Health & Fitness Coaching


Fitness Testing & Assessment

It is strongly recommended that all clients undergo an evaluation of their medical and psychological status, dietary habits, and fitness level. The extent and scope of the assessment will be contingent upon the level of medical attention provided and the program setting. Fitness testing and assessment provides information on the fundamental or minimum requirements of physical and psychological health, fitness parameters, readiness to exercise, and motivation or readiness to change (for a comprehensive review of assessment methodologies, refer to the Fitness Testing section).

Physical Assessment


Physical Assessment

Fitness evaluation and testing can determine the criteria for a well-balanced program, but only a physician can evaluate an individual's medical condition. The most qualified people to assess a health history and conduct a physical exam in order to identify obesity-related illnesses and determine the appropriateness of a diet and exercise program are physicians, physician assistants, and nurse practitioners.

A significant number of individuals who are substantially overweight frequently regain the weight they have lost. Research has demonstrated that individuals who lose a significant amount of weight regain approximately two-thirds of it within one year and almost all of it within five years (Wing & Phelan, 2005). The pursuit of an optimal weight is no longer the primary focus of guidance in response to such disappointing outcomes.

As an initial objective, obesity specialists have recommended a 10% reduction in body weight over the course of six months (NIH, 1998). Once clients achieve this objective, they may become motivated to focus on maintaining their initial weight loss. On the other hand, individuals who remain motivated may establish an interval goal of losing additional weight, with reevaluation occurring after each successive interval. In many instances, clients will not achieve their ideal weight through modest weight loss.

However, even minor weight loss, such as 10%, can yield significant health benefits and increase the likelihood of long-term maintenance. The results of body-composition testing can also be employed to establish an initial objective or to establish a reasonable weight by reducing the percentage of body fat to a healthier level.

Even when aerobic exercise is the sole form of exercise, it is essential to comprehend that muscle weight can increase. Periodically throughout an exercise regimen, it is imperative to evaluate body composition, especially when fat weight reduction appears to have reached equilibrium.


Criteria for Medical Clearance

While it is advisable for all clients to obtain a physician's consent prior to commencing a fitness and weight-management program, it is particularly essential for clients with the following medical conditions:

  • BMI greater than 30
  • Cardiovascular disease, angina, arrhythmias, and congestive heart failure
  • Chronic kidney failure
  • Diabetes
  • Elevated cholesterol or triglyceride levels
  • Extreme obesity
  • Hypertension
  • Hyperthyroidism or hypothyroidism
  • Liver disease
  • Pregnancy-present or planned
  • Significant emotional problems
  • Substance abuse


    • Basic Health Screening

    For clients who appear to be in excellent condition and do not disclose any significant medical issues, it may be enough to gather the following health information as a starting point before implementing a program (National Task Force on the Prevention and Treatment of Obesity, 2000):

  • Assessment of obesity-related risk factors
  • Blood pressure and resting heart rate
  • BMI or body composition (percent body fat)
  • Current medical history
  • Current medications
  • Family health history
  • Health habits (e.g., cigarette, alcohol, and recreational drug use)
  • History of chronic illnesses
  • Waist circumference


    • Psychological Assessment

    It is important to exercise caution when evaluating behavioral and psychological factors, as most Health & Fitness Coaches lack expertise in mental health. The objective of such assessments should be to collect information for the program, rather than diagnose, evaluate, or categorize a client's medical or mental condition.

    Understanding the purposes that the current behaviors support is the first step in conducting an effective behavioral assessment, which is essential for program design, acceptance, and long-term program compliance (Groden, 1989). For instance, the first step towards adopting good eating habits is to comprehend the client's present eating patterns and the significance they play in their lives. Advising a client on what foods to consume and what not to eat alone won't cause a long-term behavioral shift. Instead, the health coach must develop a more thorough awareness of the client's behavior, including the locations and times of day when the undesirable behavior is most prevalent.

    Habits and behaviors have a purpose for a client, so health coaches should make an effort to comprehend how the client benefits from negative habits (e.g., avoidance or instant gratification) as well as identify the environmental, social, or emotional triggers that cause the bad habits.