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Often I write about fitness, but most of the major improvements I’ve ever made in my life that have led to read happiness are outside of the gym and even more frequently things I’ve done for people outside of myself.  Today I wanted to share some of the things that have helped me to become who I am, some I’m still working on, and some that may just help you.

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45 Ways to Live an Incredible Life

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Everybody knows when you’re checking yourself out in the mirrors at the gym.  Stop it.

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Read.

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Turn off the TV.

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Put down your damn phone.

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No…seriously.  Put it down.

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Tell your parents you love them.  You never know when they’ll be gone.  (I miss you so much Dad).

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Be present.

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Hug your kids every chance you get.

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Pay for the coffee of the random stranger behind you in line.  Make their day.

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Drink plenty of water.  Drink little of everything else.

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Remember that love is a choice and not a feeling.  Love your spouse.

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Lift heavy things often.

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Eat adequate protein.

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Leave time to recover.

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Don’t skip your cardio.

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Get a foam roller.  Use it often.

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Do more mobility work.

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Go to bed early.  Get up early.

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Remember that more sleep = less fat.

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If you have over 600 pictures on Facebook and they’re all of you, get some therapy.  :)

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Remember most thoughts on fitness blogs are opinions.  You know what they say about opinions.

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Don’t be spoon fed opinions.  Read research.

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Don’t text and drive.  This is dumb.

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Don’t drink and drive.  Seriously.  Don’t be an asshole.

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If you want big arms train your arms.  Don’t skip it just because some internet guru said so.

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Play with your kids.  Be engaged.

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Life is garbage in garbage out.  Cut out the garbage you put into your mind and body.

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Deadlift.  (Yeah, this one gets its own line)

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Remember weight loss is all about calories in and calories out.

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Fat loss is mostly diet.  Don’t kid yourself with “metabolic circuits“.

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There are no magic hormonal changes brought about by certain types of training that will bring about miracle results.  Know this.

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Understand that Muscle Growth = Time + Effort + Consistency.

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Don’t argue on the internet.

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Be nice to your neighbors.  They are the only ones who can tell your good screams from your bad screams.

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Rapid fat loss programs most often lead to rapid weight regain.  Don’t be that guy (or girl).

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Slow progressive behavior change is the way to long term fat loss.  Accept this.

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Don’t chastise overweight people for being overweight.  Rarely has putting anyone down brought them up to a new level.

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Ever notice that the research based fitness professionals don’t listen to Mercola?  Take a hint.

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Today, help someone with no expectation of return.

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Give money to the homeless guy you pass without judging where you think he’s going to spend it.

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Go play on the climbers.

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Sprint.

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Pray.

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Be quick to apologize.

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Most of all, define what you want out of life, who you’re living for, and the person you want to be and pursue it with relentless passion.

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What are your tips for living an incredible life?  Leave ‘em below!

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PS: Please “like”, share, tweet, +1, or whatever other social media thingy you’re addicted to.

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PPS: Friend me up on Facebook and Twitter.

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Since I wrapped up the Training Clients with Obesity series here this week and I’ve been super busy I’m just going to share a couple quick things with you today before I skip out for the weekend.

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1.  This week I had my first article posted on the Personal Trainer Development Center site that is run by my good friend Jon Goodman.  Here’s a snippet of the article:

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Personal training is a unique profession in that we are charged with the development and implementation of programs that can impact people’s weight, body composition, performance, injury status, emotions, and health.  Yet, as a profession we struggle with the fact that  people just don’t take us seriously.

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Heck, I’ll even admit that when a friend or family member tells me that they’ve hired a personal trainer my first reaction is to cringe (at least on the inside).  Trying not to jump to conclusions I usually ask a few questions until I get a feel for the background and, more importantly, the methods the trainer is using to bring about results.  And all too often, I am disappointed to hear that my initial response was appropriate and that makes me sad for our profession.

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While there are probably many possible reasons for this, I think that a major part of the problem stems from the fact that many trainers are researching health and fitness exclusively from the same places as those they are supposed to be trying to help.  To make matters worse, many of those trainers have no objective method to determine whether the methods presented in the materials they are reading are valid or are just pseudoscientific hype fueled by money and marketing.  In short, a lot of us are falling prey to the same mistakes as the people we are trained to serve.  No wonder nobody takes us seriously!

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You can read the rest of this article HERE.

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2.  Crunches may be good for your spine?

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In recent years there has been a definite trend away from repeated flexion based movements (i.e., crunches) in the training of the abdominals due to the suspected risk of injury to the spine.  But a brand spanking new review written by my good friends Bret Contreras and Brad Schoenfeld presents pretty convincing evidence that perhaps flexion is not only less risky than we thought, but that some repeated flexion might actually be good for us.

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I’ll be the first to admit that I was pretty solidly on the anti-flexion bandwagon, but since reading this article I’m very much reconsidering my stance to the point where I think it is reasonable to include some (although limited) flexion based work for the core.  I’d also consider those interested to check out Brad Schoenfeld’s latest post called “Do Crunches Cause Poor Posture?” that I think dispells yet another fitness myth.

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I can’t wait to see the waves that this new article is going to make in this industry.  :)

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3.  Muscle Imbalances Revealed – Upper Body is coming!

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Last year I reviewed a product from my friend Rick Kaselj called Muscle Imbalances Revealed and it was absolutely stellar!  Rick had pulled together a bunch of really smart guys to put together several presentations examining muscle imbalances in the lower body and how to deal with them.  With Mike Robertson, Dean Somerset, and Eric Beard on the project was an obvious winner from the start.

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Finally, a year later, Rick has put together yet another rock star cast including Dean Somerset, Tony Gentilcore, and Dr. Jeff Cubos to talk about muscle imbalances in the upper body and I couldn’t be more excited.  In fact, as I write this I’ve got my advanced copy of Tony Gentilcore’s corrective strategies video cued up to go in another browser window and I’m pumped to watch it (which is why I’m typing so fast and there are probably a ton of typos in this post).

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The bad news is that the product actually won’t be released until August 9th.  The good news, however, is that Rick is giving away two free reports (one video and one text) called “8 Steps to Unravelling Your Muscle Imbalances” that you can access right now!   If you’re interested in scoring some free swag (who doesn’t love free stuff?) you can pick it up HERE.

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And that’s it for me.  Have a great weekend!

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Over the past few weeks I’ve put together an extensive (and I hope valuable) series on training clients with obesity.  In Part I of the series I described the categorization and classification of obesity.  In Part II I shared some resources and very important concepts about obesity management.  In Part III I discussed how I would go about training those with a BMI greater than 35.  In Part IV I talked about the training I would use for those with a BMI below 35, but still above 30.  And in Part V I presented a summary of the various types of bariatric surgery that are most often sought by those with obesity.  Today I want to finally bring the series to a close with a final piece about nutrition for those with obesity.

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What We Know About Diets

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I think some of the largest trials comparing diets in the real world (such as the famous A to Z Study) have demonstrated that while low carb diets generally get the lead for early weight loss, after a year they aren’t really that much better than moderate or higher carb diets.   Granted, there was a statistically significant difference in the A to Z Study, but is it really significant in terms of what it means to you or your clients?  Here are the results from the paper.

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Mean 12-month weight loss was as follows: Atkins, −4.7 kg (95% confidence interval [CI], −6.3 to −3.1 kg), Zone, −1.6 kg (95% CI, −2.8 to −0.4 kg), LEARN, −2.6 kg (−3.8 to −1.3 kg), and Ornish, −2.2 kg (−3.6 to −0.8 kg). Weight loss was not statistically different among the Zone, LEARN, and Ornish groups.

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So basically, the Atkins group lost an average of 10.3 pounds, the Zone group lost 3.5 pounds, the LEARN group lost 5.7 pounds, and the Ornish group lost 4.8 pounds after one year!!!  In this case the “best” diet yielded an average weight loss of approximately 0.2 pounds per week.

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What I feel this study really tells us isn’t that one type of diet is superior to another for weight loss, but that our biggest issue with diets is compliance.  In fact, what I think you’ll find if you talk to any client with obesity is that many of them have tried numerous diets for weight loss in the past and some of them may actually have done VERY well (losing even 100 pounds or more) only to put it back on.  The key here is not to find some magical diet that will elicit the most rapid fat loss possible, but to find a nutrition plan that the client will be able to maintain for life.

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Wait a Minute…

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Isn’t that what I usually say for non-obese clients too?  Gee willikers.  Could we be on to something here?  Does this mean there is no magic diet that will instantly result in ripped abz for only $39.99?  Could it also be that if we simply identified and address the barriers that prevent us from being able to adhere to ANY diet we’ve selected that we’d get better results?  Nah…couldn’t be.  That would make too much freakin’ sense.

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Anyway, the biggest nutritional factor that is required to result in weight loss success is a moderate calorie deficit.  As simple as it sounds, the key is to make sure the calories consumed by the client are less than those that are burned.  I should reiterate again that this should be a MODERATE deficit and your client need not lose weight rapidly and you must resolve to teach them the proper way to lose weight despite their insistence that they’d like it to go faster.  The more severe the plan, the less likely the client is to stick to it for life which (as we discussed above) the single MOST important element of any nutrition plan.

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I should note that in some medical obesity management programs very low calorie diets (VLCD) consisting exclusively of nutritional protein shakes totalling 800-900 calories per day are sometimes used for rapid weight loss.  You should NOT follow this practice with your clients.  Programs like these MUST be medically supervised as there are risks associated with gall stones from rapid weight loss (possibly leading to pancreatitis), low sodium levels, and life threatening blood sugar crashes if the person is on insulin (as many with obesity who have Diabetes are).

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Aside from that, the diet should contain enough protein for muscle maintenance, fiber, and plenty of fruits and vegetables.  But I need to state again that creating a moderate calorie deficit and finding a nutritional lifestyle program that will stick (along with identifying and addressing barriers to compliance) are the two biggest concerns.  Without these, you can pretty much forget about everything else.  And, of course, since these clients often struggle with sudden change and making it stick in the long term (as do most clients actually), it is important to implement progressive behavior change to get the client onto the plan rather than an instant jump to super strictness.  Doing this will empower the client and make them more willing to take further steps as their confidence grows.

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In short, there is no magic but consistant and slow behavior change and a reasonable diet.  Anything else is just setting your client up for failure.  And if you doubt it, I’ll leave you with this.  Below is an image of the weekly weight values of a client I’ve worked with for the last nine years.  The first year averaged a 2-3 pound per week weight loss and beyond that it was much slower.  But the point to be really taken is that weight loss is easy.  Long term maintenance which is where the truly gifted trainer aims to shine.

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As usual, if you have any questions, comments, or random insults you can leave them below and I’ll make sure to address them.

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Also, if this article has been useful to you please don’t hesitate to share, “like”, tweet, +1, or whatever funky social media thing you can do to spread the word.

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Today I’m going to take a quick break from my Training the Obese Client series to share a few quick updates.

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1.  I am super stoked to announce that my grad thesis work is now published as my very first peer reviewed article in the European Journal of Applied Physiology.  Of course, as some of you know, I left my grad program after completing my study (due to my father’s passing) and my colleague Dan Moore wrote up the piece on my behalf.  You can check out the abstract HERE.

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Basically, what we were able to demonstrate is the eccentric contractions are not better for strength or muscle growth than concentric contractions when the mechanical work is matched.  Take that dogma!  :)  I’m excited to hear the discussions that this article will surely stir up in the weight training community.

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2.  Just yesterday I had the opportunity to speak to a room full of internal medicine residents on the role of exercise and activity in obesity management.  This was really exciting for me as I think it shows that physicians are slowly starting to recognize evidence based fitness professionals as a legitimate part of healthcare.  But more importantly, at least a small number of physicians that will shortly have their own practices now have an appreciation for the role of exercise in weight management (which, of course, relates to other weight related health problems as well).

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3.  Recently the legendary Tom Venuto asked me to do an interview for his site and it turned out to be a monster.  In fact, it was so long it ended up being a two part interview and I honestly believe it is one of the best I’ve done on the topic of research and its application to fitness, fat loss, muscle gain, and performance.  You can check out part one HERE and part two HERE.

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4.  I recently got shipped a Travel Roller by Adam Wood.  I’ll do a more complete review on this shortly, but if you’re into foam rolling you can probably just do your self a favor and pick one up now.  They’re awesome!

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5.  Last week my buddy Eric Cressey emailed me a video he recorded on the elbow, related muscles, dysfunctions, and treatments.  Long story short, it wasn’t created with the intent of selling it.  It was recorded for a few staff that weren’t able to be present, but it turns out so well that he decided to sell it.  It runs just under 30 minutes, but the information is rock solid.  As this is obviously an area where Eric is well versed and very comfortable, the information is presented with ease and you’ll grab lots of superb information from this video.  And it is only 10 bucks!!!

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More to the point, half of all proceeds will go to a charity called Youk’s Kids which provides things for at risk children, sick kids, and a whole host of other great things that you can read about HERE.  So…for only 1o bones you get yourself some excellent information and get to support sick and at risk kids.  I highly recommend this product and think it is totally worth checking out.  You can pick it up HERE.

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6.  This week I hope to wrap up my obesity series and move on to some other exciting stuff I want to cover.  I also have some great guest posts coming as well.  I’ve got one on getting strong by strength coach Sam Leahey, a stellar interview with fitness pro Rachel Guy, and an absolutely epic 4 part series on dealing with the psychological elements of behavior change by Chi Chu (who also wrote a great review here on Gary Taubes book Why We Get Fat).  So stay tuned.  Knowledge bombz to come!

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7.  Finally, anyone that knows me well knows that I’m a social media addict.  If you’re not following me on Facebook and Twitter you should definitely feel welcome to friend me up and share in the lively discussions that take place on my status updates and such.  Also, if you’re on Google+ you can now find me HERE as well.

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Recently I started writing a series on training obese clients that has evolved into much more than I had expected.  In Part I of this series I described the categorization and classification of obesity, in Part II I shared some resources and very important concepts about obesity management, in Part III I discussed how I could go about training those with a BMI greater than 35.  In Part IV I talked about the training I would use for those with a BMI below 35, but still above 30.

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Today I want to begin talking about nutrition for those suffering with obesity.  However, discussions about nutrition and the obese client would be lacking without at least a brief mention of gastric bypass surgery.  So today I will cover that, and then I should have only one more post on nutrition related stuff that should wrap things up.

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Now before you tune out because you think gastric bypass has nothing to do with you or your clients, trust me when I say you need to hear this.  Even if you are not a believer in this type of surgery, chances are that if you train obese clients long enough you’ll run across one that is considering or has had some form of bariatric surgery.  If or when that happens, you should be informed with the best possible information so that you can provide appropriate guidance and support.

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And even if you never happen to personally train someone who has had this surgery or wants to have this surgery, it will help to inform you that this surgery is by no means “the easy way out” that some may perceive it to be.  I feel that fitness professionals should make an effort to at least understand the basics bariatric surgery as this is part of weight management for many (even if you don’t agree with it).  So…let’s get at it!

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Laproscopic Banding

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The first and least invasive type of bariatric surgery is simply called laproscopic adjustable banding (popularly known as the Lap-Band).  With this surgery, a small adjustable band is inserted through very small incisions and placed laproscopically around the top of the stomach.  This limits the amount of food that can enter the stomach and thereby causes people to lose weight.  This is called a restrictive surgery because of this limitation.  People that have had this surgery also have a port below the skin in the abdomen that allows them to have saline added or removed to make the band tighter or looser depending on their needs.  Of all of the bariatric surgeries available, this is the least invasive and it has the smallest surgical risk.  It is also removable so if some decides it isn’t right for them, the band can be removed.

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From the data I’ve seen at conferences and from hearing surgeons talk about this procedure, it seems as though the weight losses seldom meet the expectations of the patient, weight is almost fully regained in many cases, and the band is frequently removed.  As a result, it seems that gastic banding is losing favor in some circles.  One of the things that strikes me as most interesting about banding is that we’re basically providing a removable (temporary) treatment for what I’ve suggested is a chronic condition.  If removing treatment results in the return of the condition, it might be wise to question the use of temporary solutions.  Of course, I’m not saying that there isn’t a place for banding (they often use them when they feel such a surgery is warranted in children – don’t even get me going here), but the data I have seen on them is generally not promising.  I won’t ignore that some have great success with these, but I think this is the exception rather than the rule.

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Sleeve Gastrectomy

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The sleeve gastrectomy is also a laproscopic procedure in which part of the stomach is actually cut off and removed.  The remaining section of the stomach is actually quite small which limits the amount of food a person can consume and allows them to lose weight.  This too qualifies as a restrictive procedure and it is only slightly more risky than the laproscopic band, but it is permanent.  This surgery generally has greater weight losses than laproscopic banding and (from what I’ve seen) is better in terms of preventing weight regain.  However, the results aren’t as great as with the “gold standard” gastric bypass surgery we’ll talk about next.

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Roux En Y Gastric Bypass

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While there have been many versions of this surgery over the years, the roux en y gastric bypass is now the gold standard against which all bariatric surgical procedures are compared.  In this surgery, like the sleeve gastrectomy, part of the stomach is removed to limit the amount of food that can be consumed except that with the sleeve the stomach can hold 150ml of food while this procedure typically limits food to about 30ml (two tablespoons).  Then, the small intestine is cut part of the way along and attached to the new stomach pouch.  This prevents much of the food that is ingested from being absorbed by the body resulting in even greater weight loss.  For this reason, this procedure is classified as a restrictive and malabsorptive procedure.  It is obviously not reversable.

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The highlights of this procedure is that the weight loss is typically greater than the two previously mentioned.  It also does have some greater weight loss maintenance than the other two as well.  What is more important though (and probably why this procedure gets so much appreciation from physicians and patients) is that it can be an almost instant cure for Type 2 Diabetes.  In other words, you could be a Type 2 Diabetic today, get the surgery, and then you’re pretty much off your meds.  There is even some talk about doing this procedure on non-obese Diabetics whose disease is really difficult to control, but I’m not sure whether this will pan out.

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I want to be clear here with my own perspective in that I don’t think the data on this is 100% reliable as the follow up isn’t the best in many of these studies and some are not randomized controlled trials.  The big issue with follow up is that the people that are probably most likely to make themselves available for this are those that are doing well.  Those who aren’t probably don’t want to be followed up.  For this reason, I think that perhaps this surgery may be good for some Diabetics, but I’m cautiously optimistic.

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I also want to be clear about some of the downsides.  First, the surgical risk is higher with this than the other surgeries I’ve mentioned.  I don’t think it is terrible, but worth noting.  And because the surgery is malabsorptive, there are some major nutrient deficiencies that occur with many patients.  Of course, they are typically told to take certain vitamin and mineral supplements for the rest of their lives following surgery, but some are non-compliant with this and they end up with serious issues.  There are also other issues like increased rates of suicide, divorce, addiction, and other issues following this surgery that make it important to weigh the risks and rewards of this procedure.

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Biliopancreatic Diversion with Duodenal Switch

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This procedure is the most intensive procedure of them all and it is only usually considered for the very obese patient.  Generally it begins with the restrictive component where the stomach is reduced very much like the sleeve gastrectomy.  From there, it becomes difficult for me to describe so I’ll just use a video to illustrate for those who are interested.

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This procedure can be done in two parts with more severely obese patients.  In the first procedure, the restrictive part is done to reduce the size of the stomach.  Then, after the patient has lost some weight and is less of a surgical risk, the surgeon can go back in and add the malabsorptive element to continue the weight loss.  While the roux en y is the gold standard, the duodenal switch can also be used for those who have regained weight after this procedure as it is pretty much the only thing left in the surgical arsenal.

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As you might guess, the risks for this surgery are higher than those associated with any of the previous, but the results are also usually pretty darn good too.  Ultimately, the more risky the surgery, the greater the potential weight loss.  However, with all surgical procedures you really have to look at the pros and potential cons of this operation.  Similar to gastric bypass, there are many possible issues that can present.

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I honestly can’t tell you what to do in the case of a client that has had any of the above surgeries because they’ll all present differently.  My primary goal with this post was to bring a basic understanding of surgical weight management to the fitness world in the hopes that it will begin to build a bridge between fitness and physicians as we attempt to understand each other’s methods.

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I can tell you that without lifestyle modification any of the above surgeries can result in weight regain and the reappearance of obesity related issues like Diabetes, hypertension, and so on (remember what I said about obesity being a chronic condition?).  So even if we don’t agree with the methods, it is important that we be prepared to partner with people that have had them (and their physicians) because many family doctors are at a loss for what to do with these patients.  By having at least some understanding, you will be in a position to help.

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If you want more information on this topic I would highly recommend you take the time out to read Dr. Sharma’s series called Why I Support Bariatric Surgery.

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There are 5 parts and they are all fantastic.  They can be found here. 1, 2, 3, 4, 5.

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But before you think I’m totally going to allow only the positives to be highlighted here, Dr. Sharma wrote a 5 part follow up series called Why Bariatric Surgery Can Fail which I think is also solid and provides more information than I can possibly cover here in this single post.

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You can read this series here. 1, 2, 3, 4, 5.

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In the end, I guess I didn’t teach you much about how to handle these clients, but being aware of them, what they’ve had done, and the potential issues can only point you in the right direction.  If nothing else, you probably just learned something you never thought you’d learn in this industry. 

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If this article helped you in any way or you think it may help others you know, please share it on Facebook, Twitter, Google+, or whatever social media outlet is your addiction.  Or if you’re lazy like me just hit the “like” button or +1 button.  Thanks.

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PS: I know I possibly covered a lot of unfamiliar ground here so if you’ve got questions, drop ‘em below.

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PPS: Check out Part VI of this series HERE.

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