9. Visit a physician who specializes in the treatment of obesity.

Discuss the steps the physician follows to

determine the best treatment. What kind of nutritional advice does the physician give? When does the
physician recommend surgical intervention? When does the physician think a personal trainer would be
beneficial? How could you, as a trainer, fit into their program? If you cannot gain access to a physician, feel
free to do your own extensive research on the topic of obesity and provide detailed analysis of the potential
common causes (physiological, psychological, etc.), treatments, prevention strategies, etc.

Even though our world has reached a high technological level, our bodies seem to fall behind as fast as
technology is spreading. Obesity is a constant issue and it is increasing. In the subway, or in the car, you
see people holding their phones and pretending to be so “alive” on the social media. I look outside and see
children using hoverboards or whatever they’re called. When has walking in the park became old-
fashioned? Instead of telling them: Go play! or Let’s play! parents get rid of their children faster with Hold
this phone, or Hold this tablet, while I do something else and I don’t want you to bother me.

And after they become obese, their parents (in lucky cases) seek help. Help that comes from specialists:
physicians, doctors, personal trainers, dieticians, etc.

Looking for information regarding the treatment of obesity, I have reached a physician who was kind
enough to answer my questions. I will present next what she said, answering each question in order.

1. The steps the physician follows to determine the best treatment:

The steps the physician must take are quite like the ones you take in fitness. First, the client must answer
questions about their health. Also, some blood tests are required – if there are any indications that there
may be Diabetes 2 developing, if there are signs of Hypothyroidism, levels of LDLP and HDLP (cholesterol)
and triglycerides. You must rule out health issues and make sure that it is a classical obesity you are
handling. Also, lifestyle questionnaire is a must. BMI, waist-hip ratio and subcutaneous body fat
measurements taken with skin fold callipers. Also, blood pressure and heart rate.

Now, based on the results and the answers the client gives you – you will have the treatment
determination:
1 – increased physical activity with corrections in nutrition which are referring to healthy and balanced
nutrition – this is the case if the client’s obesity is class 1 – low risk obesity with BMI 30 to 34.9.
2 – increased physical activity with diet regime which will focus on lowering the carb intake and increasing
protein and healthy fat intake – client’s obesity is class 2 – moderate risk obesity with BMI 35 to 39.9.
3 – increased physical activity and very strict diet regime (example: Atkinson diet or Ketogenic diet would
be appropriate) – client’s obesity is class 3 – high risk obesity with BMI equal or more than 40. And here we
can talk about taking surgical intervention.

Now, please be aware that increased physical activity will differ from one client to another. Some are more
able to sustain fitness, some are not. Activity is considered to be anything from a walk that will last more
than 45 minutes and can go up to vigorous fitness. So, client’s previous fitness level will determine what
activity will be advised – prescribed. If it’s class 3, most likely it’s going to be swimming and aqua aerobic –
because the water reduces the pressure on the joints. Also, light to moderate tempo walk will be desirable.

2. What kind of nutritional advice does the physician give:

The physician is not authorized to give detailed advice on nutrition. A registered dietitian is entitled to do so.
A physician will talk about healthy eating guidelines, water intake, high and low GI, difference between
carbs and protein and fat. But only a dietitian can actually prescribe a diet. So, obesity treatment is actually
a work of a full team, not just one person.

3. When does the physician recommend surgical intervention:

As far as I know, it is only recommended if a client had severe issues with the GI tract (for example
expanded stomach which is causing constant hunger or some ulcers or pathological conditions). Also, it
can be prescribed if after a long period of time the client still hasn’t managed to lose weight. Then they also
do a shrinking procedure to make the stomach smaller.

4. When does the physician thinks a personal trainer would be beneficial:

Most of the times, especially if a client has no record of previous physical activity. This type of clients
generally need guidance and support 24/7 so that they manage their goals.

5. How could you, as a trainer, fit into their program:

Listening, understanding, and supporting the client. One cannot treat the client with obesity in the same
manner as someone who is little bit overweight, not to mention someone who is in full training. As trainers,
you must be aware of all obstacles your client is facing and help them. We need to be able to make them
feel comfortable so that we build a relationship with them, with mutual respect. Creating a fitness program
for an obese person is not easy, especially if their weight has reached class 3 obesity. The risk of injury is
huge and you need to be aware of their physical boundaries – watch their heart rate, facial expressions,
colour of the skin, see if they have issues communicating with you during their workout, etc.
It is a long and difficult journey and you need to give them support every step of the way so that they don’t
lose hope and motivation and give up.
In terms of prevention, good habits should be educated from childhood. Physical activity and a balanced
nutrition will prevent adulthood obesity and other related problems.