Tips on Training an Obese Client

[sking1001]

Hi Andy. I just read both your articles on Coaching the Obese again. I never really appreciated them as much as I do now.

I'm training a 52 year-old female that is 5'7 about 265 pounds. I've had 5 sessions with her in my small one-man gym. I don't have a leg press there, but I was pleasantly surprised that she was able to assume a full squat without the bar on her first day. Further, she was able to get into low bar position with a 45 pound bar and squat nearly to depth. She's now able to reach depth on most reps, as long as she's cued, and we worked up to 50 pounds for 3x5 last Friday.

She missed her last couple of session, and when I asked her about it, she says she is having severe knee pain.

Now, after reading your articles again in light of this new client, there's some things I realize. I gave her the option of either doing HIIT or LISS cardio (preferably fasted). However, I left her to do this on her own, and she has neglected it. I'm going to actually go with her to the commercial gym and start her on the treadmill, making sure she is doing that 6-7 times per week, obviously not doing HIIT. My wife is working with her on her diet and any possible psychological issues with the weight loss.

As her trainer, my lack of involvement in her necessary cardio was a mistake, which I realize even more after reading your articles. I don't think she is ready to squat yet, although she can continue to deadlift, press, and bench. I'm really going to focus on her cardio though, because I can see her getting discouraged.

My question is, since I'm going to be working with her at a commercial gym with access to a leg press, would it still be better to have her continue to squat with dumbbells as opposed to the leg press, since she is actually able to get into the position?

As another possibility, she could leg press on Monday as heavy as she can, air squats on Wednesday, and progressing squats with dumbbells on Friday, like a HLM schedule. I keep asking myself, What Would Andy Do?

[Andy Baker (KSC)]

You know what works awesome for people like this? Working them up to 100 squats without telling them. Oddly enough, people don't really keep count of what they are doing in the gym when they have a trainer. On the air squat day work her up to do like 5 x 20 or 5 x 15 + 1 x 25, etc and maybe "hide" it within the context of a longer circuit.

At the end of the workout you say something like "do you realize you just did 100 squats?" It's pretty awesome to watch their face light up. It might be the first physical accomplishment of their life. You aren't doing it for the physiological effect but rather for the positive mental/emotional impact. It helps.

But yeah, on other days you can do whatever.....squats, leg press, etc. Doesn't matter. With really obese clients I just like really glycolytic activity to level off their blood sugar. Not too concerned where it comes from. The Novice Effect is still going to be getting her stronger so don't obsess about rigidly sticking with SS.

Push her hard but look for cues as to what she LIKES to do and ALWAYS get something positive done in every session. Harp on her accomplishments. She may still quit on you. Just a sad fact that most of them will find their way out of reaching their goals. It's beyond your control though. Just do what you can.

Email me and I'll send you an article I just wrote for a local magazine here. It's on mindset. You can print it out for her, it'll probably be helpful. KingwoodStrength@gmail.com

[vanslix]

Medically, I'd add that at that level of obesity, she almost certainly has some osteoarthritis of the knees and potentially in the hips, as well. I'd be cognizant of that when considering HIIT at her current level. Her joints will likely light on fire with pain in response to high intensity.