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Medical News Today: How to do pelvic floor exercises

The pelvic floor is a set of muscles that supports pelvic organs, such as the bladder and bowel. These muscles aid urinary control, continence, and sexual function.

Both men and women can experience pelvic floor weakness over time. As with other muscles, people can perform exercises to strengthen the pelvic floor, enhancing bowel and bladder control.

Pelvic floor exercises offer women many benefits, including a lower risk of vaginal prolapse, better bowel and bladder control, and improved recovery after childbirth.

They can also benefit men by speeding recovery after prostate surgery, reducing the risk of rectal prolapse, and improving bowel and bladder control.

Anyone who has recently had surgery or given birth must talk to a doctor before beginning an exercise program for the pelvic floor to ensure that they can safely begin working these muscles again.

1. Kegels

Group of mature gym goings doing squats
Pelvic exercises can help improve the function of pelvic muscles.

Kegel exercises focus on tightening and holding the muscles that control urine flow. This exercise is suitable for men and women.

A Kegel exercise consists of the following steps:

  • Sit in a comfortable position, close the eyes, and visualize the muscles that can stop urine flow.
  • Tighten these muscles as much as possible.
  • Hold this position for 3–5 seconds. It should feel as though the muscles are lifting up as a result of the squeezing.
  • Release the muscles and rest for several seconds.
  • Repeat up to 10 times.

People can vary this exercise by performing it while standing, lying down, or crouching on all fours.

2. Squeeze and release

This exercise is a rapid “squeeze and release” movement that builds the ability of the pelvic floor muscles to respond quickly.

To perform this exercise, a person should:

  • Sit in a comfortable position.
  • Picture the pelvic floor muscles.
  • Squeeze the muscles as quickly as possible and release without attempting to sustain a contraction.
  • Rest for 3–5 seconds.
  • Repeat the movement 10–20 times.
  • Repeat the exercise twice later in the day.

3. Bridge

Woman performing bridge exercise as a yoga pose on mat in classroom
A person should stop any exercises that cause pain or discomfort.

While bridges primarily strengthen the buttocks, they also help work the pelvic floor.

People can do a bridge using these steps:

  • Lie down on the back, bend the knees, and place the feet flat on the floor about hip-width apart. Let the arms fall to the sides with the palms facing downward.
  • Contract the buttocks and pelvic floor to lift the buttocks several inches off the ground.
  • Hold this position for 3–8 seconds.
  • Relax the buttocks and pelvic floor muscles to lower the buttocks to the ground.
  • Repeat up to 10 times.
  • Rest, then perform up to 2 additional sets.

As the strength of the pelvic floor increases, many people will find that they can do more repetitions.

4. Squats

Along with the bridge, squats can promote a stronger pelvic floor and buttocks.

To perform a squat, a person should:

  • Stand with the feet hip-width apart, keeping them flat on the floor.
  • Bend at the knees to bring the buttocks toward the floor, going only as low as is comfortable. Keep the back straight and leaning slightly forward. The knees should be in line with the toes.
  • Focus on tightening the buttocks and pelvic floor while returning to a standing position.
  • Repeat this exercise to do a total of 10 repetitions.
  • Rest before performing any additional sets.

Not all squats target the pelvic floor. Wide-legged or deep squats may make it difficult to retain a pelvic floor contraction. When strengthening the pelvic floor, narrow and shallow squats tend to be more beneficial.


People may have difficulty targeting their pelvic floor specifically to perform the exercises. Specialized physical therapists known as pelvic floor therapists can help a person identify their pelvic floor using different feedback devices.

One example is a biofeedback device that involves placing sticky electrodes on key areas of a person's body and asking them to contract their pelvic floor muscles. The electrodes send signals to a computer that can identify when they are contracting the correct muscles.

Sometimes, a person may have nerve damage that prevents them from contracting their pelvic floor muscles on their own.

Where this is the case, a pelvic floor therapist may offer pelvic stimulation therapy, which can help produce muscle contractions.

Exercises to avoid

Set of dumbbell weights in gym
Lifting heavy weights may weaken pelvic muscles.

Some exercises may be too difficult for a person with a very weak pelvic floor. Performing the exercises may further weaken their muscles and lead to more problems with incontinence.

Until a person has done several months of pelvic floor work, they should avoid the following exercises:

  • situps with straight legs in the air
  • lifting heavy weights for minimal repetitions
  • double leg lifts
  • running, jumping, and other high-impact activities

One common misconception about pelvic floor exercises is that it is beneficial to try to stop urinating midstream to test pelvic floor muscle control. This is not an effective practice as it could result in incomplete emptying of the bladder.

Incomplete emptying can increase the risk of urinary tract infections (UTIs) and other urinary disorders.

A person should talk to their pelvic floor therapist, doctor, or physical therapist about whether there are any specific exercises they should avoid after surgery or childbirth.


In addition to practicing pelvic floor exercises on a daily basis, everyday activities can help strengthen the pelvic floor. These include walking, standing up straight, and sitting properly.

Both men and women can also tighten and squeeze the pelvic floor muscles each time they sneeze, cough, or lift something heavy. These activities help strengthen the pelvic floor further and prevent incontinence.

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Tests to tell how healthy you are

You probably know that you should have an annual physical exam, but does that mean you’re healthy? It depends, says Robin Berzin, MD, the CEO of the functional medicine practice Parsley Health. She believes that certain tests give a stronger idea of an individual’s overall health—and can help health care providers and patients work better together.  Here, the Well+Good Council member outlines the top markers of good health, plus shares her advice on getting your own health evaluated.

You work out at least four days a week, eat clean most days, and are all about that self-care. But are you actually healthy? So many people come to my practice, Parsley Health, asking this question, and the answer really differs for everyone. Regardless of how healthy you think you are, the best way to measure your health is through specific lab tests that are reviewed by a doctor. The problem is, most doctors only test the basics. To truly get a full picture of your health, it’s best to work with a doctor who is trained in advanced medical testing and will know how to interpret your results.

These are the top markers of good health that everyone should be tested for at least annually.

do you know if you're healthy?Photo: Stocksy/Rob and Julia Campbell

Low inflammation

Chronic inflammation has been linked to everything from depression and poor sleep quality to heart disease and cancer, so keeping inflammation levels low is crucial. Two good inflammatory markers to get checked are hsCRP and homocysteine.

Moderate levels of hsCRP are associated with cardiovascular disease, while high levels could be related to an acute sickness like a cold or flu—or could be a more serious sign of an autoimmune disorder or other inflammatory process. Scientists have linked elevated levels of homocysteine to dementia and vascular disease.

A healthy thyroid

Your thyroid produces hormones that are involved in regulating cell metabolism, so when your levels of these vital hormones are off, it can have a ripple effect throughout the body. Thyroid diseases and sub-optimal levels of these hormones are associated with weight gain, fatigue, constipation, and even miscarriage.

Traditional lab work looks at your TSH, or thyroid stimulating hormone levels, but usually doesn’t include total T3, free T3, reverse T3, free T4, and anti-thyroglobulin and anti-TPO antibodies. I recommend getting these tested as well. I like to see my patients in the clinically “optimal ranges” for these rather than the “normal ranges.” For context: Just because something is “normal” (meaning within a few standard deviations of the mean), that doesn’t mean it’s optimal (meaning ideal for you and your body).

Ideal nutrient levels

Nutrient deficiencies are more common than you might think, but most people don’t know they have them. These deficiencies could show up as symptoms like fatigue, brain fog, and irritability. Usually they are a sign of a deeper problem or might be caused by another medication, so it’s necessary to address not just the deficiency, but also the underlying cause. I recommend getting tested for some of the most common deficiencies: vitamin D, magnesium, B12, iron, and iodine. Again, aim for “optimal ranges.” true markers of healthPhoto: Rawpixel on Unsplash

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A normal cortisol pattern

A four-point cortisol test measures the stress hormone cortisol and how your levels fluctuate over the course of the day. Ideally, they are high in the morning when you wake up and naturally drop throughout the day to the lowest point at night. If your levels follow a different pattern, it can explain things like high blood pressure, weight gain, and insomnia.

Balanced sex hormones

Whether or not you’re taking hormones like the birth control pill, checking up on on your sex hormones is essential. A hormonal imbalance might be a sign of PCOS, or it could be the reason you have irregular periods, acne, weight gain, hair loss, fatigue, or infertility. Ask your doctor to check your levels of estrogen, progesterone, DHEA-S, and testosterone. We typically look at female hormones on day 21 of the menstrual cycle in pre-menopausal women, but if you don’t have a regular cycle, are post-menopausal, or are specifically checking markers of fertility, other days might be preferable.

Cholesterol under control

You’ve probably had your cholesterol taken many times, and for good reason—cholesterol levels are important! But most doctors only order a basic lipid profile, which measures total cholesterol, LDL and HDL cholesterol, and triglycerides. I check the NMR profile of my patients, which, in addition to those measures, looks at lipoprotein particle number and size. Research shows that looking at numbers of specific particles is more indicative of cardiovascular risk than basics like total cholesterol and total LDL. Most people can manage their cholesterol levels by adjusting their diet and exercise, but it’s important to take preventative action before serious damage is done.

Remember, just getting these tests done is not enough. You need the guidance of a doctor or health coach to interpret the results, like we do at Parsley Health. Then, you need to make changes in your life that will help optimize anything out of the ordinary. Once you make changes—such as those made through diet, exercise, and supplementation—get follow-up tests done to make sure you’re on track.

Robin Berzin, MD, is the founder and CEO of Parsley Health, an innovative primary care practice with offices in New York, Los Angeles, and San Francisco. Dr. Berzin attended medical school at Columbia University. She is a certified yoga instructor and a meditation teacher.

What should Robin write about next? Send your questions and suggestions to


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15 Amazing Benefits of Green Tea

57 15 Amazing Benefits of Green Tea

Green Tea, botanically known as Camelia synensis, is perhaps the world’s healthiest drink. Having originated in China, Green Tea is used as a medicine as well as a refreshing aromatic beverage in many parts of the world. White collar diseases, cancers and several other health disorders are byproducts of stress, anxiety and the sedentary lifestyle involved in modern day living. Consistent studies have revealed that Green Tea is anti-carcinogenic, anti-diabetic, anti-depressant and it also fights bad breath, controls bad cholesterol etc. “Magic Potion” – if that sounds like over exaggerated description of Green Tea, then read on…

Resists development of Cancer cells:

Laboratory studies have confirmed that Green Tea contains a naturally occurring chemical called “polyphenol”, an antioxidant that has anti-carcinogenic and anti- inflammatory properties. The human body keeps generating cell damaging reactive chemicals also known as “free radicals”. Epigallocatechin-3-gallate or (EGCG) is a bioactive polyphenol present in Green Tea that has been found effective in eliminating free radicals. Green Tea is a warehouse of both these chemicals. It contains up to 50% of polyphenols w/w and almost 80% of this is EGCG.

A meta-analysis conducted recently, revealed the fact that Green Tea has the potential to reduce the risk of development of certain kinds of cancers like the mouth cancer and lung cancer. It was observed that women who drank Green Tea were less prone to developing cancer of the food pipe. Despite the fact that most studies on anti-carcinogenic properties of Green Tea have remained inconclusive, researchers still believe that it does help in resisting the development of cancer cells. This is based on the reality that people in countries with higher consumption of Green Tea tend to develop a higher degree of resistance towards cancer than those where the consumption of Green Tea is lesser.

Prevents Type-2 diabetes:

In 2004, a study on effects of Green Tea on Blood Glucose levels, conducted by a group of Japanese researchers concluded that healthy human volunteers who consumed Green Tea displayed stimulation of 1.5g/body during the glucose tolerance test. Green Tea miraculously lowered the blood glucose levels of diabetic mice.  How does this happen? – Green Tea obstructs the enzyme amylase that is secreted by the salivary glands, thus lowering the rate at which the sugar in the starches is released in the blood. This requires lesser amount of insulin to transport the glucose in the blood and this is how Green Tea curbs the release of large amounts of insulin.

Burns Fats and helps weight loss:

Fitness and weight loss concept

Unlike many weight reducing pills, Green Tea increases the metabolism slowly and that too without affecting the normal heat rate. The polyphenols and caffeine present in Green Tea activates a gradual process of heat generation known as “Thermogenesis” in the human body. This in turn triggers the oxidation and burning process of fats. A recent study conducted in the U.S. suggested that overweight men who drank Green Tea thrice a day burnt 200 extra calories per day and the good news is that they dint have to change their regular diets, lifestyles and gym regimes.

Reduces the risk of heart disease:

Thrombosis or abnormal clogging of arteries is the most common reason behind heart attacks worldwide. Thrombosis is caused by over accumulation of “Triglycerides”, a type of fat in the blood that is used by our body for energy generation. Higher levels of triglycerides in the blood add up as nasty fats in the form of adipose tissues and clog up the arteries. These extra fats, like bad cholesterol, react adversely with the oxygen in the bloodstream. Certain ingredients of Green Tea act like “fat absorbers” by slowing down the absorption and metabolism of triglycerides in the digestive track and then passing them out. So drinking Green Tea is like taking a preventive dose of Aspirin!

Lowers high blood pressure:

Our kidneys secrete an enzyme called as “angiotensin converting enzyme” (ACE).  Over secretion of ACE leads to narrowing of the blood vessels due to the contraction of their muscular walls, thus causing high blood pressure or hypertension, as it is commonly known.  Green Tea is a natural wonder drug that contains ACE inhibiting ingredients.  Findings from a study aimed to measure the ACE inhibition (IC50 Values) of various plant extracts mentions that the IC50 value of Camelia synensis or green tea is 125 µg/mL. This is considered as one of the highest amongst similar other medicinal plant extracts.

Shields against Alzheimer’s disease:

Henry L. Paulson, renowned neurologist and professor at the department of neurology of Michigan State University is one of the several Doctors, who acknowledge the power of a flavonoid (EGCG) in the green tea. Most neurologists are of the opinion that EGCG inhibits the accumulation of “amyloid plaque”, widely believed as the root cause behind deterioration of brain. According to a research, the EGCG present in Green Tea binds with beta-amyloid, a kind of protein that ultimately forms amyloid plaques and alters it to prevent it from forming plaques. This finding is supported by an experiment carried out by a team of researchers from the University of Leeds, where they added the extracts of Green Tea to that of globules of amyloid protein. They observed that the bioflavonoids present in Green Tea hindered the sticking of plaques to the nerve cells, thus endorsing the fact that Green Tea does protect against Alzheimer’s disease.

Improves Immunity:

Researchers from the Harvard University observed that the natural chemical ingredients of Green Tea helped in stimulating the Gammadelta T Cells. The gammadelta cells are like our first line of defence against various diseases and infections. In other words, regular consumption of Green Tea immunizes our system from basic forms of harmful bacteria, virus and fungi.

Fights allergies:

young female having a cold

Researchers in a laboratory based in Japan identified a compound known as methylated epigallocatechin gallate present in Green Tea. This compound blocks a major cell receptor that is responsible in activating an allergic reaction. Methylated epigallocatechin gallate also blocks two other compounds – histamine and Immunoglobulin-E that trigger and facilitate allergic reactions in our body.

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Prevents development of Arthritis:

A protein known as cytokine interleukin-1 beta or IL-1B plays a major role in degradation of cartilage of bone joints in patients with rheumatoid arthritis. The EGCG present in Green Tea blocks the IL-1B’s capability to produce proteins and enzymes that penetrate the joints and damage the cartilage between the bone joints. Apart from this, EGCG also blocks the activity of three other molecules – the IL-6, Cox-2 and prostaglandin E2 that cause inflammation of joints. This is how Green Tea works as good as anti-inflammatory drugs.

Green Tea prevents Bad Breath:

Microorganisms present in the mouth destroy proteinaceous substrates and produce cysteine and methionine that are ultimately converted into Volatile Sulphur Compounds (VSC’s). These VSC’s are a major cause of bad breath. A group of Japanese scientists studying the effect of green tea on volatile sulphur compounds in mouth air concluded that Green Tea was highly effective in controlling the malodour of mouth because of its disinfectant and deodorant properties. Green Tea consists of polyphenols that have antimicrobial properties that controls the number of microorganisms in the oral cavity.

Safeguards against Hepatitis:

Green Tea consists of polyphenolic catechins (CATs), epicatechin gallate (ECG), epigallocatechin (EGC) and several other ingredients that have anti-inflammatory, anti-bacterial and antitumorigenic (anti-tumour forming) properties. EGCG in the Green Tea displays a remarkable antiviral action against hepatitis B and hepatitis C virus. To explain that simply –EGCG prevents the HCV or hepatitis C virus from entering the liver cells, thus safeguarding the Green Tea drinkers against Hapatitis.

Effective against Food Poisoning:

Food poisoning occurs when harmful bacteria contaminate the food and food products that are half cooked or improperly stored under unhygienic conditions. It causes vomiting, dehydration and severe abdominal pain and generally lasts for a few days. However, chronic food poisoning can be fatal. Green Tea consists of catechins, which have an astringent taste, but possess powerful anti-bacterial properties capable of killing the harmful bacteria in such foods. This was proven by a group of scientists from the Showa University of Japan, who claimed to have killed millions of virulent bacterium called E-coil-157 after they were bred in 1 cc of green tea for five hours. Green tea also retards the growth of Salmorella and the catechins in the Green Tea adhere to the proteins and obstruct the bacteria from attacking the food surface. Apart from the killing action, the catechins also destroy the toxins caused by the bacteria.

Eases Stress and Fatigue:

Young exhausted woman sleeping at the table in the office.

Acute fatigue usually disappears after a good rest, however bad effects of persistent fatigue can be irreversible. An experiment was conducted on rats that were subjected to fatigue inducing activity of swimming with loads tied to their body. It was observed that rats who had been administered a certain dose of EGCG swam for a longer duration than those that were administered with saline. This experiment concluded that the EGCG present in Green Tea has antioxidant effect on liver damaged due to oxidation due to stress. Hence, Green Tea can prove beneficial to human beings to overcome stress and fatigue in routine life.

Controls Hair Loss:

Dihydrotestosterone or DHT is a male sex hormone that is responsible for hair loss in adult males as well as females. The catechins present in Green Tea help in suppressing the DHT levels and thus help in curing hair loss naturally. Other ingredients like carotenoids, zinc, tacopherols, selenium and ascorbic acid also prevent hair loss and stimulate hair growth, simultaneously.

Green Tea boosts memory:

A simple experiment carried out by a team of researchers from the University of Basel, Switzerland revealed that a group of volunteers who drank a beverage containing 27.5 grams of green tea extract, performed better on memory related tasks. The study concluded that Green Tea stimulates the interaction between various brain areas resulting in a better ability to recollect the information. In a nutshell, it increases the amount of neural juices that aids memory.


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8 Unintentional Ways Trainers Promote Disordered Eating (and What to…

Dear fitness professionals, are you inadvertently misdirecting your clients? Are you unconsciously promoting disordered eating?

What we hear, think, and say has a profound influence on how we feel about our health and our bodies. As personal trainers and fitness instructors, we have a powerful platform that can impact our clients in meaningful and lasting ways. We know the positive results — it’s why we love our jobs! There’s nothing better than watching our clients accomplish goals in the gym and in life they never thought they could.

Unfortunately, we can also unintentionally have a negative impact on a client’s health and body image by the messages we inadvertently send through how we speak and what we do in our sessions.

The fitness industry often amplifies rather than interrupts the messaging of today’s diet culture, which is fueled by a 60-billion-dollar diet industry. It’s a culture that is more interested in fads than facts, and in which health has become synonymous with the image of a lean, white individual with rock hard abs.

Weight loss and calories burned have become the primary markers of success. Marketing slogans and fitness challenges like, “Summer Beach Body Challenge,” “Weigh Less for The Dress,” and “Little Black Dress Challenge,” are everywhere. You can’t go far without hearing about the powers of “clean eating,” 30-day challenges, and detox kick starts.

Our current fitness paradigm is keeping clients stuck in cycles of dieting, food perfectionism, and using movement primarily for weight loss. Below are eight pitfalls I challenge us to avoid as trainers, as well as eight alternatives that can promote true health and positive body image.

1. Complimenting Weight Loss

What we say: “Wow you’re looking great! Looks like you’ve lost weight!”

What our clients hear: You didn’t look as good before. Thinner is better. Your trainer is evaluating your body.

What research shows: Although seemingly harmless, research shows that the positive reinforcement of weight-loss-related compliments is a big factor in increasing dieting behaviors and negative preoccupation with body [1,2]. Some clients also feel a sense of personal boundary violation when someone comments on their body. Furthermore, weight loss isn’t necessarily an indicator of health. A client’s weight may have shifted because of disordered eating, a negative life event, depression, stress, or sickness.

The alternative: Do not comment on someone’s body. Praise things like effort, consistency, strength, or actions. For example:

  • “I can really tell how dedicated you’ve been to your workouts.”
  • “I really appreciate your attitude and effort each session.”
  • “Your consistency is really admirable.”
  • “Your energy seems really great today.”

2. Perpetuating Weight Bias

What clients may say: “Ugh, I feel so fat!”

What we say: “No, you look great!”

What our clients hear: Being fat is bad. The smaller your body the better.

What research shows: These comments perpetuate the weight bias and stigma around body size in our culture. Weight stigma has been shown to have numerous negative impacts on health, including exercise avoidance, psychological stress responses, and disordered eating behaviors [3]. Many individuals in larger bodies avoid joining gyms or fitness classes because of the fear of being shamed.

The alternative: Use this as an opportunity to connect with your client. Fat is not a feeling. Find out more with questions such as: “I can hear you’re not feeling good in your body today. What’s going on?”

3. Using Punitive Language Around Food and Exercise

What we say: “Come on, gotta earn that [cheat meal/holiday/weekend]! Let’s burn those calories!”

What our clients hear: In order to enjoy or “deserve” certain foods, you need to compensate with added exercise. Calories in, calories out.

What research shows: Focusing on calories burned increases feelings of guilt and preoccupation around certain foods, and it decreases enjoyment of movement. In addition, the “calories in, calories out” model, otherwise known as the Energy Balance Equation, does not accurately capture the dynamic and adaptable system that is the human body [4]. When you cut calories or increase exercise, a cascade of changes in the body occurs to self-regulate and stabilize.

The alternative: Avoid talking about exercise as a compensatory tool. Instead focus on the empowering benefits of movement for encouragement. For example:

  • “Way to go, feel those strong muscles work!”
  • “Keep that amazing effort through this last rep!”
  • “Let’s start your weekend with some endorphins!”

4. Choosing Measurements Over Other Progress Markers

What we do: Using BMI or body fat measurements to calculate progress, measure health, and motivate clients.

What our clients internalize: Measurements are accurate and are the most important reflection one’s health and progress. Improvements in health behaviors such as increased sleep, stress reduction, or consistency with movement don’t matter or aren’t “enough” if measurements are staying the same.

What research shows: The BMI was created in the early 19th century by a mathematician, not a physician, and was not intended to be a health indicator. It’s an indirect measure of body fat that doesn’t take into account important details about age, gender, hormones, bone structure, and fat distribution [5,6]. The BMI tends to overestimate fat in very muscular people and underestimate it in elderly individuals.

Studies have repeatedly demonstrated that fitness is more protective of health than a low weight or particular BMI. This means that a larger, metabolically fit person is more likely to have a longer lifespan than a thinner individual who may look healthy but potentially have hidden health risks. In fact, studies involving women show that some extra weight on the hips and thighs is actually beneficial and can lead to a longer life [7].

Furthermore, measurement tools used such as BMI handheld machines have high degrees of variance and don’t give consistent readings. Even methods touted as the gold standard such as underwater weighing and DXA scans disagree by an average of 7 percent [8]. Inaccuracies from measurement to measurement can be very upsetting to clients who are unaware of the limitations of these tools.

The alternative: Focus on meaningful markers of well-being that still resonate with your client’s goals such as increasing metabolic fitness, reducing stress levels, improving quality of sleep, and supporting positive body image.

If a client asks to be weighed or measured, use it as an opportunity for dialogue. Our clients look to us as the experts and often just assume measurements are important because of the messaging the fitness industry sends. Ask questions like:

  • “How is the information going to be helpful to you?”
  • “How do you typically feel after getting measurements done?”
  • “Do you find that getting measurements taken influences your eating habits the rest of the day?”

Some fitness locations require trainers to do measurements. If this is the case, there should be an ethical responsibility to provide a disclaimer on the variance that comes with measurements, their impact on body image, as well as the poor correlation between measurements and markers of health or effort.

5. Marketing With Before-and-After Images

What we do: Display before-and-after images and marketing materials that celebrate weight loss and smaller bodies.  

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What our clients internalize: You can’t be healthy in a larger body. Exercising will result in weight loss if you’re working out correctly.

What research shows: Multiple meta-analyses research studies show that adding in physical exercise actually has very minimal impact on weight in and of itself [9]. Also, using body size as a reflection of health is highly problematic. Our health is determined by many factors beyond weight, including:

  • Genetics
  • Access to quality healthcare
  • Stress
  • Social and economic inequality
  • Sleep
  • Social connection
  • Nutrition
  • Movement
  • Smoking
  • Alcohol
  • Mental health

More importantly, when people exercise for enjoyment and well-being rather that weight loss, they are more likely to make movement a consistent part of their lives.  So while weight loss marketing might get clients through the door, letting go of weight loss and body size as the primary image of health or success is crucial to long term client retention and in supporting a client’s emotional well-being.

The alternative: In marketing materials, include images of diverse body types engaging in movement. Use testimonials and language that focuses on the ways movement can improve one’s life holistically (for example, being able to play with one’s grandkids). This imagery and wording will resonate and feel more welcoming than a stock photo of a thin fitness model that clients will inevitably compare themselves against.

6. Asking About a Client’s Diet Without Permission

What we say: “Tell me about your diet?” or “So, what did you have to eat this weekend?”

What our clients hear: There is a “right” answer. Foods are either bad or good, and I will be judged on my response.

What research shows: Your clients respect you as their trainer and often want your approval [10]. Because the word “diet” isn’t neutral in our culture, asking questions about what a client eats can feel very personal and cause anxiety and shame, especially if they have a history of chronic dieting or an eating disorder.

The alternative: In an initial conversation when first meeting your client, explore their history through an open-ended question such as, “If you feel comfortable sharing, I would be interested in knowing a bit more about your relationship with food and how, or if, you hope I can be a support in that area of your health.”

During the rest of your time with a client, let your client take the lead on initiating conversations around nutrition. If you have a question you want to ask, start by asking permission. For example, “Nutrition is sometimes an area where clients find support helpful. Would it be OK if we checked in on that? If not, that’s OK! I’m always here as a resource.”

7. Assigning Moral Value to Food

What we say: Using terminology like “clean eating,” speaking of food strictly as “fuel,” categorizing food as either “good” or “bad,” or challenging your clients to only eat “real, whole, foods.”

What our clients hear: Nutrition is something that can be done perfectly. You always can and should be eating better than you are. Refined foods just damage your health and should be avoided.

What research shows: Being concerned with the nutritional quality of the food you eat isn’t problematic in and of itself. It’s when people become so fixated on so-called “healthy eating” that it impacts their physical and psychological well-being.

For example, orthorexia is a disorder that centers on obsession with proper or “healthful” eating. According to the National Eating Disorder Association, symptoms can include [11]:

  • Compulsive checking of ingredient lists and nutritional labels.
  • An increase in concern about the health of ingredients.
  • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products).
  • An inability to eat anything but a narrow group of foods that are deemed “healthy” or “pure.”
  • Unusual interest in the health of what others are eating.
  • Spending hours per day thinking about what food might be served at upcoming events.
  • Showing high levels of distress when “safe” or “healthy” foods aren’t available.
  • Obsessive following of food and “healthy lifestyle” blogs on social media.

It is common for personal trainers and even doctors to essentially promote or prescribe disordered eating behaviors, increasing stress and preoccupation around food and body.

The alternative: You can still talk about nutrition or support a client in incorporating more nutritionally dense foods into their life. But it is important that you understand your client’s mindset around food. Dieting and diet behaviors are so common place that it is easy to overlook destructive patterns. 45 percent of American women and 25 percent of American men are on a diet on any given day. 35 percent of dieters progress to pathological dieting. Of those, 20 to 25 percent progress to partial or full-syndrome eating disorders [12].

We can use conversations around nutrition to help clients shift away from a “morality” approach to food. As Ellyn Satter, dietician and internationally recognized leader in eating competency, says, “When the joy goes out of eating, nutrition suffers” [13].

8. Pushing Diets for Weight Loss

What we do: Encouraging your clients to track their calories or try a certain diet program for weight loss.

Note: Be wary of diets in disguise. In the past decade, the word and concept of “dieting” has been replaced with phrases such as “healthy lifestyle” or “clean eating.”

What our client hears: Dieting will result in sustained weight loss. The trainer knows what foods are best for you.

What research shows: Research shows that 95 percent of all dieters will regain the lost weight in one to five years [11].  The majority of those people will even gain back more. Weight loss and weight gain from yo-yo dieting is more harmful on the body than a stable weight at a higher BMI [7]. Dieting also increases preoccupation with food and negatively impacts body image.

The alternative: If you engage in conversation with your client around nutrition, focus on helping them determine what foods and eating patterns feel best. Remove morality in food by avoiding “good” vs. “bad” terminology. Help them explore the barriers that are getting in the way of them finding consistency. Reflect what you are noticing from what they are sharing instead of trying to “fix.”

This approach, also called intuitive eating, is an evidenced-based health intervention that helps people reconnect with internal hunger fullness signals, allowing them to become the experts of their own bodies.

Dieticians and originators of the approach, Evelyn Tribole and Elyse Resch, define an intuitive eater as someone who “makes food choices without experiencing guilt or an ethical dilemma, honors hunger, respects fullness and enjoys the pleasure of eating” [14]. Studies have demonstrated that intuitive eating leads to decrease in thin idealization and triglycerides, as well as an increase in well-being, good cholesterol, and self-esteem.

So Where Do We Go From Here?

As professionals in the fitness industry, we want to support our clients’ physical and mental health. Helping them connect with movement in a positive and empowering way is far more effective than simply blasting them with the most intense workout or latest nutrition fad.

Let’s focus on helping our clients become the experts of their own bodies. Let’s encourage them as multidimensional people, not just a set of measurements, and let’s expand the definition of health to encompass the whole person and a wide range of health behaviors. Let’s dispel the harmful myth that wellness is indicated by the size of one’s body.

Let’s have conversations around nutrition carefully, with permission, and without inserting judgment and morality into food. There is no one “right” way to eat. Pleasure and satisfaction are key elements of nutrition and rules or restrictions are often more harmful than helpful. The nutrition scope of practice for a personal trainer is limited and most certifications have minimal to no education around nutrition psychology. When in doubt, refer to a weight-inclusive nutrition professional.

Lastly, we need to remember that health itself is not a moral imperative or requirement. Everyone gets to decide if and how they want to take care of their bodies. Our role is to be a coach and support on their journey, not to judge or determine their choices. That’s the trust our clients have placed in us.


  1. Budd G, Disordered Eating: Young Women’s Search for Control and Connection, Journal of Child and Adolescent Psychiatric Nursing, 26 June 2007.
  2. Engeln R, Beauty Sick: How the Cultural Obsession with Appearance Hurts Girls and Women, Harper, April 2017.
  3. Puhl R, Suh Y, Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment, Current Obesity Reports, June 2015.
  4. Thomas DM, Gonzalez MC, Pereira AZ, Redman LM, Heymsfield SB. Time to Correctly Predict the Amount of Weight Loss with Dieting. Journal of the Academy of Nutrition and Dietetics, 2014.
  5. Rothman KJ, BMI-related errors in the measurement of obesity, International Journal of Obesity, August 2008.
  6. NPR, Top 10 Reasons Why The BMI Is Bogus, Weekend Edition Saturday, July 4 2009.
  7. Lavie CJ, Loberg K, The Obesity Paradox: When Thinner Means Sicker and Heavier Means Healthier, 2014.
  8. Fogelholm M, van Marken Lichtenbelt W, Comparison of body composition methods: a literature analysis, European Journal of Clinical Nutrition, August 1997.
  9. Ross J, Janssen I, Physical activity, total and regional obesity: dose-response considerations, Medicine and Science in Sports and Exercise, June 2001.
  10. Melton D, Dail TK, Katula JA, Mustian KM. Women’s Perspectives of Personal Trainers: A Qualitative Study, The sport journal, 2011.
  11. National Eating Disorder Association, What Are Eating Disorders, Orthorexia,
  12. Eating Disorder Hope, Eating Disorder Statistics & Research,
  13. Ellyn Satter Institute, How to Eat, Adult Eating and Weight,
  14. Tribole E, Resch E, Intuitive Eating: A Revolutionary Program That Works, St. Martin’s Griffin, September 2003.

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