Obese Individual Assessment 1

Running Head: Obese Individual Assessment

Obese Individual Assessment and Recommendations Tonia Pfaff Kaplan University

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Obese Individual Assessment and Recommendations For the Unit 8 assignment, I chose to evaluate an obese individual. I have many family members who are considered morbidly obese and I felt that by focusing on this subject I may be able to take some useful information back to my friends or family. Obesity has become such a chronic health condition that without trainers who focus on these types of obstacles, our country will continue on this downward spiral. Par-Q Rating In completing the Par-Q form, Marsha answered only one question with a no. She is currently has high blood pressure and is taking blood pressure medications in order to control it. Martha is obviously obese I decided to have her fill out the HSQ because it is a much more specific form. I wanted to feel at complete ease before beginning testing with Martha. Health Status The information gathered was much more concise when taken from the HSQ. Martha is a 51 year old female. She stands 55and weighs 240 lbs. She has been to the medical doctor in three years for a health exam. Aside from being extremely overweight Martha appears to be in overall decent health. Her doctors visit confirmed the existence of high blood pressure but no other indicators to avoid testing. Doctors consent was obtained. General Medical History Currently, Marsha has not had any cardiovascular issues. She has not experienced any of the symptoms or taken any medications related to heart problems. She currently does not have any type of diabetes or asthma and she is not pregnant. She does not have any joint or pain problems that will keep her from performing our fitness tests. Her overall personal medical history coincides with her doctors consent to perform physical activity. Risk Factors and Pre-cautions Marsha has several risk factors to acknowledge. She has high blood pressure, which is currently being found at 152/88 mmHg. Her fathers side of the family has dealt with heart disease, as well. This is a possible risk factor to consider. She is physically inactive for most of her day. She works at a sedentary job, does not have participated in any physical activities nor does she get in any daily, structured exercise. Marsha is reluctant to have skinfolds taken at this time but her waist circumference appears to be greater than 35 inches. Taking these risk factors into consideration, I will definitely adjust the intensity of the fitness assessment. Medications Marsha is currently only on one prescribed medication. This medication is to help control her high blood pressure. Marsha has stated that one of her goals is to be healthy enough

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to discontinue taking this medication. Marsha currently does not take any supplements, herbs or vitamins. Health and Lifestyle Related Behaviors Currently Marsha engages in many negative behaviors. She works at a sedentary job for 8-9 hours a day. She is not involved in any physical activities such as gardening or leisurely aquatics. She also has not had any kind of structured exercise in many years. She currently watches 2-5 hours of television per day, 1-3 hours of computer time and gets only 5-6 hours of sleep each day. Some of Marshas goals are to lose 90 lbs. and have more energy during the day. She also has stated that she wants to be cleared to be off the BP medication as noted above. Nutrition Marshas current nutrition is mainly made up of fast foods or highly processed food cooked in a microwave. She has also stated that she does not eat breakfast but has several cups of coffee instead. After completing a 7 day food diary, I discovered that Marsha does not meet the suggested RDAs of fruits, vegetables or healthy fats. She does however, exceed the RDAs for saturated/trans fats, sodium and protein. Marshas has several goals to help her nutrition work with her exercise plan. She is going to start slowly by cutting down the amount of days per week that she eats out and she is going to increase the fresh fruits and vegetables in her diet. She will slowly begin to trade her processed frozen dinners for easy to make, fresh and healthy dinners. Marsha acknowledges that it will take time to implement all of these changes and will try to avoid becoming discouraged. Body Composition Marsha was unwilling to undergo skinfold tesing at this time to calculate total body composition. However, I was able to use her height and weight to determine her total BMI. Standing 55 and weighing 240 lbs. her calculated BMI is 40%. She is considered to be morbidly obese according to results at www.exrx.net. This was a definite concern to both Marsha as well as me. This is a dangerous place to be but as explained to Marsha, changes will soon occur. Assessment Results I began Marshas assessment by first checking her resting heart rate. I tested by placing my finger on the veins just beneath her thumb. Her heart beat was beating 95 BPM. After verifying these results on www.exrx.net, I found that her heart is out of shape and is working far too hard while doing nothing. Before, continuing testing I had Marsha take a warm-up lap in order to get her muscles warmed up. The first test performed was the Balke cycle test. Marsha was to pedal for as long as she was able to. I explained to Marsha because she had been inactive for so long that this test may

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feel overwhelming. I suggested that she work at only about 40% intensity while performing the task at hand. Unfortunately, Marsha was only able to last for 7 minutes and 12 seconds. This is an extremely low score, placing her in the lowest percentile and considered poor by exrx.net test results. The next test performed was the half sit-up. I showed Marsha an example of the proper way to perform the task. She said she felt comfortable in trying and was able to complete 1 proper half sit-up. Again, this places her at the bottom of the percentile, which receives a poor rating. The final test performed was to test Marshas flexibility. We opted for the simple sit and reach test. Marsha was able to reach forward 4 inches. This also is a poor score for the average woman her age but was expected. Even knowing the Marsha was obviously out of shape, these tests were still necessary. It is important to find the starting point for Marsha. We will now be able to find where to begin as well as create attainable goals to be met. This information is necessary for change and was explained to Marsha as such. These results were in no way meant to make her feel negatively toward herself. Readiness for Change Marsha is currently in stage 2 for a readiness to change. Although she is not currently doing any physical activity she is definitely ready for the next stage. After receiving the couple flyers sent out to the general public she has sought out the facilities assistance. She has stated she is willing to pay for a gym membership but needs guidance to figure out where and how to start. She is apprehensive about the atmosphere of the gym setting and is concerned of other peoples views of an obese person trying to get fit. These issues will be acknowledged with the test results. Recommendations After reviewing test results, I had several recommendations for Marsha. Marsha is going to engage in structured physical activity 6 days a week for at least 30 minutes per day. Because Marsha is morbidly obese the initial exercise prescription will consist of walking most days. She will walk the treadmill for 25 minutes each day at about 40% intensity. She will do this at the gym so a trainer may be available to assist her if any health issues arise. Marsha is also going to work on upper body strength. While seated at her home, Marsha, will work her triceps and biceps with a 3 lb. weight. She will perform 2 sets that consist of 8-10 repetitions. She will perform a bicep curl on each arm as well as an overhead press.

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Marsha is also going to keep a food journal in order to record her daily caloric intake. She will attempt to remain within 1900 calories per day. She will avoid fast food and soda. She will address issues that may possibly cause her to eat for reasons besides hunger. After 6 weeks, Marsha will be re-evaluated and re-tested. The newer test scores will be studied and a new exercise prescription may ensue. This could include water aerobics, more weight bearing exercises and yoga for flexibility. Motivational Strategies and Techniques There are many strategies that will be beneficial to Marshas weight loss journey. The first is the realization that this is going to take time. She did not become obese in only a few months and progress may take just as long. This is her starting point and she will soon be able to look back on it and realize that everyone has to start somewhere. Marsha is going to track her daily progress as it pertains to the goals she set herself. She will be able to see weight-loss, improvement in diet and increased energy. Marsha will also take a group class to help stay motivated and feel supported. The final strategy Marsha will use is to try and get her family to join her. Their support and improved health will help Marsha continue even after her initial goals are met. After completing this assignment, I can back quite informed. I see that overweight and obese individuals may feel as if they are a lost cause when it comes to weight loss. Perhaps they cant imagine where to begin or how to begin. This is why it is crucial for health and fitness professionals to get the information out there and readily available for people who are ready for the next stage of change. I can only hope some of this information may be helpful to my family and their health.

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References Marcus, B. & Forsyth, L. (2003). Motivating People to Be Physically Active: 2nd Edition. United States: Human Kinetics. Howley, E. & Franks, B. (2007). Fitness Professionals Handbook: 5th Edition. United States: Human Kinetics. www.exrx.net