Ok, almost to the end. Continuing from Training the Obese Beginner: Part 4 today I want to start start to bring together everything I’ve talked about in this series. First I want to address why I think the inclusion of both weight training and cardiovascular/aerobic training of some sort is important for the obese beginner along with why I think both should be done from Day 1 of the training program.
Then, I’m going to describe how I personally approached the first workout with the obese (and usually the non-obese) beginner in terms of structure along with talking about some generalities of training. I’ll finish up in Part 6 (next week) and talk about progressions in the weight room, on the cardio deck, etc.
Let me note up front that some of what I’m going to write simply represents what I did/found to work in this population when I was working as a personal trainer all those years ago; some of it will be more what I would do now were I still working with that population. You’ll note that nothing really would change now except in degree (e.g. I might do things a touch differently in the weight room in terms of rep ranges or total volume). Someone on the support forum asked me about stretching (mainly to address the issues that tend to come along with our modern life) and I’ll try to touch on that at some point as well.
With that out-of-the-way, I first want to look at what I feel are benefits of getting the obese beginner into weight training from Day 1 (when I originally wrote this series, I had apparently gotten some comments that had misunderstood what I wrote in earlier parts of the series).
As I mentioned in Training the Obese Beginner: Part 2, an under-appreciated fact is that the obese frequently gain muscle mass in the process of becoming obese. So while weight training can still play several important roles, putting an enormous amount of time and energy into it is, as I argued previously, somewhat misplaced. You should do some, but you don’t really need tons of it in this population.
So what are some of the benefits of including weight training in the training of the obese beginner?
Benefits of Weight Training #1: Enhanced Fat Burning/Calorie Partitioning
Well, one I already talked about rather extensively in previous parts of the series. Specifically, you can use weight training to begin depletion of muscle glycogen to start improving whole body fat utilization and the efficiency of fat burning pathways. A long with a lowering of carbohydrates/calories in the diet (often by just removing the most egregious foods from the diet), this can exert a powerful partitioning effect by giving the fatty acids (floating around in the bloodstream) somewhere to go to be burnt off.
Quite in fact, as I discussed in Adding Muscle While Losing Fat – Q&A, I suspect that one of the reasons that over-fat beginners can gain muscle while losing fat has to do with some of the dynamics of what’s going on physiologically due to the development of obesity. Now, realize that properly performed training is possibly the single most powerful tool we have to alter calorie partitioning (where calories go) with regular training increasing nutrient uptake into skeletal muscle in preference to other tissues.
So let’s look at a situation where obesity has progressed to a point where, due to the development of whole-body (and especially fat cell) insulin resistance, fat cells are effectively “pushing fat calories away” since they are full. If you now give those calorie a place to “go” through training, you see this situation where the body seems to shift calories away from fat cells and into muscle. Voîla, fat is lost while muscle is gained.
I’d mention again that, as the obese already have gained some extra LBM in the process of becoming obese, specifically trying to gain muscle mass usually isn’t much of a worthwhile goal. It happens but it’s really not the main “target” in this population and it’s not going to accomplish a whole hell of a lot (in terms of metabolic rate or fat loss).
It is worth being aware of as increases in muscle mass can offset scale weight changes (i.e. you’re gaining 1-2 pounds of muscle while losing 4 pounds of fat so the scale only drops 2 pounds) and make it appear as if fat loss is occurring at a slower rate. This tends to generally only be the case in the very early stages of beginner training but it’s something to let your clients know about sooner rather than later.
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Benefits of Weight Training #2: Improving Quality of Life
But beyond that, what are some other benefits of weight training in this population? One has simply to do with correcting many of the imbalances that occur as part and parcel of daily life. This was brought up in the comments to Part 3 and is important and worth consideration; never forget that health is (or at least should) be one end-goal of the whole process. And modern life tends to cause a host of problems as a function of sitting all day, etc. At least some of this can be addressed with basic weight training, improving people’s qualify of life.
This goes to my point in an earlier part about keeping the obese beginner coming to the gym until they notice some objective improvement which is sufficient to make them want to keep continuing. While most are focused on body composition changes, even a change in the relative ease of some aspect of their life is often sufficient to keep them coming back.
As an example of this, I remember specifically a client who I was working with who was getting frustrated with the lack of scale changes. Then, about week 3 (when most are losing faith) she went hiking with her husband and child. It was the first time she was able to keep up and carry her kid at the same time and she came into her next session ecstatic about it. That simple improvement in her life was enough to hook her.
There are other things that can be addressed as well. Going to the issue of stretching and mobility work in this population, keep in mind that full range weight training tends to exert a stretching effect. If you do rows through a full range of motion, you get a stretch to the pecs and anterior deltoids, helping to offset some of the postural issues that our modern life causes. Certainly in some cases you can add specific stretching work as needed but that’s kind of beyond what I can cover here. I’ll touch on it in the final part of the series.
In some cases you can also address very common injury patterns that tend to crop up. As another specific example: back in my 20′s, I couldn’t count the number of clients I had with minor knee problems (especially females) or shoulder problems that had persisted for years that went away with even the most basic of weight training. A set or two of end-range knee extensions (now I might use a different movement) and some basic shoulder re-balancing (stretch what’s tight, strengthen the external rotators) fix most of the issues unless there is an explicit injury; my clients always thought I was a magician when I fixed long-standing problems in 2 weeks with simple exercises.
Once again, outside of specific injuries, this usually doesn’t take much work in the weight room but that small time investment can go a long way in helping to convince the obese beginner (reminder: they frequently don’t want to be there in the first place) of how important exercise is because they notice that it’s making other aspects of their life better and/or easier.
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Benefits of Weight Training #3: Positive Reinforcement to Improve Adherence
There is another huge benefit to weight training that I think is often under-appreciated and really goes to the stuff I bored you with in Training the Obese Beginner: Part 4; specifically I’m talking about issues of positive reinforcement and adherence. As I’ve mentioned a few times in this series, as a generality, a lot of obese beginners don’t want to be in the gym in the first place (for various reasons). That’s why I argued that beating the crap out of them on day 1 is such a mistake; giving someone a miserable first experience when they don’t want to be there in the first place is a fantastic way to make them never come back.
But reversing that, on top of starting slowly, it’s equally important for such trainees to see damn near immediate improvements in what they are doing. This provides a positive reinforcement and psychological/physical reward that makes them want to keep coming back for more. And, as I found years ago, and still feel now, weight training, at least properly approached, provides that type of positive reinforcement in a way that aerobic training simply does NOT.
The problem is that aerobic adaptations tend to be fairly slow to occur; there’s just not the immediate bang for the buck that I found the typical obese (or non-) beginner needed to make them feel good and positive about what they were doing. It might be 3-4 weeks before someone really “feels” fitter during aerobic work and gets that first adaptation.
Given that some absurd percentage of beginners quit around the 3 week mark, that was simply too slow to make a difference; many clients would quit before they started to feel or see any real benefit. Even if they came out of every workout with positive affect due to proper intensity selection, I needed to make them feel as if they were making progress and moving forwards immediately.
And I found that I could get exactly that benefit with weight training. By approaching it in the way I’ll describe shortly, I made the trainee feel as if they had made improvements from the first to second workout. As you’ll see, some of this was a bit of trickery on my part but, you know what? I didn’t care. Whatever got them coming back was more important than a bit of deception to make it happen.
Basically, by picking exercises and weights that they could see immediate improvement in from the first to second workout, I generated a huge positive reinforcement effect. Rather than feeling as if they couldn’t do exercise or sucked at it or whatever mental state they carried in with them (based on either pre-existing expectations or simply past experiences), I got them an immediate feeling of success. Cardio didn’t do that quickly but weights did.
So there ya’ go, at least three solid reasons to include some resistance training from Day 1 of training the obese beginner: metabolic, functional and psychological benefits. There are probably more I’ve forgotten but, honestly, I think that’s enough reason to include it from the first day out. Again, you needn’t put overwhelming amounts of time and energy into it but I do think that weight training should be part of the training of the obese beginner from the start.
I bring this up explicitly because there is often an odd idea that the obese beginner should just focus solely on cardio to get fat/weight loss moving and worry about weights later. But for the reasons I’ve outlined above and throughout this series, I think that including it in at least some form or fashion from the get-go is worthwhile.
So let’s now switch gears and talk about some of the benefits of aerobic/cardiovascular exercise in the obese beginner population.
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Benefits of Aerobic Activity #1: Improving Fitness
I mentioned in a previous part of this series that at least initially, most obese beginners have a very low tolerance for any sort of activity and this tends to include anything but the most low intensity cardiovascular exercise. Even that is often problematic beyond a few minutes at a go. As I detailed, this makes the expectation of burning a tremendous amount of calories or fat through cardio pretty much a pipe dream. At least initially.
I would note, very tangentially, that several studies have found that accumulating activity throughout the day can generate, at least in the initial stages of training, benefits equivalent to doing it all continuously. That is, 10 minutes of activity done three times per day generates at least similar effects to doing 30 minutes all at once. For beginners with extremely low tolerance to activity, that’s one way to get a larger daily total without having any single bout be too overwhelming.
Now, this is normally suggested within the context of someone’s full day. But in some circumstances, a gym trainer can even put this to use. Maybe you start with 5-10 minutes of cardio to warm-up. Go do a few weight exercises. Then back to cardio. Back to weights. Back to cardio. If you have an hour, not only are you breaking things up but, boom, you’ve just accumulated 15-30 minutes of aerobic activity without killing the client or boring them to death.
But beyond that, the only way to improve something is to do it regularly. For that reason alone, doing some cardiovascular work from the get go is important. Even if someone can’t do much to start, this will improve over time. So in addition to any metabolic benefits on insulin sensitivity, caloric expenditure or whatever, the simple fact is that, over time fitness can and will improve if training is applied correctly.
So even if the obese beginner can’t do much to start with, they can gradually increase their capacities over time. As they become fitter, they can do more in their training, driving fitness further, allowing them to do more. It’s just one big feed-forward cycle if you do it correctly. Of course that means starting gradually and not killing them, progressing as they are able, etc.
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Benefits of Aerobic Activity #2: Improving Program/Diet Adherence (Maybe)
But what about benefits beyond that? Perhaps one of the most important, and this also got mentioned in the comments to a previous part, is overall adherence to the program, especially to diet. This is something I’ve mentioned in several of my books but, at least in some groups, there is a mental association that tends to occur with activity and diet. To whit, on days that people do some sort of exercise, they often stick to their diet better. There is sort of this underlying logic of “I worked out, why would I blow my diet?” In contrast, days without activity tend to be less predictable or be worse in terms of dietary adherence.
I’d note, and please realize that discussing in detail this would take another overwritten article series, that this is a very complicated issue and how exercise does or does not affect things like dietary adherence or appetite depends heavily on the psychology of the dieter and a host of other factors. More specifically, we’ve all known those people who justify that they “earned that cheeseburger and milkshake” because they worked out, usually based on the faulty assumption that they burned far more calories than they actually did.
But that’s an issue of education as much as anything else (there is a related issue of individual psychology that I’m not going to get into) and making people understand that they did not in fact burn 1000 calories with 30 minutes of brisk walking. Or even an hour aerobic class. Or in anything that they are currently capable of. And in also making them understand that they can all too readily offset (and then some) any deficit from activity if they don’t keep their diet under control.
But assuming they understand that, for many people a day that they exercise is a day that they are more likely to adhere to their diet. That’s good, especially given that dietary modification may be the most important target to work on in terms of getting fat loss started anyhow.
I won’t give it its own section but, as you’ll see below, I personally used cardio sessions during to give clients little mini-lectures since I considered education as important as anything else I was doing. With them walking on the treadmill, I had a captive audience and I could teach them about things like training (I might explain RPE or the FITT equation) or talk about aspects of diet or what have you. Not that I’m suggesting that you necessarily use that part of your hour to do that, but it is another possible way to put cardio to use beyond the most commonly thought of purpose (burning calories and fat).
So there you have multiple benefits to including cardio in the program from day 1. There are the obvious metabolic effects, the simple fact that the only way to improve fitness in an activity is to do it and possible adherence issues. Trainers can also use it as a time to educate their clients while they have them captive and aren’t worrying about details of the weight room. And don’t worry, I’m not skirting the whole “Interval training for beginners” issue; I’ll tack that on in the final part of the series.
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Putting it All Together
Ok, with all of that out of the way, let me try to put all of this together in a more applied way. Basically, here I’m going to outline what I personally did with this population of clients years ago. As I mentioned at the outset, I’d probably do some things a bit differently now but the differences would be in the details more than anything else. The overall structure of how I approached it or think it should be approached wouldn’t change.
I’m also not saying that what I’m going to write is the only way to go about things. Clearly there are a lot of workable approaches within the issues I’ve tried to address in this series. This was simply mine (much of which was a function of the gyms I trained in, what I had access to, my client base, how much time I had, etc.) Just focus on the principles of what I’m talking about; don’t get hung up in minor details.
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The First Workout
Most trainers work on a 50 minute hour more or less. And all too often make the mistake that if they have an hour of training, they need to fill it up to “give the client their money’s worth”. There is some truth to this (it’s hard to keep someone coming back and writing the checks if you make them sit around half the session) but in the beginning stages, you have to forget that stuff, the goal is not to beat on them for an hour. The goal is to break them in without breaking them as I discussed ad nauseum in Training the Obese Beginner: Part 4. And that’s how I approached it.
Anyhow, here was my ideal first “hour” session with the typical obese beginner (really any beginner):
First I’d spend 25-30 minutes on intake paperwork. Just the various pieces of information, including injuries, health risks, a quick look at diet (to look for any major red flag areas), etc. that needed to get done so I knew what I was dealing with and if there were any major issues. For anybody who’s interested, I’ve uploaded a zip file of the exact paperwork I used. Click here to download it. If I were doing measurements of any sort (skinfolds or tape measure), I’d do them here at the very end of the paperwork.
I’d note that, as I got more experience as a trainer, I often did away with the measurement part of the initial consultation. For the very obese, not only are the measurements pretty useless, they can be embarrassing which is not what you want at the outset. In many cases, you can’t get a good measurement anyhow. Trying to get a good skinfold on the thigh of an obese woman is pointless. Not only won’t you get a good measurement, odds are you’ll make her feel really embarrassed so it’s just a lose/lose situation. It’s just not worth it in my opinion.
Skinfolds also don’t really tell you anything that other less invasive methods won’t tell you, as I discussed in Initial Body Fat and Body Composition Changes, almost any weight loss in the obese is from fat assuming the program is not completely moronic. Taking skinfolds doesn’t tell you anything useful and may be a negative psychologically. If the clients weight is going down, most of it will be fat (again remember that small increases in muscle mass initially may offset fat loss in terms of the total weight loss).
Even if some of that loss is LBM, if they are weight training, it’s most likely inessential LBM and glycogen/water which isn’t worth caring about (recall that many obesity experts accept 25% LBM loss as “normal” and “acceptable” in the obese). Basically, simply putting them on the scale tells you most of what you need at this point.
At most at this point, I might take tape measure measurements but only to show how much those numbers had changed at the 6-8 week mark. This can be useful since often weight won’t show a major change initially although inches are being lost (e.g. fat is being lost while some muscle is being gained and offsetting the scale drop). Again, you have to weigh this against potential embarassment of the client and the simple fact that changes in how their clothes are fitting will tell you just as much as taking formal measurements.
The same goes for exercise testing which I stopped doing very early on. Testing a max bench or leg press or whatever nonsense on day 1 is simply pointless in this population. It tells you nothing since most will improve by the second workout just based on practice alone and given that the goal is to start sub-maximally, there is simply NO logic to putting a beginner through a maximum exercise test of any sort on the first day so that you can then back them off to 50% of that to start the actual exercise program.
Most flexibility evaluations (i.e. sit and reach) are worthless too, they don’t measure what people think they measure anyhow (and yes I realize a lot of people are big into movement screening these days). Just do the paperwork, maybe take tape measure measurements and stick them on the scale and then get them in the gym. The rest of it, if you decide to do it at all, can wait until after the first 6-8 week block of training.
Now, I could usually bust out the initial paperwork, etc. in about 25-30 minutes tops. On an hour session, that left me 25-30 minutes for their first workout. Yes, that’s right I “wasted” the first half of their first session with paperwork and such. But it wasn’t a waste in my opinion. First and foremost, it was information that I needed in the first place and I universally found that 20-30 minutes of activity was about the most that the typical beginner (obese or not) could handle.
Doing it this way got me the information I needed and basically made sure that their first workout couldn’t be too much. Since the client didn’t feel like the first half of the session was wasted either, that was a double benefit. Simply, this was just a way to ensure that their first session was a way to break them in without breaking them. Because in that 25-30 minute training session, I could have them do just enough to get started and walk out of the gym feeling good without doing too much so that they were wrecked. Again, there are always exceptions. If I got an athlete or someone with a previous sports background and I’d do it differently. But that’s not the topic of this series.
But in this population, the rank newbie (again, obese or not) 20-30 minutes was about right. And before you dismiss me out of hand, think about it this way: a coach starting with a new runner might have them go for a 20 minute jog on their first day. Possibly less than that. What makes you think an obese beginner needs more training than that other than the fact that you work on a billable hour and want to “Show them your stuff”?
Quite in fact, I often did 30 minute workouts with people in the long-term. As I mentioned in Training the Obese Beginner Part 3, that’s plenty enough time to do the weight training they need to do. Assuming that they will do aerobic work on their own, I saw no point in charging them for me to watch them do cardio. So I’d often do 30 minute workouts with them.
So specifically what did I do in that first workout and how did I progress it over time? What reps, what intensity, what volume? What about progression? What about interval training which we all know has shown to be superior to everything ever? That I’ll talk about in the final part next week.