HRV, so it is important to find the right balance between exercise and rest.
Regular relaxation and stress management techniques can help counteract the effects of stress and improve HRV. Relaxation techniques such as progressive muscle relaxation and guided imagery can help reduce stress and increase HRV.
Getting enough quality sleep is essential for overall health and can increase HRV. Consistently getting 7-9 hours of quality sleep each night can improve HRV.
Eating a balanced diet rich in whole foods can improve overall health, which can in turn increase HRV. Foods that are high in omega-3 fatty acids, such as fish and nuts, have been shown to increase HRV. Conversely, a diet high in processed foods and sugar can have a negative impact on HRV.
Limited alcohol and caffeine consumption. Caffeine can increase heart rate and activate the sympathetic nervous system, while alcohol can have a depressant effect on the parasympathetic nervous system. Limiting alcohol and caffeine intake can positively impact HRV.
Pilates is a total body exercise method that is highly effective for strengthening and lengthening the entire body. While Pilates is mostly known to improve core strength (the “Powerhouse”), posture, and range of motion, this exercise method can be used to improve respiratory function in those suffering from respiratory diseases. Respiratory diseases include asthma, COPD, chronic bronchitis, emphysema, lung cancer, cystic fibrosis, pneumonia, and now COVID-19. These diseases affect the way one breathes and lowers oxygen saturation that the body needs to function properly. One of the main principles in Pilates is breathing, thus the need to take a closer look at the effects of Pilates on respiratory function.
Joseph Pilates, the creator of Contrology, stated in his book Return to Life Through Contrology: “Lazy breathing converts the lungs, literally and figuratively speaking, into a cemetery for the deposition of diseased, dying and dead germs as well as supplying an ideal haven for the multiplication of other harmful germs.”1
The literature is scarce and sometimes conflicting about the benefits of Pilates breathing related to the respiratory system. However, there are some existing studies that look at the increase in lung volumes, respiratory motion, SpO2, and the reduction in respiratory rate using Pilates breathing exercises. More research needs to be conducted. Refer to suggested reading at bottom of article.
Fitness Professionals & Personal Trainers: Become a Respiratory Disease Fitness Specialist!
Some of your clients may suffer from a respiratory disease and you may be an important source of relief. The Respiratory Disease Fitness Specialist online course will equip you with the knowledge to safely and effectively work with these clients to help improve their quality of life.
CarolAnn, M.S. Exercise Science and Health Promotion, is a 30+ year veteran in the fitness industry educating other health/fitness professionals to increase their expertise and brand influence. She is on the MedFit Education Advisory Board and the head health/fitness educator for FiTOUR. She is currently the Head Instructor at Club Pilates in Athens, GA.
Suggested Reading
References
Our heart is at work literally 24/7 for us and without it doing this constant job for us, well, we know the consequences. An irregular heartbeat (arrhythmia) can pose complications that increase the risk of having a stroke or even heart failure. It can be frightening for someone and can also impact their daily living.
Weight management is a, if not the, Holy Grail of lifestyle change for many, especially for women. Not that men don’t seem as concerned about their weight; it’s just that many men don’t see themselves as overweight when they look in the mirror – they see the same kid who played ball in high school.
Normally, I do not like to focus on weight loss. In taking a health professional’s perspective on weight, it’s just a number…until it’s not.
That is, focusing on weight is an excess we in the West – the wealthy, industrialized, relatively-safe from famine and disaster societies – tend to overindulge ourselves with. But, for those same reasons, we also are prone to illnesses and diseases that correlate with our lack of food scarcity. Thus, watching one’s weight is synonymous with watching one’s health unless one goes to extremes such as with eating disorders/disordered eating.
With this in mind, the advent and profusion of interest and usage of anti-obesity medications (AOMs) such as Wegovy, Ozempic, etc. are worth addressing.
As this blog post from the American College of Sports Medicine by Renee Rogers, Ph.D. FACSM (Dec. 18, 2023) discusses, the health and fitness professional (HFP) might feel threatened by a flurry of OAMs that might detract from his/her potential market. People who are trying or need to lose weight can now do so without having to engage the services of the HFP. In her essay, she notes that OAMs do work very well but that permanent weight loss and subsequent health and functionality still depend on maintaining a fit and strong body.
Also, now that we have meds that prove, essentially, that weight loss is not simply a function of willpower – that, because they work by effecting hormone changes that signal the brain and the GI system that they are not hungry, overeating is not necessary (excuse the simplification), people can now attend to engaging in healthful exercise and activity for other purposes: health (obviously), fitness, energy, fun, etc.
Finally, allow me to introduce Sheila Olsen, a freelance author on topics pertinent to health, fitness, and diet. Below is her excellent and well-researched review of weight loss for women. Thank you, Sheila, for reaching out to me and offering to contribute to the STEPS Fitness blog:
Being healthy and at a healthy weight is important for everyone, but women have different health concerns than men and often lose weight differently.
The Differences
The biggest reason why men and women lose weight differently is hormones. For women, hormonal changes due to menstruation, pregnancy, and menopause can cause them to gain or lose weight. In addition, the hormones that control a woman’s appetite and metabolism are different from those that control a man’s. This means that women often have a harder time losing weight than men.
Another reason why women and men lose weight differently is that they tend to eat differently. Men are more likely to eat high-calorie foods and snacks, while women are more likely to snack on healthier foods like fruits and vegetables. This difference in diet can also lead to different rates of weight loss.
Though there are many reasons why women and men lose weight differently, the most important thing is that both sexes should focus on eating healthy foods and exercising regularly. By doing this, nearly everyone can achieve their goals for healthy weight loss, or at least healthy living.
Personal Training
Personal training services are specifically designed to support women on their weight loss journey, offering tailored fitness programs that cater to individual goals and needs. With a focus on sustainable and healthy weight loss, these services include one-on-one coaching, nutritional guidance, and customized workout plans that are both effective and enjoyable. The experienced trainers at Steps Fitness understand the unique challenges women face in losing weight and are committed to providing the motivation, support, and expertise needed to achieve lasting results.
Working Out at the Gym
Another great strategy for losing weight is to join a gym. Gyms offer a wide variety of machines and classes that can help you lose weight and get in shape. When working out at the gym, include cardio exercises such as running or elliptical training. Strength training is also crucial because it will help you build muscle mass, allowing you to burn off calories throughout the day.
Eating Mindfully
To lose weight, you must be mindful of the foods you eat. This means choosing healthy foods that are low in calories and fat. Diets high in processed foods and sugar can lead to weight gain, so it’s important to avoid these types of foods when trying to lose weight. Instead, focus on eating fresh fruits and vegetables, lean proteins, and whole grains. Additionally, be sure to drink plenty of water as this will help you stay hydrated and full throughout the day.
Consuming Caffeine
Caffeine is often highlighted for its potential effects on weight loss, especially among women, due to its ability to increase metabolism and enhance fat burning in the short term. Moderation is key, as excessive caffeine consumption can lead to unwanted side effects, so understanding and managing intake is crucial for leveraging caffeine’s benefits for weight loss effectively. For women considering caffeine as a part of their weight loss strategy, it’s important to be aware of the caffeine content in their favorite beverages. Online resources can be incredibly helpful for this, offering detailed information on the caffeine levels in various drinks, from coffee and tea to energy drinks and sodas. By consulting these resources, women can make informed decisions about their caffeine intake, ensuring it aligns with their health goals and dietary needs.
Staying Hydrated
As mentioned above, staying hydrated is key to losing weight. Drinking plenty of water throughout the day will help you feel full and satisfied so that you’re less likely to snack on unhealthy foods. In addition to water, green tea is an excellent beverage for weight loss as it contains antioxidants that can boost your metabolism. Aim to drink eight glasses of water or green tea per day.
Choosing the Right Health Insurance
Health insurance is an important factor to consider when it comes to trying to lose weight. Choosing the right health insurance plan can help you by providing meaningful support and resources that can make a huge difference in achieving your weight loss goals. Insurance plans can provide access to effective nutrition counseling and consultations. If you’re currently self-employed and not covered, you still have options. You can explore health insurance plans through the Freelancers Union or Affordable Care Act, or you can join your spouse’s plan.
Establishing SMART Goals
It can be helpful to establish SMART goals for your weight loss journey. SMART stands for Specific, Measurable, Achievable, Relevant, and Time-based goals. These goals should be realistic and attainable so that you don’t get discouraged along the way.
For example, a SMART goal might be “to lose 10 pounds in three months by eating mindfully and exercising three times per week.” This goal is specific (lose 10 pounds), measurable (three times per week), achievable (exercising three times per week), relevant (lose 10 pounds in three months), and time-based (in three months).
Managing Stress
One common health concern for women is managing stress. Stress can have many negative effects on your health including causing weight gain. When trying to lose weight, it’s crucial to find ways to manage your stress. Getting regular exercise, practicing meditation or deep breathing, journaling, spending time outside, and spending time with friends or family can all help.
How Surgery Can Help
Weight loss surgery, such as gastric bypass or sleeve gastrectomy, can be a beneficial option for individuals struggling with severe obesity and related health issues. These surgeries can lead to significant and sustained weight loss, helping to reduce the risk of obesity-related conditions like diabetes, hypertension, and heart disease. Furthermore, they often lead to improved overall quality of life and increased mobility for those who have struggled with obesity for an extended period, making them a valuable tool in managing long-term health.
Whether you’re working with a personal trainer, walking more often, or finding a better health insurance plan, these tips can help women lose weight in a healthy way. Remember, every woman’s body is different, so what works for one person might not work for another. The most important thing is to find what helps you and stick with it. With consistency and perseverance, you can reach your goal weight and stay healthy!
Originally printed on STEPS Fitness blog. Reprinted with permission.
Dr. Irv Rubenstein graduated Vanderbilt-Peabody in 1988 with a PhD in exercise science, having already co-founded STEPS Fitness, Inc. two years earlier — Tennessee’s first personal fitness training center. One of his goals was to foster the evolution of the then-fledgling field of personal training into a viable and mature profession, and has done so over the past 3 decades, teaching trainers across through country. As a writer and speaker, Dr. Irv has earned a national reputation as one who can answer the hard questions about exercise and fitness – not just the “how” but the “why”.
Musculoskeletal issues have become the number one reason for physician visits.(1) Doctors are starting to agree that many surgeries may have been unnecessary.(2) The opioid crisis is a symptom of a larger societal issue to be sure, but it appears that too many people are turning to pain medications to manage their various aches and pains. Certainly pain medication and surgery can help many diseases and symptoms. However, they can also have long-term detrimental effects on human health. Can supervised exercise contribute to helping the problems of too many surgeries and too many pain medications being prescribed?
The modern research on this subject continues to support the notion that properly dosed and executed exercise can have a long-term positive impact on pain and possibly reduce the need for surgery. Who in the health and wellness community conducts supervised exercise? The Personal Fitness Trainer and Exercise Professional.
Personal Trainers are sought out to create fun and challenging workouts, help people lose weight, or help athletes perform better for their sport. We feel that although important, this puts exercise professionals like personal trainers in too narrow of a box.
Can a Personal Trainer be more?
Can an Exercise Professional transcend these service niches and be considered part of one’s healthcare team?
We not only believe so, we think that we must.
Exercise has more power than we, and the exercise consumer, give it credit for. Exercise can stimulate powerful natural medicine to help individuals overcome chronic pain and possibly even avoid surgery.
Our goal is to trumpet this message to exercise professionals and consumers alike and work to support the development of the exercise professional to meet this demand. Our plan is to be one of the pioneers that move exercise to the forefront of healthcare as a powerful, and often overlooked, process to be integrated proactively within a healthcare team for supporting individual health where pain persists and surgery is being considered. Will you join us?
Article co-written by Greg Mack and Charlie Rowe of Physicians Fitness.
Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease.
Charlie Rowe has been in the fitness industry for almost 20 years, and currently a Muscle System Specialist at Physicians Fitness. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist. Charlie hold numerous certifications, including Cooper Clinic’s Certified Personal Trainer, NSCA Certified Strength and Conditioning Specialist, the ACSM Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and ACE Certified Orthopedic Exercise Specialist Certifications. Charlie’s experience and continued pursuit of education make him one of the best in his field.
References
(1) Musculoskeletal Injuries: A Call to Action and Opportunity for Fitness Professionals, ACE Prosource 2013 by Nicholas A. DiNubile, M.D.
(2) Doctors Perform Thousands of Unnecessary Surgeries. Peter Eisler and Barbara Hansen, USA Today. Published 3:25 p.m. ET June 19, 2013. Updated 1:34 a.m. ET June 20, 2013
Pain is a very personal and subjective experience. Modern pain science no longer views pain as a sensation; rather, pain is viewed as an experience that results from an amalgamation of inputs that are physical, psychological, emotional and social. These inputs must be viewed interdependently, because they all directly affect one another and the overall pain experience.
Researchers and clinicians have structured the bio-psycho-social (BPS) model of modern pain to better understand and treat chronic pain.
“Bio” represents biology, biomedical and/or biomechanical. This is the historical way chronic pain was treated—seeking disease, dysfunction or damage and then designing interventions that would address it.
“Pyscho” represents the current psychological characteristics of the chronic pain sufferer. This could include the individual’s beliefs about his or her situation, historical references related to past pain experiences, anxiety, depression and expectations about the future. Many of the psychological elements are influenced by family members and/or perceived experts or authorities (e.g., doctors, nurses, physical therapists and personal trainers).
“Social” represents the social implications of the pain experience. Social stressors relate to doubts that those around us don’t believe our pain is real and whether there is a social support structure in place. Additional stressors may be related to missing important social events, traveling or the inability to maintain employment or familial responsibilities.
The International Association for the Study of Pain defines pain “as an unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” The word “potential” is significant in this definition because it describes pain even in the absence of tissue damage.
In a 2018 paper, the Centers for Disease Control and Prevention (CDC) noted that 50 million Americans suffer from chronic pain and 20 million suffer from high-impact chronic pain. High-impact chronic pain is chronic pain that “frequently limits life or work activities,” according to the report.
As a health and exercise professional, the likelihood of working with clients who have chronic and/or recurrent pain is high. These are clients who have been cleared for exercise by their physicians and who have either completed or are currently involved with treatment by a licensed medical provider such as a physical therapist or chiropractor. Understanding evidence-based strategies for exercise and maintaining professional scope of practice provide an important service to this population. Exercise programming to reduce mechanical stress and improve movement confidence and function are well within our professional role. But at no time should a health and exercise professional attempt to treat or diagnose any condition or provide medical advice.
The growing body of evidence around pain is reshaping treatment approaches by medical professionals. As a health and exercise professional who will very likely work with clients experiencing chronic pain, understanding the bio-psycho-social paradigm and what it means in reference to program design, communication and expectations are paramount.
One of the most effective strategies for introducing physical activity to clients with chronic pain is to establish rapport, which in turn, may help relieve anxiety and fear and set expectations. Here are three strategies to get you started:
Pain is a complex issue and it is neither helpful nor accurate to approach client communication and programming from an outdated paradigm. The current bio-psycho-social model contains elements of biology, psychology and sociology, of which all must be taken into account for lasting, pain-free movement.
Article reprinted with permission from Anthony Carey.
Anthony Carey holds a Master’s degree in biomechanics and athletic training and is the inventor of the Core-Tex™. Anthony is recognized internationally as a leading expert in biomechanics, corrective exercise, functional anatomy and motor control. He was named Personal Fitness Professional Magazine’s 2009 Personal Trainer of the Year and has received recognition for his work in the national media, including the New York Times, Time Magazine and Oprah’s “O” Magazine.
Anthony has authored two best-selling books: The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulders and Joint Pain and Relationship and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community, and consults for the San Diego Chargers as well as some of the largest equipment manufacturers and health clubs in the world.
More people are starting to question the accuracy of the BMI (body mass index) measurement. Essentially, this is a measure of your weight to height ratio. Maybe this formula is outdated going back to Lambert Adolphe Jacques Quetelet’s 1832 development (your weight in kilograms divided by your height in meters squared). Popularity didn’t strike until the 20th century when insurance was being evaluated for risk potential and among specific populations.