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Archive for the ‘Programs’ Category
Tuesday, January 4th, 2011
Dominique Adair, MS, RD
*courtesy of HFPN.com*
Weight loss drugs, referred to as pharmacotherapy, have been popularly used since the 1950s, though long before that there were products available claiming to contain sanitized tapeworms available for purchase. Following several drugs such as dinitrophenol and the amphetamine-like compounds that posed serious side effects, the weight-loss drugs most commonly used today are appetite suppressants and nutrient absorption blockers.
While lifestyle measures remain the cornerstone of prevention and treatment of obesity, adding anti-obesity agents is considered by some physicians for obese patients who did not achieve sufficient weight loss after lifestyle modifications. Often positioned as an adjunct to diet and exercise, weight loss drugs are meant to supplement these behavior interventions and not to replace them. This article will review these classes of drugs, how they work, and the criteria with which physicians prescribe them to their patients.
Classes of Drugs
Today, most commonly prescribed weight loss drugs are either appetite suppressants or fat absorption blockers. For both, the goal of pharmacological intervention is to decrease feeding behavior and reduce weight. Appetite suppressants facilitate weight loss by tricking the body into believing that it is not hungry or that it is full. Most of them decrease appetite by increasing serotonin or catecholamine — two brain chemicals that affect mood and appetite. For example, the drug Subutrimine acts by increasing noradrenaline and serotonin levels in the hypothalamus, nucleus accumbens and the brainstem, all regions associated with energy homeostasis (1). Other centrally acting drugs that also work through the modification of neurotransmitters are presently being aggressively researched to determine if these novel approaches lead to clinically meaningful weight loss and improvements in comorbid conditions such as diabetes and cardiovascular disorders.
Clinical experience data on the success of these drugs suggests that weight loss produced by any one agent is limited and rarely exceeds 10% of the starting weight (2). This initial drop also plateaus. The ‘ceiling effect’ observed is probably due to adaptive changes as the body continues to maintain a balance in favor of energy conservation or the body’s metabolic “slow-down” in response to chronic underfeeding. One approach that some weight loss specialists have adopted to overcome this issue is to develop combination therapies that tackle the problem through more than one mechanism in an effort to minimize the impact of these adaptive changes.
Fat absorption inhibitors work by preventing the body from breaking down and absorbing ingested fat. These medications act on the gastrointestinal system and work by blocking the action of lipase, the fat-digesting enzyme, thereby reducing fat absorption in the gut. The non-absorbed fat is then eliminated in bowel movements. It also blocks the availability of fat-soluble vitamins (vitamins A, D, E, and K), so patients may also take a vitamin supplement (3).
The most commonly prescribed fat absorption blocker is the prescription drug Orlistat (brand name Xenical). Research has explored the effectiveness of Orlistat compared to other drug treatments, placebo, or behavior-focused interventions. Avenell et al. carried out a systematic review of trials involving a combination of diets, drug therapy, exercise, and behavior therapy and concluded that adding Orlistat to a dietary intervention improved weight loss by 3.26kg up to 24 months (4). Research also indicates that Orlistat reduces cholesterol and blood pressure levels and improves glycemic control when compared to placebo (5).
As of 2007, Orlistat became available over-the-counter (OTC). Sold as the brand name “Alli,” which is half the strength (60mg versus 120mg) of the prescription drug, Orlistat was the first clinically-proven OTC product to be combined with a comprehensive support program. Research indicates that both Orlistat and Alli can improve weight loss if used alongside behavioral and lifestyle interventions, however due to unpleasant side effects (urgent bowel movements, diarrhea, and gas with oily spotting/anal leakage) there remain problems with adherence and much variability in patient outcomes.
The Best Candidates
While each physician develops their own specific criteria for prescribing weight loss drugs, guidelines do exist. The National Heart Lung and Blood Institute’s evidence statement on pharmacotherapy for weight loss asserts:
“Weight loss drugs approved by the FDA may only be used as part of a comprehensive weight loss program, including dietary therapy and physical activity, for patients with a BMI of 30 with no concomitant obesity-related risk factors or diseases, and for patients with a BMI of 27 with concomitant obesity-related risk factors or diseases. Weight loss drugs should never be used without concomitant lifestyle modifications. Concomitant assessment of drug therapy for efficacy and safety is necessary. If the drug is efficacious in helping the patient lose and/or maintain weight loss and there are no serious adverse effects, it can be continued. If not, it should be discontinued” (6).
Before selecting a medication(s), physicians will also consider health history, possible side effects, and potential interaction of weight-loss drugs with other prescribed and OTC medications.
It is extremely important for physicians to emphasize to their patients that weight-loss drugs don’t replace the need for changes in eating habits and activity level. In fact, several studies on drug intervention alone demonstrate that once patients stop taking the drug, they may have a higher rate of regain compared with people who also have some behavior modification support (7).
Weight-Loss Drugs and the Fitness Professional
When combined with a low-calorie diet and regular exercise, weight-loss drugs produce an average weight loss of 5% to 10% of total body weight within a year, a typical initial goal for any weight-loss effort. Losing 5% to 10% of total weight may not seem like much, but even modest weight loss can improve health by:
* Decreasing blood pressure
* Decreasing lipid levels
* Decreasing blood glucose levels
* Increasing insulin sensitivity
With interventions that combine lifestyle behavior change and pharmacotherapy, it is difficult to determine how much of weight loss success can be attributed to each. Regardless, both during drug intervention and after, lifestyle behaviors, as supported by fitness professionals, remain an exceptionally important part of the success equation.
References:
(1) Sargent B and Moore, NA. New central targets for the treatment of obesity. Br J Clin Pharmacol. 2009 December; 68(6): 852–860.
(2) Tziomalos K, Krassas GE, Tzotzas T. The use of sibutramine in the management of obesity and related disorders: an update. Vasc Health Risk Manag. 2009; 5: 441–452.
(3) Hollywood A, Ogden J. Taking Orlistat: Predicting Weight Loss over 6 MonthsObes. 2011;2011:806896. Epub 2010 Nov 11.
(4) Avenell A, Brown TJ, McGee MA, et al. What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behaviour therapy or combinations of these interventions. Journal of Human Nutrition and Dietetics. 2004;17(4):293–316
(5) Padwal R, Li SK, Lau DCW. Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. International Journal of Obesity. 2003;27(12):1437–1446
(6) http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4325.htm last accessed 12.12.10.
(7) Warziski Turk, M Randomized Clinical Trials of Weight-Loss Maintenance: A Review. J Cardiovasc Nurs. 2009; 24(1): 58–80.
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Posted in Building Muscle, Eating Right, Expert Tips, Fitness Training, General Information, improve your health, Nutrition, Programs, tips to living better | Comments Off
Saturday, March 6th, 2010
Everyday new ways to help your clients get fit are reaching gyms and trainers across America. Whether it is new routines, exercises, or tools, expanding your fitness business means exploring new realms of fitness to enhance your clients’ experiences. Private group training has made its way onto the fitness floor and the spotlight has been turned to just how great training in groups can be.
Do you have what it takes?
Group training can provide a fitness professional with a lucrative option to enhancing their clientele without overloading their hourly work day. While enhanced economics is enough to entice many professionals, please be warned that you will have your work cut-out for you. There is a necessary skill-set to training small groups. To be sure you are ready for taking on a small group; here are some skills that might be helpful for success in this new endeavor.
Become a fan of change. You must be prepared to convert, manipulate or change exercises on the fly. Regressions and progressions may be necessary depending on the abilities of those participating in your small group and in order to ensure success of each participant, exercises must be appropriate for their skills and abilities. Prepare a few different programs before your sessions so you can make changes quick and your clients won’t miss a step!
Embrace your inner cheerleader. Motivating your clients in one-on-one sessions is generally easier because you have one client to focus on. When there is one person in the spotlight, you know your client’s emotional triggers, you understand the buttons you can push to keep them moving and you can adjust your personality to meet their needs. With small group training, there are more personalities to try to know, understand and motivate. Eat an energy bar before you train because you will need the energy to keep up with all the personalities and emotions you might face during the session! Stay upbeat and don’t worry – the more you train the group, the more you will understand their unique dynamic and you will be able to adjust your personality accordingly.
“Speak softly and carry a big stick…you will go far.” Okay, maybe you won’t need to carry a big stick, but be ready to be a strong leader. Remember groups can quickly turn into mobs if they are not controlled properly. Make sure you are ready with rules and guidelines for the group, and stick to them! Stay strong when you lay down your training ground rules, make sure that every participant knows and understands your guidelines and the reasons why you put them in place – you are trying to help them and in order to do so, your training sessions must have structure! If you let the group take over your sessions, this prosperous endeavor may cost you your sanity.
Money matters.
Group training can have a positive effect on your income stream. Working with several clients during one hour can help you raise your hourly wage while decreasing the cost for those clients participating in your group session. Overall, this can be a win-win situation for everyone involved.
Your Group Rate Should Make “Cents” If your current hourly wage is $45 per hour to provide one-on-one service, lowering the cost to $30 per hour per client for a small group session gives your client a break on the cost (potentially incentivizing them to train more) and could raise your hourly wage to $60 or $90 depending on the size of your small group (factoring in 2-3 clients per hour).
There are several ways to determine your price breakdown – you can propose a flat fee despite how many group members you have (as shown in the example above), or you can provide a tiered cost-break, giving a discount based on the number of clients in the group, for example, 2 clients can cost $35 per person per session / 3 clients drops to $30 per person per session, and so on. Before you start counting your pennies, there are a few economic factors to consider such as the costs associated with training more than one client at a time. First, adding more clients often calls for increased equipment. If you are an independent trainer, this investment might cost you more than you planned for- be sure to add up your additional costs for items such as extra bands, balls and dumbbells. But don’t worry – this is a sound investment, having extra equipment can help you in a pinch in case something breaks or ends up missing (as items often do). Second, space might be an obstacle. If the small group cannot fit into the studio or area you want to train them in, you might consider using parks or gymnasiums to work out your clients. Often, renting space can cost you – check with the park service or city civic center for permission to train on their grounds or in their facilities and add up any fees they might charge for allowing you to rent their space. In addition, make sure your personal training insurance covers multiple locations and clients.
With more than one client, you might think about increasing your coverage in case of multiple injuries. Check with your insurance provider to make sure you have the best coverage for your new endeavor – this can cost you, but it will save you more in the long run should a client suffer an injury.
If you are a trainer in a gym you won’t have to invest in equipment, but you face other challenges. You might have plenty of equipment at your disposal, but it might be limited by the time of day and space that is provided for your small group. Before you begin small group training, sit down with your fitness manager to determine potential solutions for any road-blocks you can foresee with your small group. Often the club might be willing to invest in extra equipment that can be offset by the increased income from the multiple clients you are training per hour. In addition, make sure your hourly compensation will be adjusted before you take on more clients per hour. You don’t want to do more work and get paid less! Take the time to communicate with the management at your club and propose ideas on how to tackle issues, both financially and operationally.
All in all, the cost of your sessions should cover the time you take to prepare for your sessions as well as the cost of extra equipment, space, insurance and the increased work load you face during the session. This can help you determine the appropriate price break down for each client without an arbitrary decision that might leave you in a deficit rather than a profit.
Expert Advice
In addition, Aniciete adds,“Email communication is a great way to keep healthy thoughts and actions on the group’s mind outside of your sessions – try to open up an email connection and send them tips and advice. Once you learn to adapt and modify your workouts according to the vibe of the group, you and the clients will have lots of fun. There will be always something to talk about.”
Sage advice is often the best companion to any new endeavor you propose to take on and when it comes to small group training – ask those who know – it can get sticky at times!
According to Jeremy Aniciete, a full-time trainer with Lifetime Fitness in Omaha who leads about 4 group sessions a day, heading up a group training session means laying down some ground rules and making sure you have a plan. “Always incorporate assessments to show results as this helps motivate the group members to keep showing up.” However, Anciete warns, “keep those results personal – if a client wants to share their results they can, but maintain a person’s privacy.” In addition, place some responsibility on the group to ensure attendance and adherence to the rules. “Use the members to hold themselves accountable for nutrition, cardio and strength training. Your role is to motivate them while they are there but let the group members push the others to make the commitment and stick with it! Clearly and definitively let the group members know that the schedule of sessions is laid in stone with optional days for make-ups. Make certain every client is aware of the rules and agrees with them.” Beyond laying down the foundation, Aniciete advises to keep your group talking and having fun in and out of every session.
Group training can mean higher wages, more efficient training hours and loads of fun! Just make sure to maneuver your sessions carefully through proper planning and communication. With more money comes more responsibility so make sure you are ready for all the ups and downs of a group session. Keep it fun and keep them moving – and they will keep coming back for more!
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Tags: fitness, group training, trainers across America
Posted in Fitness Training, Programs | 3 Comments »
Friday, December 18th, 2009
 - Succeed Today
Why wait until New Year’s day to make your resolution to live a healthier and happier lifestyle?! Today is the day you should be thinking about making the change.
Every year we vow to change something in our lives. Why not vow to make a change that will give us a longer life, better outlook on things, and immediate results? If you want to enjoy life, be successful, and live healthy; you have to step in and take control of your bad habits. Recognizing that you need to change is the first step, the second requires you to get involved.
Begin by seeking out a good fitness center. The fitness center of your choice should have cardio and strength training circuits, a certified fitness trainer on board, and a number of training programs you can take advantage of. The membership to a club like this is extremely beneficial. While a home gym sounds ideal for the individual that cannot get out much, it unfortunitly doesn’t always work.
Bounce Fitness is offering new members an opportunity to start working towards their 2010 fitness goals today.
It’s programs like these that make a difference. When you’re ready to commit to a new routine, you should take advantage of every promotion a club has to offer. The steps towards your weight loss success starts here at this point.
If you can’t invest some time to check out the clubs in your area, at least spend some time walking. Although it is colder now that it’s winter, a brisk walk can get the blood pumping through your body and warm your muscles quickly. Anything you do is better than nothing.
Tags: bounce fitness special, new year resolution
Posted in Programs | 8 Comments »
Friday, December 18th, 2009
 Fitness Health 1. Making the Commitment. So you’ve decided to get in shape, lose some weight, take up a sport, lower your cholesterol and/or attempt to keep up with your children. Whatever the reason, you’ve taken the first step toward a healthier lifestyle. Once the decision is made, do not wait – start immediately. When you first decide to do something is when you are the most enthusiastic about it; don’t squander the enthusiasm, use it!
2. Setting a Goal. The most popular goals are to lose weight and tone up, but what does that mean? Your goals must be defined, quantitative, and achievable. For example: “I want to lose 8 pounds in one month.” Goals like this give a specific purpose and a time frame in which to achieve them. Without a specific goal, you will lose focus and quit before you can get any results.
3. Seeking Out Information. Now that you have your goal strictly defined, you need to find out the best way to achieve it. Unfortunately, there is usually a cost attached to information. Fitness professionals make their living based on giving out this information.
However, there is plenty of information available on the Internet. The problem is finding which information is right for you. This is when online personal trainers become a valuable resource. You can get information directly from a qualified personal trainer at a fraction of the cost. This is the way of the future.
4. Designing Your Program. This is the second most complex part of your overall program. The reason it is so complex is because exercise is different for each individual person. Have you worked out before? If so, how much and for how long? Do you have any knee problems? These and many other factors will have an effect on your program.
5. Nutrition. This subject can be pretty confusing — entire books have been written about it. The best advice I can give you, in one short paragraph, is to seek out as much information as possible from credible sources. Armed with the right information, you’ll be able to make healthy decisions when it comes to dieting and controlling those pesky cravings.
6. Staying Motivated. Staying motivated is easiest with a partner, someone to work out with and call when you need nutrition support. But do some research before picking one: If your partner loses motivation easily, it will make success very difficult.
7. Knowing When to Change Your Program. You must change your program every 3-4 weeks, depending on your fitness level. The average person needs a change around the third week. Do not skip this step. If you don’t change your program regularly, you will become used to it and your body will stop responding to it. Worst of all, you may become bored and stop exercising altogether.
8. Summing It All Up. Ultimately, you need help. If you are getting sued, you get a lawyer. If you are sick, you call a physician. If you are looking to improve your health and become fit, you need a certified personal trainer. These people make a career out of knowing what needs to be done and how to do it. There is no way you can wade through all of the information available on fitness and nutrition while juggling all of life’s obligations… it can be overwhelming. Get help.
About the author: EDIETS
Posted in Fitness Training, Programs | 5 Comments »
Wednesday, November 4th, 2009
 Exercising at Work We all know the positive benefits of exercise: reduce the chance of developing heart disease, cancer, diabetes, reduce body weight and fat, build healthy muscles, bones, and joints, reduce depression and anxiety, enhance and improve physical performance, and on and on and on. So why hasn’t your small business taken an active role in improving the lives of your employees by promoting exercise?
The answer is simple: you don’t have the time, energy, or money to put a corporate fitness program together, or pay to have someone do it for you. That’s no excuse! Encouraging your employees to get into shape can have exponential returns in increased employee productivity, reduced health insurance costs, and decreases in employee sick days.
Better yet, you might not have to pay anything at all. There are many fitness companies and personal trainers that will come provide information, employee-paid fitness classes, and other services at no charge to the small business itself. Here are a few ways you can encourage fitness (without spending any money):
Fitness Education for Your Employees
Many fitness companies, personal trainers, and nutritionists would jump at the opportunity to speak to your employees about fitness and nutrition, FOR FREE! Look for fitness professionals around your area and ask them if they’d like to come speak about a specific topic, like weight loss, eating right, or overall fitness.
Organize Group Fitness Activities
Rather than waiting until team cohesion breaks down to schedule some kind of corporate retreat in the mountains, make physical exercise like hiking, biking, running, and casual sports like soccer, basketball, and softball part of your weekly or monthly schedule. This will enhance teamwork while getting everyone into shape.
Local Fitness Programs
If you look around your area, you might find a local gym or fitness company that conducts lunch-time exercise programs
. You might want to encourage your employees to get a membership and attend the classes at lunch as a group activity. If you’d like to help with the expense, maybe offer to pay for some of the class, or negotiate a group rate with the gym. If you don’t have the money for that, offer your employees a “fitness hour” to go to the gym and keep them on the clock.
On-site Fitness Classes
Some fitness companies and trainers will conduct on-site fitness services in or outside your location. Depending on the type of training, some companies will even bring the necessary equipment with them to conduct the class. If you can’t afford to pay for the class, your employees might. See if you could get a per-session rate from the trainer that is reasonable for all your employees to pay.
Tags: benefits of exercise, bones and joints, corporate health programs, employee productivity, exercise programs, fitness activities, fitness classes, fitness professionals, fitness programs, health benefits, health insurance costs, heart disease cancer, physical exercise, time exercise
Posted in Fitness Training, Programs | 41 Comments »
Wednesday, November 4th, 2009
 Team Involvement The number of corporations that set up employee wellness programs continues to rise this year. Investments in wellness programs are increasingly being given serious thought. Studies show that having a sound employee wellness scheme in place brings about benefits, not only to the workers but to the companies as well. Some of these benefits include:
• higher worker productivity
• reduced absenteeism
• a considerable boost in employee morale
• lower health care costs and;
• decrease in employee turnover.
For a company to thrive and succeed in the market place, it is vital for it to provide its labor force with an environment that they are happy to work in. A highly productive work force translates to business success and longevity.
So what makes a good employee wellness program?
A well-devised fitness program
Companies should encourage its work force to be more active and they can do this by providing ample opportunities for exercise. Some companies have in-house facilities such as swimming pools, corporate gyms, basketball and tennis courts and the like. If the current location doesn’t have these facilities then perhaps companies can offer their employees free memberships at clubs and offsite fitness facilities.
Family-inclusive
A wellness program that includes workers’ family members is good motivation for them to keep performing well. This gives off the impression that the company is truly concerned about its workers. Fitness is a family affair and what better way to sustain fitness efforts than to get everybody in the family involved?
Stress reduction program
Stress in the work place is a very serious matter and is often one of the major causes of employee burn out. A good wellness scheme should address the issue of stress management by providing support programs such as counseling or other professional services designed to reduce anxiety disorders, depression and so on.
In-house health care facilities
Having health care services available in-house is beneficial to both employees and companies. This helps reduce medical and insurance costs and at the same time, it provides employees with immediate medical help should they require it.
Wellness coaching
A wellness program is likely to be more successful if there is constant support provided along with it. Employees are given assistance when it comes to monitoring physical fitness progress, motivation, counseling and discussing stress reduction techniques among others. Regular counseling sessions are also beneficial for those suffering from high risk conditions.
Strict implementation of no smoking rules
Smoking is one of the major contributors to serious health problems and it is important for companies to be uncompromising in its rules when it comes to smoking. It isn’t enough to set up rules, though. More importantly, there should be adequate encouragement and support for those who want to quit smoking. Some companies even go as far as counseling and providing medication to facilitate quitting.
Weight loss programs
Obesity is another major health risk but this can be reduced by having a well designed weight loss program. It is important that employees be encouraged to lose weight by providing opportunities for weight reduction activities. It is even more crucial that they be monitored regularly in the long term.
Tags: corporate fitness, employee wellness, weight reduction, wellness program
Posted in Fitness Training, Programs | 11 Comments »
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