• Three Tips for Earning the Trust of the Weight-Loss Client
    Losing weight requires having a support system of fitness professionals, dietitians, and other clinicians that are dedicated to improve the well-being of their client. Learn first-hand from a weight management specialist about the skills needed to encourage weight-loss clients and build their confidence.
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  • Weight Loss ClientRecently, a patient came for his initial appointment at the weight management center where I work. He was 5’10”, weighed 275 lb, and had a body mass index of 39.5, placing him just on the edge of morbid obesity.

    Imagine for a moment that you are that overweight or obese person desperately seeking to lose weight, coming to meet for the first time with a fitness coach specializing in weight loss. In the past, you have tried many different diets with mixed results—sometimes you lost weight, but other times you gained. Now you are taking a different approach and meeting with someone that is professionally trained in both fitness and nutrition (a wellness coach, a highly qualified fitness professional or a registered dietitian). What thoughts are going through your head? Are you nervous about disclosing some of your deepest feelings? Wondering whether the coach will listen to what you have to say? What determines whether you will place your full trust in this new advisor?

    Often, the fitness coach preparing for this initial meeting is focused on issues he thinks will be instrumental in the weight-loss battle (e.g., calculating energy expenditure, creating a meal plan, perhaps determining nutritional deficiencies that may be present, etc.). How would this approach feel to you as the client? Is this what you came to learn about? Would the coach’s focus on these issues make you more or less willing to be completely open with the coach?
     
    A wide-ranging initial interview with the nearly morbidly obese patient revealed that, despite painful joints and other comorbid factors, he was extremely motivated to run a half marathon.To help advance the client toward his goals, the weight-loss professional must dig deeper than what is apparent. And to solve any individual’s mystery of weight gain, the advisor must gain the patient’s full trust. A wide-ranging initial interview with the nearly morbidly obese patient revealed that, despite painful joints and other comorbid factors, he was extremely motivated to run a half marathon. How can the fitness professional build the trust necessary to get this man running 13.1 miles? Three steps are vital. First, listen carefully and patiently to what the client has to say; second, demonstrate belief that the client is capable of achieving the desired results; and third, provide truthful and accurate information based on facts.

    Listening or Thinking
    Have you ever reflected on what you were thinking about during a conversation with a client? How about what percentage of the meeting you talked to your client and how much of the meeting you spent listening? And while you were listening, were you at the same time thinking about what you were going to say next?

    Each of us can remember back to a time that we felt fully listened to and completely understood. Almost certainly, the conversation did not involve a snappy comeback from our partner, or a quick and easy solution to a problem. Much more likely, it took place at a slow pace, with plenty of pauses for reflection. The fitness professional needs to get an effective amount of “hard” information from the client in each session, but finding out what the client wants is essential as well. Ask the client, “What do you want to get out of the session?” Allow as much time as necessary to see what he has to say. Resist the temptation to answer for the client after a couple of seconds of silence. Allow the pause to happen while remaining relaxed—you may be amazed at what will come of it. Consciously work to separate the tasks of listening to the client and thinking about solutions to his weight-loss problem.


    Belief in Capability
    In what has come to be known as the Pygmalion Study, two researchers told teachers at a California elementary school that a certain number of their students could be expected to learn significantly more during the school year than their classmates. In fact, the “fast learners” were chosen at random; no evidence supported their ability to learn more than other children. At the end of the year, testing established that first and second graders in the “fast learner” group had learning gains that were greater than their classmates by a statistically significant amount. The teachers had unconsciously behaved in ways that facilitated learning in the group of students they were told would be successful (2).

    The weight-loss client is similarly sensitive to, and dependent upon, the fitness professional’s confidence that the client can reach his goals. Take opportunities to show the client that you expect success for him through your words and actions. Anticipate barriers to weight loss, or plateaus in success, so that you can communicate your belief that the client is capable of persisting through challenges. The client’s mindset is critical to successful weight loss, but the fitness professional’s mindset toward his client’s capabilities is also quite important. 
    The client’s mindset is critical to successful weight loss, but the fitness professional’s mindset toward his client’s capabilities is also quite important.Educate Based upon Facts
    A patient in our center recently reported that her doctor told her whey protein causes liver damage and that she should stop taking the supplement. I was startled, as I was aware of literature suggesting that whey protein might have benefits for people with liver damage. But I resisted telling the patient that she had bad information. A quick internet check turned up a single report of a young weightlifter that developed painless jaundice while taking creatine and whey protein (3), as well as more numerous suggestions—including one from the Mayo Clinic—that use of whey protein might be beneficial to the liver (1). There was some basis for what the patient had been told, but the full story contained a great deal more context.

    Fitness professionals routinely hear all sorts of anecdotal claims about supplements, drugs, or exercise regimens. To maintain trust, the advisor must educate the client with facts. At times, the advisor has at hand all the information necessary to refute an outlandish claim and provide definitive advice. More often, he will need to research the issue before answering. Responding based upon facts, instead of providing an answer not supported by science, creates trust in the client—and the client is likely to appreciate the time taken to research his concerns.

    Earning the trust of the weight-loss client can be very challenging. It does not occur in one session. Like any other relationship, building trust between the advisor and client takes time and patience. Focusing on intentional listening, demonstrated confidence in the client and fact-based education will help create that trust.


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    About the Author:

    Taft Draper, RD, CSCS

    Taft Draper works at Mission Health Weight Management Center in Asheville, N.C. as a Clinical Nutrition Educator and also assists the Mission Hospital Sports Medicine Care Team with sports nutrition and human performance training.

    REFERENCES →

    1. Drugs and Supplements: Whey Protein. Mayo Clinic. Available at http://www.mayoclinic.com/health/whey-protein/NS_patient-wheyprotein/DSECTION=evidence. Accessed October 22, 2012.
    2. Rosenthal, R, Jacobson, L, Pygmalion in the Classroom. New York: Holt, Rinehart and Winston, 1968.
    3. Whitt, KN, Ward, SC, Deniz, K, Lin, L, Odin, JA, and Qin, L. Cholestatic liver injury associated with whey protein and creatine supplement. Seminar Liver Disease 28(2): 226-31, 2008 May.

  • Disclaimer: The National Strength and Conditioning Association (NSCA) encourages the exchange of diverse opinions. The ideas, comments, and materials presented herein do not necessarily reflect the NSCA’s official position on an issue. The NSCA assumes no responsibility for any statements made by authors, whether as fact, opinion, or otherwise. 
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    3 Comments

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      You did not include the age of the individual in your introductory paragraph. Interesting article on listening to clients.

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      In my experience, it is indeed critical to make the client aware that you believe in them. In the weight loss setting, poor self-esteem is a major hurdle for the obese to overcome. If they sense that you do not believe in them it will become yet anothermore» excuse to give up! Also, it is easy to give advice based on the latest and greatest study or paper. Do not let you or your clients fall prey to what I call the "n of one" syndrome. Stick with what is proven AND makes sense.«less

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      Very good article and writing style.

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