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PERSONAL TRAINER
Melissa Shanes
Bariatric Clients — A Growing Population
By Melissa Shanes
As a personal trainer and business owner, I am always looking for new ways to build my business and capitalize on my knowledge, experience and passion for health and fitness. I have discovered a specialized niche population that is both growing in numbers and shrinking in size. Let me introduce you to the bariatric client.
Two years ago, a particular client was referred to me for personal training. She was two weeks post-op from gastric bypass surgery. My background includes 17 years in the medical profession as a licensed practical nurse. We were a perfect fit.
It took everything she had to walk into the gym. She was scared and intimidated, but she knew that if her surgery was to be successful, she would need to change her lifestyle. Along with cardio, strength training and stretching, we focused on her getting to know her body, how it feels and what it can do. We discussed nutrition, meal planning and recipes weekly. She expressed emotional and psychosocial experiences that were new to her due to the surgery. As her physical strength increased, she gained mental clarity and emotional stability. Today, she has a sound sense of self, is living a clean and healthy lifestyle and knows she will maintain her 165-pound weight loss for life.
Let’s throw some statistics out there. Morbid obesity is defined as being 100 pounds overweight or having a BMI of 40 or greater. About 15 million people in the United States are morbidly obese, according to the American Society for Bariatric Surgery. In 2006, an estimated 177,600 people underwent bariatric surgery. That number is increasing every year.
Having bariatric surgery is only one piece of the puzzle. It is a tool to help jump-start weight loss by restricting food intake and caloric absorption. Once the initial weight has come off (usually within six to 12 months), patients must do what we all must do to maintain a healthy weight: They must change their lifestyle by incorporating proper nutrition and meal planning, exercise and stress management. They have not managed this successfully in the past. Without professional help, they risk the ability to maintain their weight loss.
Bariatric clients are a specialized and niche market waiting for us to offer our services. There is a tremendous opportunity for fitness professionals to branch out and customize their business to include both pre- and post-bariatric clients.
Understanding this Specialized Niche
Before you can properly and successfully work with a bariatric client, you must first be aware of and understand their specific physical and psychosocial needs. You need to be a lifestyle coach for them, providing a tremendous amount of emotional support and nutrition guidance as well as fitness training.
Most bariatric programs are comprised of a team of professionals that may include — but are not limited to — the surgeon, anesthesiologist, psychologist and nutritionist. These professionals prepare the patient for surgery and their immediate post-operative needs, including pain management, nutrition, activity and returning to work.
Trouble comes when the patient is six months, one year or several years out from surgery, and their team of professionals is no longer available in the same capacity. Patients are left to deal with their new lifestyle and the many challenges that come with it and seek help on their own. They view you as a positive, healthy and fit role model and will seek support, motivation and information.
Physical Changes
There are three types of procedures for weight loss, and you will need to know which type your client has had. Restrictive procedures limit the amount of food you can eat. Malabsorptive procedures alter the normal digestive process, causing food to be poorly digested and only partially absorbed. Thirdly, a combination of restrictive and malabsorptive procedures are also performed.
Our focus in this article will be Roux-en-Y gastric bypass, which is both restrictive and malabsorptive. Of all weight loss surgeries currently performed in the United States, approximately 80% are Roux-en-Y. In this procedure, the surgeon forms a small pouch from the stomach and reattaches it to a lower (distal) portion of the small intestine. The new pouch holds one ounce of food or less. Food enters the small intestine farther down, resulting in less time for bile and enzymes to assist in digestion and calorie absorption. This procedure results in greater weight loss but increases the risk of nutritional deficiencies.
Nutritional Concerns
As you can see, nutrition is of utmost importance to the bariatric client. It is not acceptable to eat smaller portions of the same foods they ate prior to surgery. They should have received very specific guidelines from their nutritionist, but they will look to you to help them incorporate those guidelines into their new lifestyle. When a bariatric client has a specific nutritional issue or a question you are not qualified to answer, you must suggest that they call their physician or nutritionist.( Click to Read More )
Melissa Shanes
CONTACT INFO
216-299-7730
melissashanes@gmail.com
Melissa Shanes
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" Before you can properly and successfully work with a bariatric client, you must first be aware of and understand their specific physical and psychosocial needs "
