How’s it going guys, this is my first post here, but I’m curious to your approach will obese clients in terms of strength training. I currently have a relatively large client base/following and want to pick some ideas from the trainers here.
Currently having them focus on getting activity increased, obviously diet/nutrition is the main focus, and then having them start on a light upper/lower 3x a week split just learning basic movement patterns.
Curious to hear other approaches as I want to help these people out the best I possibly can.
Apologies in advance for the length of this reply!
I’m not a trainer, but I was said obese client roughly a year or two ago, so I have a few suggestions to share.
Depending on their overall condition, obese clients face several significant problems:
They very often severely lack strength, despite the fact that they often think they must be strong to be able to move their bodyweight around all day. This is often not the case. I thought this, and once I had lost roughly 45 kg (roughly 100 lbs), I was shocked to discover that I had gone from Homer Simpson directly to Mr. Burns — I was a skinny, decrepit old man underneath the fat. Okay, you already know how to address a lack of strength.
They lack range of motion. This is one that many trainers forget, and that can be extremely demotivating for the client. Something like (bodyweight or weighted) squats or RDLs are a problem when the person’s stomach gets in the way of their quads, reducing the range of motion that’s possible. This doesn’t mean that the squat isn’t worth performing — it very definitely is — but the reduced range of motion is okay until the client loses enough weight to permit increasing it. None of this ass-to-grass nonsense for these clients. Let the clients find a comfortable bottom position for the squat and then slow the movement down a bit, so that they slowly go lower after they’ve reached the bottom position over the course of their reps. Over time — and this will take time — range of motion will improve dramatically this way.
Among other muscles, they often have extremely tight hip flexors from being sedentary for so long, which also severely limits range of motion. This makes it extremely difficult to do exercises that require an increasing stretch, like reverse lunges (or forward lunges, for that matter, but those are very hard on an obese person’s knees). As with the range of motion problem, the solution here is to slow down the movement, and allow them to come to the full stretch they can manage slowly over the course of the rep, which will also improve over the course of the reps and set(s). Over time, this works wonders for improving ROM and flexibility.
Any exercises done prone, for example those done for core training, are going to be a problem because the clients will struggle to breathe with their stomach pressing on their lungs and diaphragm. An alternative might be to substitute standing exercises of relatively light difficulty, like standing leg raises, instead (I had to do this in the beginning).
As with items 2 and 3, above, they have relatively stiff joints and tendons, and for some exercises, it may take a relatively light warm-up set or two before a comfortable work set is possible, but they will fatigue very quickly, so don’t overdo it. At first, focus on the improvements over a longer period of time rather than from one workout to the next.
Progress will be slow. Very slow. Extremely slow. Much, much slower than for a person of normal weight. Set expectations (both for them and for yourself) accordingly. This is about months and years, not days and weeks. They must forget everything they’ve read about x weeks to some result. It took me two years just to get to a place where I could even lift my own legs without assisting with my hands, for example to get into or out of the car, and I absolutely could not do Russian Twists during that time. I worked on getting to a place where I could hold one leg up while tying my shoelaces, for example. Pathetic as this sounds, it really worked over time (and it took a long time!) to get me to a place where my hip flexors and associated tendons were flexible enough, and my quads strong enough to make this possible.
Nutrition is going to be a challenge. The biggest mistake these clients can make (and I made this mistake too) is to reduce calories too much, which leaves you so severely lacking in energy, so that you can just barely manage your workouts, but you have nothing left after that and end up lying on the couch all of the rest of the day. On some days, even the workouts are almost impossible, and so you end up skipping days, or even dropping out altogether.
I suggest following CT’s formula for adjusting calorie intake, outlined here, except that I made the mistake of going directly to 9 calories per pound of bodyweight (he suggests starting at 11):
I found it helpful to think of what I was doing as physiotherapy rather than a workout. This is because I was at such a deficit, relative even to an absolute beginner, and understanding this helped me be more patient about my progress, and less embarrassed about my perceived lack of progress. It really is about learning to move, in the same way that a patient learns to walk after a severe accident.
On the psychological side, it’s also important for the clients to learn to discover joy in their body’s ability to do things. I managed to get myself to do my workouts each day by focusing on how good the movement itself felt (to this day, I’ve never met the elusive endorphin whose rush I’m supposed to feel after the workout is done). I literally got myself up off the couch by saying, “Now it’s time for good feelings.” And I got myself through the workout itself by turning it into a game and doing whimsical things, like high-fiving myself during a rest period, or pretending to fly like Superman on the air current blowing towards me from the fan or air conditioner. These seem like small, silly things, but they are huge in reframing the obese clients’ relationship with their own body — and may be even more important than the exercise itself for the clients learning to love what their bodies can do, and how good they can feel doing it.
This helped me stick with it long enough to get to a place where one day I could do a slow, controlled push-up, elevated on a stair. It was the first time I could do one without feeling like I was going to be crushed by my own weight, and silly as this sounds, it made me feel like a gymnast. I will never forget the sheer joy of that moment!
Loads of great points. I’ve been shockingly out of shape myself and I’ve seen trainers try to put obese clients through some sort SEALs prep, it didn’t seem to work as you didn’t see them for very long.
Focus on what they can do well and protect their joints.