That tough first step
There’s no trick to joining a gym. Take a tour, sign a contract and you’re in. But for the obese, just getting through the turnstile or putting on a bathing suit can be a daunting prospect.
Extremely heavy people may need more than others when starting an exercise program -- more help with equipment, more motivation, more direction in setting up a workout. Whether they get that help depends on the gym. Some fall far short of dealing with the needs of severely overweight members; others have an agenda in place.
But as obesity levels climb, more gyms are reaching out to overweight members with specially tailored programs and classes.
The offerings vary, from support groups at YMCAs and community centers to low-impact aerobics classes and personal trainers at large gyms; nutritional and lifestyle guidelines at private facilities; and thorough medical evaluations at hospital-affiliated fitness centers.
Many commercial gyms employ certified personal trainers who have knowledge and experience in working with obese people in setting goals, starting an appropriate fitness program and providing basic nutritional guidelines. Gyms also have a variety of classes for overweight and severely out-of-shape people, such as pool workouts and low-impact aerobics.
But not every personal trainer has worked with extremely overweight clients. Left to set up their own programs, obese people could injure themselves, or get bored and frustrated, ultimately quitting. Also, some exercise machines may not accommodate very heavy people.
When Judy Painter did a brief stint at a big gym chain several years ago, she says, “I never felt comfortable.” Painter, a retiree from Los Angeles who then weighed more than 200 pounds (her heaviest weight was 300), attributes part of her discomfort to the fact that “everybody else was skinny and I was the largest person there.” Personal training was never recommended.
John Jakicic, director of the Physical Activity and Weight Management Research Center at the University of Pittsburgh, believes most gyms do offer a wide variety of programs and equipment that are appropriate for obese members, but says they could do a better job of addressing more than just exercise.
“Exercise is only one part of what these people need,” he says. “I think these facilities lack in two areas -- nutrition and behavior change. These people have so many barriers that you have to show them how to adopt and maintain behaviors. You have to be a kind of rah-rah coach and address the obstacles they face.”
Personal trainers often can help define goals and set up a suitable regimen, demonstrate equipment, suggest classes, provide motivation and give broad nutritional instruction. But their certifications can range from ones obtained over the Internet to those that require a bachelor’s degree in a field such as kinesiology or exercise science, plus many hours in the field. Even the best technical training may not be enough. “Working with someone who is truly sensitive to their needs is critically important,” says Richard Cotton, an exercise physiologist and spokesman for the American Council on Exercise. “That goes beyond certification. It’s the maturity to be a good listener.”
At Bally Total Fitness clubs, private training is recommended to new members who are obese (after an OK from their doctor), with the idea that they may need more help than does an experienced exerciser. Those trainers, says Mike Divello, Bally’s director of personal training, should have experience with this population and be able to get them started safely on a program (one free session is given to all members). Those who opt to go it alone can choose from a variety of low-impact or aqua-aerobics classes at clubs with pools.
Those aqua-aerobics classes are great for overweight people, but there’s a drawback, says Hollywood YMCA Executive Director Mark Dengler: being seen in a bathing suit in public.
The Hollywood Y has taken steps to ease their discomfort. It offers a class called “Plus,” a movement-based routine that emphasizes stretching and nonimpact motion. It originally was developed for Parkinson’s patients eight months ago, but was opened up to overweight members; now they constitute half the class.
Even more successful, says Dengler, have been support groups offered at some Ys that emphasize sticking to fitness programs. Support, he adds, can be even more beneficial than sessions with a trainer who is “typically going to be a younger person who already looks fit.” He adds: “This gets them [overweight clients] in a program with other people who look like them.”
That comfort level is what brings some obese people to Sportivo, a private training facility in Los Angeles. Since it opened more than three years ago, owner Bobby Cipolloni and other trainers have helped about 60 severely overweight clients, whom he refers to as “people of size.”
New clients aren’t forced to be weighed (a common practice in some gyms) and are assured that they will feel accepted and that other patrons won’t stare at them. Trainers specializing in obese people offer compassion and “rigor,” as Cipolloni puts it -- a low tolerance for excuses. He’s taken clients on field trips to restaurants and grocery stores to help them make wise food choices.
One client, Cipolloni recalls, was thrilled he could get socks on his feet. “It’s basic things like that,” he says. “You’re getting them to move again, bend again.”
So far the program has worked for Painter, who has lost 60 pounds since she started training there three years ago. “Bobby’s there for praise, hugs, smiles, but he also cajoles and nags,” Painter says. “It’s all done with caring and humor. I’ve always felt like it was my place.”
In the foreseeable future, most fitness experts agree, both commercial and community gyms will offer more programs and classes for obese members. Bally Total Fitness is piloting a weight-management program in the Chicago area that includes nutritional information provided by a registered dietitian, plus group support.
“It’s probably very difficult to take that first step,” says Bally’s Divello, “and hopefully we can make our environment more comfortable for these people.”