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Old 04-08-2011, 04:49 PM
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Training the Obese Beginner: Part 5

Training the Obese Beginner: Part 5
BY LYLE MCDONALD


Well, I had really hoped to finish up today since I have something else to talk about next week but, wellÖ.Tuesday or todayís installment will be unreadably long, even for me. Today, I want to start to bring together everything Iíve talked about, addressing why I think the inclusion of both weight training and cardiovascular training of some sort is important for the obese beginner and why both should be done from day 1.

After that Iíll talk about how I approached the first workout with obese (or non-) beginners in terms of structure and some generalities of training and such. Finally (really, I mean it) on Tuesday Iíll truly finish up and talk about progressions, when and how to increase things and keep the beginning obese trainer progressing.

Let me note up front that some of what Iím going to write simply represents what I did/found to work in this population when I was working as a personal trainer, some of it will be more what I would do now were I still working with that population. Youíll 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).

With that said, and since I fear that some of my comments regarding exercise the obese beginner in Part 3 were misconstrued, so let me look at some of the myriad benefits of including both weight and cardiovascular training from day 1 in the obese beginning trainee.


Benefits of Weight Training

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 donít need tons of it. But ignoring that, what are some of the benefits of including weight training in the training of the obese beginner?

Well, one I already talked about rather extensively, depletion of muscle glycogen to start improving whole body fat utilization and fat burning pathways. Along with a lowering of carbohydrates/calories, this can exert a power 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 Ė 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 whatís going on physiologically secondary to obesity. Now, realizes 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 consider a situation where, secondary to whole-body insulin resistance, the fat cells are effectively pushing fat calories Ďawayí. If you give those calories a place to Ďgoí through training, the body seems to shift calories away from fat cells and into muscle. Viola, fat is lost while muscle is gained.

Iíd 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 isnít much of a worthwhile goal. It happens but itís really not the main Ďtargetí in this population. It is worth being aware of as small increases in muscle mass can often offset scale weight changes 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 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. This can be corrected with basic weight training, improving folkís qualify of life. Again, you still donít need massive amounts of time or energy in the weight room to do this.

Back in my 20ís, I couldnít 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 and some basic shoulder re-balancing 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. Other issues of posture or whatever can be targeted through the simplest of programs just through some basic stretching and/or full range lifting (e.g. full ROM movements will stretch the involved musculature).

Beyond that there is another benefit to weights that I think goes very under-appreciated and it goes to the stuff I talked about in Training the Obese Beginner: Part 4 and thatís issues of positive reinforcement and adherence. I found quickly that weight training, properly approached, provided a type of positive reinforcement for beginning clients that cardiovascular training just didnít cause.

The problem is that aerobic adaptations tend to be fairly slow to occur, thereís just not the immediate bang for the buck that I found the typical beginner needed to make them feel good about what they were doing. Even if they came out of every workout with positive affect, I needed to make them feel as if they were making progress and moving forwards immediately. It might be 3-4 weeks before someone really Ďfeelsí fitter on cardio and gets that first adaptation. Given that some absurd percentage of beginners quit at the 3 week mark, that was simply too slow.

But I got exactly that effect with weight training. By approaching it in the way Iíll describe shortly, I made the trainee feel as if they had made improvements from the first to second workout. As youíll see, some of this was a bit of trickery on my part but, you know what? I didnít care. Whatever got them coming back was more important than a bit of deception to make it happen.

And 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 couldnít 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 didnít do that quickly but weights did.

So there yaí go, at least three solid reasons to include resistance training from Day 1 of training the obese beginner: metabolic, functional and psychological benefits. There are probably more Iíve forgotten but, honestly, I think thatís enough reason to include it from the first day out. Again, you neednít 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.

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 Iíve outlined above and throughout this series, I think that including it in at least some form or fashion from the get-go is worthwhile.


Benefits of Cardio

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, thatís one way to get a larger daily total without having any single bout be too overwhelming.

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 canít 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.

So even if the obese beginner canít 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. Itís just one big feed-forward cycle if you do it correctly.

But what about benefits beyond that? Perhaps one of the most important, and this also got mentioned in the comments, is overall adherence to the program, especially to diet. This is something Iíve 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 ďI worked out, why would I blow my diet?Ē In contrast, days without activity tend to be less predictable or be worse in terms of dietary adherence.

Iíd 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, weíve all known those people who justify that they Ďearned that cheeseburger and milkshakeí because they worked out, usually based on the faulty assumption that they burned far more calories than they actually did.

But thatís an issue of education as much as anything else (there is related issue of individual psychology that Iím 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 donít 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. Thatís good, especially given that dietary modification may be the most important target to work on in terms of getting fat loss started anyhow.

Finally, as youíll see below and in Part 6 on Tuesday, I used cardio sessions during the hour as as time to give mini-lectures. I had a captive audience and I could teach them about things like training (Iíll give an example below) or talk about diet or what have you. Not that Iím 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 arenít worrying about details of the weight room.

Now letís talk about how to put this all together which Iíll start today and finish on Tuesday.

First Iím going to outline what I did years ago with clients. Iíd probably do some minor things differently if I were going about it again today but the differences would be mainly in details more than anything else. The overall structure of how I approached it or think it should be approached wouldnít change.

Iím also not saying that what Iím going to write is the only way to go about things. Clearly there are a lot of workable approaches within the issues Iíve 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, etc.) Just focus on the principles of what Iím talking about; donít get hung up in minor details.


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 Ďgive the client their moneyís worthí. There is some truth to this (itís 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 at length (ad nauseum) in Training the Obese Beginner: Part 4. Obviously I did not do this.

Anyhow, were was my ideal first Ďhourí session:

Spend 25-30 minutes on intake paperwork. Just the various pieces of information, including injuries, health risks, a quick look at diet, etc. that needed to get done so I knew what I was dealing with and if there were any major issues. For anybody whoís interested, Iíve 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), Iíd do them here at the very end of things.

Iíd 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 out of the gate. In many cases, you canít get a good measurement anyhow. Trying to get a good skinfold on the thigh of an obese woman is pointless; you wonít get a good measurement, odds are youíll make her feel really embarrassed and itís simply not something worth doing in my opinion.

They also donít really tell you anything, 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 doesnít tell you anything useful and may be a negative psychologically. If the clients weight is going down, most of it will be fat.

Even if some of it is LBM, if they are weight training, itís most likely inessential LBM and glycogen/water. Basically, simply stepping on the scale tells you most of what you need at this point. At most I might take tape measure measurements but only to show how much they had changed at the 6-8 week mark. This can be useful since often weight wonít 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).

The same goes for exercise testing. 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. Most flexibility evaluations are worthless too. Just do the paperwork, maybe take a tape measure measurements and get them on the floor. The rest of it can wait until after the first block of training. And thatís what I did.

And following that initial bit of paperwork, Iíd take them through 20-30 minute workout. Yes, thatís right I Ďwastedí the first half of their first session with paperwork and such. But it wasnít a waste in my opinion. 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. Think about it this way, a coach starting with a new runner might have them go 20 minutes easy 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 with only another 25-30 minutes to actually train them, it let me break them in without breaking them, 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. I get an athlete or someone with a previous sports background and Iíd do it differently. But in this population, the rank newbie (again, obese or not) 20-30 minutes was about right.

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, thatís plenty enough time to do the weight training they need to do. Assuming that they will do metabolic work on their own, I saw no point in charging them for me to watch them do cardio. So Iíd 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? Tune in Tuesday when I will finish this silly series up or die trying.
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