What are some good exercises for the morbidly obese? - Personal Trainer Community - Forum

[Christina]

I have a friend who is morbidly obese and I am working on a program for him. He has his doctor's ok to exercise and he has been going to the gym 3 days a week since last January. Unfortunately he is making little progress. I think he is very ashamed of his weight so the only thing he will do is walk on the treadmill. Unfortunately I do not live near him but I want to put together some sort of resistance training program for him. Has anyone had experience training the morbidly obese? If so, what exercises did you use?

Here is what I was thinking of so far: wall pushups, squats (sitting down/standing up from a chair -- in his current state he can still get up and down), and various tube/band exercises. Any other good ones? I want exercises that he can do in the privacy of his own home. He cannot do many of the exercises that normal clients can do because of the excess weight around his abdomen.

Christina

[MedicineMan442]

I have found that working in such fundemental ways as sitting on the ground/laying on the ground to standing, stretching to increase ROM, are some good places to start. Weight Bearing exercises may be a bit much for the morbidly obese, so i would stay away from running or the like. Water based exercises would be a good alternative as well, taking some pressure off the joints and bones that could injure your friend due to weight on the bones. Some shallow water walking, bobbing, or even kicking with a kickboard, if it seems practical. Im not sure how obese your friend is so use your best judgement. So i would stick with exercises that are most related to ADL's. But most importantly, motivate him. Get him to eat healthy and work out on a regular basis. These are the keys to getting him back into shape where he can enjoy life to the fullest. Joe Cannon has an excellent book out on supplements and nutriants. Its the most complete book available today. Thats a good place to start nutrition wise, but i suggest getting the nutriants from natural sources. Also, any questions that I cant answer, he can. He is a great guy too. So let me know if you need any help. Give your friend my email if he has any questions himself.

--Lance Special Populations Fitness Instructor

Email: MedicineMan442@hotmail.com

P.S: Diabetes is common amoung the morbidly obese. Have your friend talk to a doctor, even if he sure he doesnt have diabetes. Any questions, you can email me, and ill give you my number and talk you through some easy exercises. Good luck!

[Christina]

Hey Lance,

Welcome and thanks for the suggestions. We have hit a major roadblock as far as motivation is concerned. In fact, we haven't even gotten to the point of exercising. It seems like every time he is supposed to begin his exercise program he comes up with an excuse. It has gotten to the point where I simply had to back off because I am not sure what else can be done. I don't know if you read in one of my other posts that I am working on my fitness coaching certification but I am hopeful that I will be better equipped to handle these sorts of issues in the future.

Out of curiosity, how have you handled lack of motivation with your special pops?

Christina

[MedicineMan442]

Well, motivation is a tricky area. Some people are motivated by a trainers commitment, others by fear of the consequences if they dont work out. Explain to your friend WHY you are training him. Even if he says he know, he may not REALLY know. Tell him that obesity leads to Type II Diabetes, which if left unchecked, can lead to Type I diabetes and insulin injections for life. Osteoporosis is another huge problem that is accompanied with obesity, and will make life hard in the later years of his life. So try to change his mentality about fitness by making it fun. Reward him for his acheivments and try not to scare him off. Little changes. Baby steps eventually get you there. Maybe take him to a movie one day, and instead of getting opcorn: , try bringing a healthy snack and some water or protein shake. If its an option, suggest you walk to the theatre. Or maybe just a short walk outside or in a park. These things are often not thought of as fitness, but if you impliment these little things into his daily life, he will be working out and not even know it! What better motivation is there then if someone told you "I will help you work out and get healthier without you even knowing you're exercising." I don't know about you, but where do i sign? These things will make fitness less frightening. All excuses are used for is to cover up fear or loathing of an activity. Maybe a success story, check your local gym, will influence him and motivate him. Someone who has 'been-there-done-that' and turned his/her life around. Show him there is hope and he is not a lost cause. Thats all i can think of right now. Anything else let me know, and ill update as i come up with new ideas. Good working! :respect:


-Lance

[Christina]

Hi Lance,

I appreciate all of the suggestions -- thanks! Unfortunately my friend does not live near me (we live in separate states) so I cannot exercise with him. Believe me, if I lived near him I'd have him in the gym every day!

The sad thing is he already has Type II diabetes, high blood pressure, high cholesterol, and joint issues (hip/knees) but for whatever reason he is not motivated to lose weight. I think he has pretty much given up and figures trying to lose weight at this point would be too difficult. :?:

Christina

[Dave, ElevationFit.com]

Christina,
Have you worked on any goal setting, or extrinsic motivation techniques with your friend? I spent my undergraduate internship researching and teaching other trainers how to effectively work with obese clientele. Some of my favorite tools include increasing the activities of daily living (ADL) as Lance suggested, and then setting up some concrete goals. Using a visual tracking and rewards system. Literally, a calendar where each day a workout is completed is marked off. Having your friend display this calendar in a high traffic area of their home serves to both remind them to exercise as well as reinforcing the success of workouts already completed. This can help people get through some of the barriers that keep a new program from getting off the ground.

You mentioned that your friend lives too far for you to workout with them in person, have you tried any of the internet based programs that allow for building and tracking of workouts online? This way you can see what your friend is doing, and offer encouragement without having to call all the time.

Elevation Fitness LLC does this very well already and will be posting some information soon about client motivation and program adherence that you might find really helpful.

[megfit]

Hi Lance,

I appreciate all of the suggestions -- thanks! Unfortunately my friend does not live near me (we live in separate states) so I cannot exercise with him. Believe me, if I lived near him I'd have him in the gym every day!

The sad thing is he already has Type II diabetes, high blood pressure, high cholesterol, and joint issues (hip/knees) but for whatever reason he is not motivated to lose weight. I think he has pretty much given up and figures trying to lose weight at this point would be too difficult. :?:

Christina

Hi Christina!

Well, no matter how much we want to help others in this type of situation, no one can motivate him but himself. And the sad thing is he may eventually decide that the pain and fear is greater than the fear/pain that KEEPS him in this place. People do not become morbidly obese by accident.

The best course of action you could suggest to him is to find a counselor he would feel comfortable working with. And, as his friend, your best course of action is to just be there to support him. Sometimes even when we are watching someone kill themselves, all we can do is be there.

Margie

[Joe Cannon MS CSCS]

Medicine Man - thanks for the recommendation of my book! I appreciate the feedback
Joe

[kennyjoyy]

I suggest Water based exercises would be a good alternative as well, taking some pressure off the joints and bones that could injure your friend due to weight on the bones. Some shallow water walking, bobbing, or even kicking with a kickboard, if it seems practical. Im not sure how obese your friend is so use your best judgement.

[mindguru]

The thing with motivation is that a person either needs to feel so bad, scared etc that they feel compelled to take action - or they need to have such a compelling future in their mind that they are drawn towards taking action to achive it.

There is a great video explaining this here: YouTube - Motivation, secrets and mistakes

If you could take the weight off your client for 3 months (so he got to experience the lighter him) then put the weight back on him - he'd be like a rabid dog chewing and his lead to get on with losing weight - because he'd have a clear sensory mental image of te lighter him and how good it felt.

My guess is that your client doesn't believe he can lose weight, so why bother .

I'd suggest listening to his language for whether he's talking about things he wants, or doesn't want then ramp up the pressure in his natural direction.

So if he's talking about what he doesn't want - then paint bad images in his mind of what will happen if he doesn't lose weight...

If he's talking about what he does want - then get him to describe all the benefits - in sensory detail, really get him into the detail of what he will see, hear and feel...

Hope this helps,

Dave.