How To Train Obese Clients Safely & Effectively


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10 Question Exam (sent via email)

Cardio: Have your client start with Walking or if available, a Recumbent Bike that is easier on your client’s back. Have your client walk at a comfortable intensity. They should be able to Pass the “Talk-Test” meaning: they should be able to converse with you. Increase Intensity after your client’s RHR (Resting Heart Rate) reaches 70. Have your client walk up to 40 mins at a time. Never exceed 45 mins in one session as this causes an increase in Cortisol production that needs to be avoided. You can also break-up Cardio sessions to 2-3/day if feasible.

Stretching: ALWAYS have your client properly warm-up. Stretching is best done after Cardio. Have your client stretch each muscle group, performing each stretch to a point of Tightness…NEVER PAIN! Have them hold the stretch for 30secs, then go into a slightly deeper “Developmental” Stretch for an additional 30 secs…again NO PAIN…ONLY TIGHTNESS! NEVER allow your client to perform a stretch for more than 90 seconds. Instead, have them build-up to 3 Reps/Stretch. You can stretch every day, even 3 times/day for more benefit.

Once you get your client’s RHR (Resting Heart Rate) under 70 and RBP (Resting Blood Pressure) to 120/80 or below, you can incorporate a strength training program for your client.

For those with RHR under 70 bpm and RBP 120/80 or lower, strength training provides multiple benefits including increased fat loss, muscle gain, body composition improvements, strength-speed-power-endurance-agility-balance-coordination-flexibility-symmetry-and biochemical improvements. It also has a powerful impact on all the physiological systems of the body, including the Endocrine System that increases the anabolic hormones: Human Growth Hormone (HGH), Testosterone (T), Insulin-Like Growth Factors (IGF), Insulin and more. The increase in Insulin production along with improvements in insulin uptake inside your cells, glucose sensitivity, increases in ATP-Kinase and cAMP, not only improve overall health and rejuvenate the body, but are the best possible treatments for Type 2 Diabetes and pre-mature Aging! Strength Training has been shown to be the ONLY Protocol to reverse Type 2 Diabetes and this starts to occur after the very first training session!

The basic Anti-Aging Strength Training Program (I recommend your client begins on machines for safety’s sake).

1) Squats (deadlifts or leg press are suitable substitutes if you are worried about your client’s knees or back)

2) Leg Curls

3) Bent-over-Reverse Flys

4) Seated Row

5) Chest Press (keep client’s elbows flared 45 degrees to the body to protect the Shoulder Complex, sub.: Push-ups if are concerned about your client’s shoulders)

6) Lat Pull-Down (ALWAYS to the front, Angled back about 10 degrees. Pulldowns to the rear are contraindicated stress on the Shoulder Complex)

7) Shoulder Press (sub: Lateral Deltoid Fly)

8) Bicep Curl with Dumbbells

9) Tricep Extensions (Prefer: Standing Cable Machine)

10) Heel Raise (Standing)

11) Crunches (improve digestion/posture by activating the transverse abdominis by sucking gut in and holding it in while Crunching)

12) Wrist Curl

Start with a reasonable weight your client can for 15 Reps without going to failure for the First Week.

Gradually increase the weights until your client begins to struggle on the 15th Rep. After Week 1, you can add Push-ups/Crunches AMRAP: As many reps as possible.

Week 2-3: 15RM (Repetition Maximum: Use a weight that only allows your client to perform precisely 15…NOT 14…NOT 16!)

Week 4-6: 12RM (Repetition Maximum: Use a weight that only allows your client to perform precisely 12…NOT 11…NOT 13!)

Week 7-9: 10RM (Repetition Maximum: Use a weight that only allows your client to perform precisely 10…NOT 9…NOT 11!)

Week 10-12: 8RM (Repetition Maximum: Use a weight that only allows your client to perform precisely 8…NOT 7…NOT 9!)

Obviously, your client is going to get stronger, so you will need to incorporate heavier weights as your client’s strength increases. It is not unusual for beginners to double their strength in 8-12 weeks, more if they have lifted previously (Muscle Memory). Plus, you will need to increase the weight again as the intensity increases. i.e.: Going from 15RM to 12RM is an increase of Intensity and you will need to increase the weight your client uses slightly.

After 3 weeks on machines, have your client move to Free Weights. This Program is designed to be done 3 times/week: M, W, F or Tues, Thurs, Sat. The day of rest between is critical to their success.

Rules for lifting:

During the Concentric (Fiber Bundling) Phase, when the weights or weight stack goes up: ALWAYS have your client exhale and take 2 seconds to go from start to end. They should Exhale forcefully thru Pursed Lips to maximize Pulmonary function.

During the Eccentric (Muscle Elongation) Phase, when the weight or weight stack is going down: ALWAYS have your client Inhale and take 4 seconds to return the weight to the beginning position. Have your client’s fill their lungs completely with air to maximize Pulmonary Function.

Never allow your client to LOCK a joint while it is extended and under load. Ensure they work their muscles through Functional Range of Motion(FROM), but never exceed comfortable FROM.

Other Helpful Lifestyle Management Tips You Can Give Your Clients (all of the following have been shown repeatedly to increase health and longevity):

Sleep: 7-8 hours/night in a darkened (block those clock lights), cool room.

Hydrate: Drink enough water to keep your urine clear or nearly clear.

Avoid Stress: Two Rules for Stress Management: RULE #1: DON’T SWEAT THE SMALL STUFF! RULE #2: EVERYTHING IS SMALL STUFF!

Caloric Intake: Reduce your client’s caloric intake (not below 1,200 calories without doctor supervision) to achieve a healthy body fat percentage (under 20% male, 25% female) and to get waist circumference under 40 inches (male), 35 inches (female).  Don’t cheat on waist measurements…measure at the widest point, typically the belly button! Measuring the belly below the point where you look 9 months pregnant does not help your client’s causes! I have run into some guys that brag about wearing the same pair of pants from High School. BUT, they now wear them around their thighs instead of their waist and they have not seen their toes for over a decade! The smaller your waist, the healthier you become.

Eating: 6 smaller meals/day is better than 3 big meals.

Stay Social: Have a strong network of friends/relatives.

Have a pet: I prefer dogs, but any pet increases health and longevity.

Prayer: Improves health as will meditation, Tai Chi, etc

Good Luck,

Dr. Jim Bell


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