Body image encompasses four aspects relating to how a person perceives themselves. These aspects can be both positive or negative. The four aspects of body image are:
-
Perceptual - The way a person sees themself. This perception can be either accurate (how another person or medical expert may also perceive them) or unfounded (believing they are fat when in fact they are underweight).
-
Affective - The way a person feels about their body. They may be happy and/or confident about their current body shape or they may be dissatisfied and/or embarrassed by their body.
-
Cognitive - The way a person determines the reasons for their body shape and how they might improve. For example, some people believe they will look and feel better if they lose a certain amount of weight or develop more muscle.
-
Behavioural - The way a person acts as a result of their body, for example, dieting, exercising, dressing in a particular way or avoiding certain social situations. There are positive and negative extremes of all of these behavioural actions.
In addition to encouraging fitness participation and healthy eating, general methods that can be utilised to help improve a person's body image, as determined by Health Direct (an Australian Government initiative) are:
-
Question media images. There are images of unrealistic and unobtainable bodies everywhere in the media; clients should be encouraged to not compare themselves with these images and remember that often what is seen on TV and online are not true depictions of real people.
-
Avoid any media, social media or websites that make them feel bad or suggest they need to change the way they look.
-
Focus on the positive things their body can do.
-
Ask them to look for similarities between their body and the bodies of other members of their family.
-
Encourage them to wear clothes that make them feel comfortable.
-
Get them to try positive self-talk.
-
Avoid being critical of other people's bodies, negative attitudes are contagious.
It is important to recognise when a person's body image attitude is excessively negative and not improving as a result of basic fitness and healthy eating, this may indicate the need for referral to medical or allied health personnel to assist with their care. Sustained negative body image attitudes or beliefs can lead to serious conditions such as body dysmorphic disorder, anorexia nervosa and binge-eating.
Participating in regular fitness activities has strong links to improving physical and mental health and appearance and thus improving one's body image. Some of the benefits include:
-
Physical - Cardiovascular and respiratory improvement; Reduction in health risk factors (ie. heart disease, diabetes, cancer); Increased metabolic rate; Decreased risk of falls; Bone health improvement; Weight loss and reduced obesity.
-
Mental - The increased feeling of well being; Better sleep; Better brain function; Increased self-esteem.
However, starting and committing to an exercise program can be difficult for people with negative body image.
Individuals who have positive body image are more motivated to engage in fitness activities. This does not necessarily mean that they are currently fit and healthy, just that they have a positive and realistic outlook on their current situation and are seeking ways to improve themselves. These types of clients still require targetted exercise plans, goal setting, and support, however, their motivation and enthusiasm should not present much of a challenge.
For people who are experiencing negative body image the following tactics may help:
-
Know the client's preferences and insecurities - People with negative body image may be embarrassed by their body and will not seek out public or group fitness activities, they may appreciate one-on-one coaching or small groups with people of similar age and/or physical ability. Using questioning techniques to ascertain their preferences and insecurities, most commonly during an initial orientation session, will help you to plan an appropriate program. Concentrate on using open questions which require an in-depth answer (as opposed to simple 'yes' and 'no' responses).
-
Offer choice - Studies have shown that providing choice, even inconsequential, can be beneficial. It helps the client to feel in control and boosts motivation. Consider offering the choice between two types of exercises which work in similar ways or target similar body areas, or let them choose the order they undertake certain exercises or how long they participate.
-
Build Rapport - Providing regular and sincere encouragement and feedback not only helps increase motivation it also helps to build rapport. Showing genuine interest in them by asking open questions (requires a full response as opposed to a yes or no answer which is a closed question) about weekends, holidays, work, school, or family can also help. Feedback can be provided in both a constructive and also a motivational manner and can be informal, based on overall appearance, or it can be formal, based on more detailed information such as measurements and testing.
Eating a healthy balanced diet is also recommended as a means of improving body image. The benefits include:
-
Weight loss - Eating a diet consisting of vegetables, fruit, whole grains, lean meats, and certain dairy products whilst minimising the intake of processed foods that are high in fat, salt and/or sugar will have a positive effect on a person's weight.
-
Reduced cancer risk - Fruit, vegetables, and whole grains contain vitamins, antioxidants and fibre which help to lower the risk of many types of cancer.
-
Better diabetes management - People with diabetes must control their glucose intake and thus need to limit foods with added sugar or foods that are easily converted to sugars.
-
Heart health and stroke prevention - Limiting processed foods with high levels of fat and salt will help to reduce the intake of trans fats. This specific type of fats is linked to high cholesterol which in turn can cause a heart attack or stroke.
-
Strong bones and teeth - Dairy products, vegetables, legumes and certain types of fish all contain calcium and magnesium which are essential for building strong bones and teeth and preventing the onset of conditions like osteoporosis later in life.
-
Cognitive improvements, better mood and memory - Eating foods that have a high glycaemic index such as cakes, white bread, biscuits, lollies, and soft drinks, has been linked to instances of depression and fatigue. Therefore, a healthy diet consisting of vegetables, fruit, whole grains, lean meats, and certain dairy products is recommended for improving mood. These foods also have higher levels of vitamins D, C, and E and Omega 3 fatty acids which have been shown to improve memory and cognitive function.
-
Improved sleep - Sleep patterns can be disturbed by conditions such as sleep apnoea which is linked to obesity and/or drinking alcohol both of which can be improved by eating a healthy diet.
Working with clients to develop goals is an important part of developing a fitness program. It is usually done during the orientation phase and should cover all aspects of a healthy lifestyle including:
-
Fitness.
-
Health.
-
Nutrition.
-
Body composition.
However, motivation will diminish if goals are not achieved on a consistent basis. Setting realistic expectations and reviewing goals regularly is an important part of the relationship between a fitness professional and client.
When discussing goals with clients, it is important that they understand the workload and sacrifices they will have to commit to achieving their desired outcome. For example, a person who wants to achieve 'washboard abs' is going to have to commit to an extensive weight training routine and be diligent with eating healthy foods and improving their overall health. This may impact on their family or social lives and if so this factor may impact their achievement of the goal.
The concept of the SMART Goal may be a useful tactic:
The goal should be detailed enough that the client knows exactly what they are trying to achieve. Don't just say "Get Healthy" or "Lose Weight", be specific by saying "Quit Smoking", or "Lose 10kg".
Basically means adding numbers to the goal so that progress can be tracked. This may be measurements taken of initial body composition or results of an initial physical fitness assessment. By recording these numbers and reviewing them regularly a clear indication of progress will be apparent.
Striking the balance between developing realistic goals without being too blase is important. Extremely specific goals with short time frames may not be attainable, whereas an extremely easy goal will not be very motivating as body composition will not visibly improve much.
This section of the goal-setting process will depend on the individual client, some people are highly motivated and willing to commit themselves to any necessary work and sacrifice, others will have varying levels of motivation and may require more encouragement and smaller more frequent goal setting so they can see improvement gradually and experience small wins more regularly.
If the goal is not their own or if they are not particularly concerned about achieving a certain outcome then motivation will slip. Work with the client to determine what is relevant to them and what they are willing to work for.
Working towards a deadline helps with motivation. Set realistic and healthy time periods in which to see real improvement and schedule in review and measurement sessions at these intervals.
Reinforcements to an exercise routine or body composition goal are rewards set in place to help participants complete the necessary activities and stages to achieve their desired outcome. As a general rule, there are three types of reinforcements in this scenario:
-
External (extrinsic) rewards - Tangible rewards that are awarded (usually be a third party) each time a goal is reached or commitment is kept. For example, prizes, points, and praise etc...
-
Internal (intrinsic) rewards - Intangible rewards that are realised each time a goal or an exercise commitment is kept (this is a personal feeling of satisfaction and achievement). For example, achieving a personal best, attaining a personal goal, improving mental and physical well-being.
-
Negative reinforcement - Punishments that are given each time a goal is not achieved in the planned timeframe or commitment is not met. For example, financial penalties, criticism, removal of privileges. Note: This form of reinforcement is not recommended when supporting clients with positive attitudes towards eating and body composition.
Real or perceived barriers to achieving body composition goals may exist for some people.
-
Perceived barriers are issues that the client sees as barriers but which are often just their opinion or attitude. They can be overcome by providing information, support, and flexibility. For example, the perception that they are too old, too 'stuck in their ways', or too busy.
-
Actual barriers are real obstacles which must be addressed but are not insurmountable. They can be overcome by taking preventative measures, developing a strategy for coping with the situation, or seeking expert advice and support. For example, financial limitations, logistical difficulties, family obligations, or a disability.
It is important to conduct a range of discussions with the client in order to determine which of their barriers are perceived and which are actual barriers.
Some common barriers include:
-
They may not believe they personally have a problem. Some people don't realise that their weight is actually in the obese category or they don't realise exactly how many kilojoules they are consuming.
-
They have plenty of time to correct the situation. There is a common perception that heart attacks, strokes, and other health-related conditions only affect older people therefore they may believe they time available to be unhealthy now.
-
They may have just accepted that they are a certain size/weight. Some people have tried dieting and exercise previously without success and have resigned themselves to accepting their current physique.
Others are very aware that they have a problem and may have a desire to change but are unable to make the necessary adjustments to their lifestyle, possibly due to addiction, mental health concerns, or seeking comfort in eating. Either way, it is essential that this barrier be overcome if they are to achieve any real success in their body composition goal/s.
Modern life has significantly reduced the amount of time people spend moving. On average Australians spend almost 10 hours a day sitting. This is a result of:
-
Sedentary computer-based jobs.
-
An over-reliance on cars.
-
A great deal of time spent watching TV.
Inactivity can cause reduced fat-burning enzyme production and low kilojoule burning (metabolic rate), disrupted blood sugar, increased insulin, high blood pressure, and muscle imbalance leading to poor posture.
Whilst any physical activity is better than leading a totally sedentary lifestyle it is important that clients understand that irregular, erratic, insufficient, and/or incorrect exercise will not really help with improving body composition.
Current recommendations for exercise quantity (if the goal is to lose weight) is at least 30 minutes of moderate to vigorous physical activity five times a week.
In order for the body to run efficiently, it is essential that it receives good quality sleep. Quality sleep means:
-
Occurring in a quiet dark place free from interruptions.
-
Occurring at a similar time.
-
Not affected by caffeine or stimulants.
-
Lasting for between 7-8 hours.
Lack of good quality sleep can result in poor metabolism, poor repair and function of the body, inability to effectively process fats, sluggish digestive system, and lethargy.
The body releases various hormones when it is stressed, such as cortisol (colloquially known as the 'stress hormone') and also adrenaline. These hormones trigger glucose to be released into the bloodstream.
This response is the body's natural defence against a perceived danger that requires rapid energy (glucose) to either battle a predator or run away from the threat. Known as the fight or flight response.
Fortunately, not many people have to fight or run away from danger, however, they do still get stressed for a multitude of reasons and the unused glucose affects metabolism by increasing insulin levels causing blood sugar levels to drop and cravings for sugary or fatty foods to develop. Comfort eating, as this phenomenon is known, can become a habit if stressful conditions are allowed to persist.
