Cueing With Criticism ?

How some of the best trainers stumble into weight bias coaching…and compassionately climb right out.

From Fitness Trainer November/December

Cueing With Criticism ?

You’ve tried everything you can think of to help your client lose weight, but she just can’t stick to her program. Almost every trainer has probably felt this frustration at some point. Do these clients lack willpower, or do they face more powerful struggles that are beyond your awareness? Consider this: Studies show that fitness professionals, health care providers, and even obesity specialists are subject to weight bias, just like the general population. One study at the University of Alberta tested subjects’ perception of individuals who were relaxing. When a thin person was lying down watching TV, subjects assumed he or she was resting. But when people who were overweight watched TV lying down, they were seen as unmotivated and lazy. Most trainers would never hurt a client intentionally; we’re in the business of helping people become stronger, gain more self-confidence, and even transform their lives. How can we ensure that we’re not reinforcing a client’s feelings of low self-worth, fueling an eating disorder, or having another negative effect without even realizing it?

Silent Suffering

The quiet, implicit stigmatization of people because of their body weight can be just as destructive as explicit prejudiced behavior, according to a multitudes of studies. People who are otherwise fair and nonjudgmental can reinforce this stigma, even though it’s been shown to cause unhealthy behaviors and more weight gain. Weight bias, like racial bias, takes many forms. Negative attitudes and beliefs about body weight can include stereotypical assumptions, stigma, prejudice, and unfair treatment towards people because they are overweight or obese. Consequences of weight bias can include low-self-esteem, poor body image, disordered eating, and a higher risk of depression. One study of 2,400 women with obesity and overweight found that 79% reported coping with weight stigmatization by eating more food and 75% reported coping by refusing to diet. Chances are, your clients with obesity have experienced weight bias at work, their doctor’s office, in social settings, or even with family or friends. Although you try to be a positive force in their lives, they may still struggle with judgments, rejection, and low self-esteem. And if you unwittingly reinforce the stigma they feel, they could easily backslide. However, it’s relatively easy to become more conscious in how you coach.

Be Aware of your Language

Our society values slender people and blames people for being overweight or obese. It remains socially acceptable to express weight bias in both subtle and overt ways. Labeling an individual with their disease is dehumanizing. Yet news stories, articles, and other media commonly use this language, and even personal trainers are not immune. Your client doesn’t need to hear you speak that way, too. Use a “People First” approach that keeps people separate from their conditions.

Examples:

• “My client with obesity” instead of “My obese/overweight client”
• “Individuals affected by obesity may have joint pain.” instead of “Obese people may have joint pain.”

Practice Empathy

Studies show that patients treated with empathy adhere to their programs better than those who aren’t [4]. Showing empathy towards your clients will also help gradually decrease their struggles with adherence and the stress it causes. What is empathy, exactly? Being able to understand another person’s frame of reference and knowing that it’s worthwhile to do so. Empathy involves genuinely connecting with your clients and developing an authentic relationship with them, rather than making assumptions or judgments about them. You can be empathetic and professional at the same time, and in fact, clients will appreciate it if you can make this balance work.

• Lose your mask of invincibility. It’s difficult to have an authentic relationship with someone who knows everything and has the perfect body. Yet this is how some people with obesity may see us.
• Be an engaged listener, using active or reflective listening techniques.

Analyze Your Own Assumptions

Like the general population, doctors, nurses, and myriad other people, personal trainers need to carefully understand their own assumptions. If you hold a bias that people with obesity are lazy, unmotivated, and undisciplined, you may unwittingly sabotage your client by trying to shame them into complying (“You’ll never lose weight if you keep eating that.”). However, the notion that shaming people with obesity will motivate them to change is outdated and ineffective.

Emphasize Non-Appearance-Related Goals

It doesn’t all have to be about being thin and losing weight, and not everyone cares about looking good in a swimsuit. Find out what your client wants to do effortlessly in daily life and create goals around mastering those activities. After surveying your client, work on goals most important to them, like feeling confident when moving, having more energy, sleeping better, or being able to do something they used to do, like hiking or biking. Celebrate non-weight-loss goals and keep goals weight-neutral. When a client gains a better quality of life through your program, you’ll know you’ve made a genuine impact. You only want the best for your clients, and armed with more awareness, you can be a positive force of change.

References

Berry, T. & Spence, J.C. (2009). Automatic activation of exercise and sedentary stereotypes. Research Quarterly for Exercise and Sport, 80. 3, 633–640.

Rice, Rochelle, MA. Weight bias and size sensitivity (date). ACE Fitness Weight Management Specialist Program.

Puhl, R. (2011). Weight Stigma: Health Implications. Storrs, Conn.: Yale Rudd Center for Food Policy & Obesity, 1–6.

De Blasi, Z. et al. (2001). Influence of context effects on health outcomes: A systematic review. Lancet 357, 757–762.

Suzanne Digre

Is National Academy of Sports Medicine (NASM) certified personal trainer and online coach in Denver, Colorado. Suzanne also has a Bachelor’s in Journalism from Metropolitan State College of Denver. Her 20-year passion for weightlifting led her to found her blog, workoutnirvana.com, where she’s written more than 300 fitness and nutrition articles. Suzanne founded her online coaching business, Workout Nirvana Fitness, LLC, in 2011 to help women eat clean unapologetically, sculpt lean muscle, and own a fierce mind-set both in and out of the weight room. In addition to weightlifting, Suzanne loves hiking in the Rocky Mountains, cycling, and most recently, cross-country skiing. She approaches personal training with a compassionate yet determined attitude that allows clients to feel successful with small, consistent lifestyle and mindset changes.