Client A points to flab dangling from lower arm and asks, "how do I tone this?". Client B points to upper legs and asks , "how do I tone up my thighs?". Anybody who has ever worked in the fitness industry knows what I'm talking about. There are some in the fitness industry who perpetuate the myth of "toning". Remember the Thigh Master? It was a cheap hip abductor contraption that was supposed to "tone up" your inner thighs.  The makers of the Thigh Master knew what they were doing since many women look at that area as a "problem" area where they don't like to see flab. I remember seeing one woman at gym back in the 90's who would spend 10 minutes on a weighted hip abductor machine hoping to "tone up" those muscles.  Women are more likely to say they want to "tone up" more than men. Men want to build muscle. It kind of reminds me of perspiring and sweat.  The most abuse of the term "toning" is see is when it is associated with spot reduction. For instance you have the thigh master scenario, or the hip abductor machine. I can't count how many times I have heard people tell me they don't want to do legs but they want to "tone up" their triceps. Which leads to the "there is no thing as spot reduction 101" lesson.  Most fitness pros will remind their clients that they cannot "spot reduce" but I have seen one infomercial  for an ab workout video (product was backed by a celebrity trainer - think "used to be on popular network TV show) that was going to help reduce that fat in the midsection and "tone up" the abs. Slightly misleading.  Even Beachbody, who produced P90X and Insanity videos, have late night infomercials showing people going from fat to fit while doing all kinds of rigorous exercise.  However, if you actually buy these products, you will see that following their nutrition plan is a big part of getting "the look".  

Here's what I think "toning" or "toned"  means to your average person who falls for the sales pitch. "Toning" means you can see the lines of the muscle and that when you poke at it there is nothing jiggling around. This is what most people want their bodies to look and feel like.  No problem with that. However, no exercise in and of itself is going to tone the muscle. Exercise, mainly resistance training, builds up muscle along with protein intake.  Cadio burns a fair amount of calories but cannot fend off too much overeating.  If there is a layer of fat around the muscle, you will not see much "tone". So if you spend an hour a day with a thigh master or a shake weight, you aren't going to get the results you want if there is still that layer of fat. 

Truth be told, clients love to hear that exercises are going to "firm up" problem areas. I get many request to do "more abs", or something for the "triceps.  Men and some women tend to collect fat on the former area, while some women are predisposed to collect fat on the latter area.  However, doing crunches, or triceps kick backs in different variations  for a half hour doesn't really do much to get rid of the "flab". Neither exercise burns a lot of "calories" so they aren't necessarily going to eat away at the body fat. Also, everybody has a six pack and everybody has defined arms. You just can't see them if they are behind fat. There are many "rock stars" who achieved six pack abs because they were mall nourished. There is no time between  shooting up junk,  sleeping with groupies and getting on stage, to eat.  Do you think these guys do crunches?  Now I don't advocate the "rock star" life, and in fairness some of these guys actually do workout to achieve that look, but the truth is that your muscles show when there isn't enough body fat to impede its visibility.

Most people who are fitness literate know that you cannot "spot reduce"  so the fitness marketers have snuck in "toning" to insinuate the same thing.  What they do is take a picture of a guy with 6% body fat and have him in any kind of exercise contraption and the more vulnerable of us will think that the fitness model got that look by using the contraption. Now suppose the fitness contraption is "the string", or "the stick", or "The Shake Weight" and on the box you see something that says "tone up your muscles", and you will see what I'm getting at.

If you want the "toned" look, you have to stay lean. For men this means getting into the mid teens  in body fat %. Women will look their best in the around 20 % body fat and shouldn't go lower than 16 % unless they are getting a gold medal in the Olympics.  I have seen many people who are "fitness junkies" and go from workout to workout, running, lifting, Pilates, etc in an effort to pull off some stubborn flab with no luck. This is because they don't get serious enough about their nutrition. You can drink 3 glasses of wine and eat desert everyday and look okay if you exercise your ass off, but you will never have "the look" until you change your ways. So the program didn't fail you if you were negligent about what you had to cut out food wise.  Your average woman will be in the high 20's in body fat. If you are in the high 20's, nobody will mistake you for the woman in the electric wheelchair at Wal-Mart, but you will have some visible problem areas.  So if you are looking to get into "bikini shape" listen to what the trainer or the program says about proper nutrition. Keep your sweets, and liquors under 200 calories a day, or if you are disposed to carrying body fat, cut them out. Otherwise, except yourself at the weight you are and make sure that you stay average and don't ride the slippery slope to obesity.  Put it this way, one donut, one coke, or one can of beer equals a mile of running. It is easier to limit the stuff that makes you  fat then to constantly add more exercise to fight off the inevitable.  So next time you see a product that is supposed to "tone" your problem areas see it for what it is, a marketing scam. Work out hard and eat clean and you will get results.  You might even end up looking "toned".

Tom Pollard

Body Mass Index is a fairly common tool for health professionals to determine if someone is overweight.  It is also used by insurance companies, governments, even the World Health Organization. BMI is a chart that indicates how overweight/underweight you are relative to your height.  Although these weights compute to some sort of average, the numbers and the system are antiquated. BMI is a throwback to the days when people didn't eat as much but they didn't exercise as much.  For instance, Joe Blow in 1970 graduated school at 5'9 150, got a desk job and put on 30 lbs.  Joe Blow,  now 5'9 and 180 in 1972 (when BMI came into use),  is told by his physician that he is overweight and that he needs to calm down at the table.  Most likely in 1972, a 5'9 180 lb man was overweight but something since then has happened along the way.

Weight training started to take off in the 1970's and 1980's. Of course you had Arnold and Sylvester Stallone movies, but you also had sports coaches encouraging  their athletes to train with weights when a few years earlier they shunned weight training because they mistakenly believed that weights would make their athletes slow. Now there was the factor of steroids in sports, that's another story, but in general athletes started getting bigger and stronger and their BMI's went up.  The general public soon followed. No longer was muscle building a Venice beach freak sideshow but something many mainstream Americans engaged in across the nation.

With all these changes you'd think that BMI would have been thrown in the trash with the TV antenna and the eight track. However, I still see it on personal trainer's websites, and in general health articles. So if Lebron James, needs to know that he's overweight (hahaha), all he needs to do is plug his height and weight into a BMI calculator. At 6'8, 250 lbs, Lebron James is overweight according to the Body Mass Index. "Nice dunk fatso", isn't something you hear opposing fans scream at Miami Heat road games.,  I suspect BMI, might be used because it is a simple tool. If you're a trainer, there is money to be made in having every other person think they are overweight. BMI is also kinder to women than men. A 5'5 150 lb person is classified the same whether they are a woman or a man but the reality is that women should carry more body fat than men as a percentage of weight.  BMI's inefficiency can work the other way.  In truth, if I start training a 5'4, 140 lb woman with no history of exercise, I would guess that she is probably carrying a few lbs of fat on her. The term "skinny fat" is a popular expression for those who aren't relatively heavy, but have low muscle development.  Back in the old days before obesity rates skyrocketed you had a lot of "skinny fat".  People didn't have as much food on the table but they weren't exercising much either.

What most fitness professionals and astute healthcare professionals are looking for nowadays is body composition. Body composition is what percentage of your weight is body fat. If you go by body fat percentage, Lebron James is now  a lean dunking machine and not some average Joe who needs to lose some flab. Why is this important for people to understand? Take Susie Skinnyfat, she feels winded and tired climbing up a flight of stairs, she just quit smoking, and doesn't like the flab on her arms, so she hires a personal  trainer.  She starts off with the trainer at 5'4, 120 lbs and six months later she is 5'4, 125. Now she's gone up a few lbs and if she doesn't have an idea of how lean body mass works, she might even be disappointed and discouraged.  Now if here trainer measures her body fat on her first and last session there will be a different story to tell. It is not unconceivable for Susie Skinnyfat to gain 12 lbs of muscle and bone density as a result of weight training while shedding 7 lbs of flab. Now say she started at 30 % bodyfat, borderline overweight for most premenopausal women, the 12 llb of lean mass and the loss of flab will result in a more swimsuit friendly body composition of 23 %. The 5 lb weight gain is irrelevant if not beneficial.  So the scale isn't the best tool in this scenario for measuring progress. Body Mass Index for Susie still keeps her in the normal range and doesn't take any progress into account. Now if we start with a 5'10 200 lb man at 30% bodyfat, who  puts on 20 lbs of muscle while maintaining the same bodyweight, he will still be considered obese according to the Body Mass Index even though six months later he is a healthier 20% bodyfat.

So what tools can we use to measure body comp, while we discard BMI and quit stressing about the scale?

Underwater Weighing - This is supposedly the best way to test for body comp, but it is expensive and generally available at major universities.  So, unless you're an Olympic hopeful, or an astronaut, I would forget about this procedure.

Body Calipers - I have used these in the past, but they can be tricky. it's easier to grab a loose skin then marbleized fat. Also, you have to take measurement in a bunch of different places because fat stores differently for different people, and if you have a client who is generally uncomfortable with a stranger pinching adipose tissue all over their body, - body calipers could be unreliable.

Body Monitors -  Brands like Tanita, and Omron sell scales and hand held devices that shoot pulses through your body that if impeded will read in a higher body fat.  These devices are fairly useful for tracking progress, but some of them use algorithms like age and weight to estimate what your body fat percentage should be in relation to the pulse. Since older people generally collect more body fat, it might actually tell a a lean, ripped,  50 lb man he's 15 % body fat when he's probably single digits.  Although there is some variance, and I have measured husky people who measure a lower body fat than less robust people at the same weight. So the pulse accounts for something. Some of the newer devices have an option for "athletes" so the body fat calculation is less for them, but it is kind of hard to determine who is an athlete.  What I really like to use these devices for is to track progress. So I might disregard the meaning of whatever body fat percentage the device says a person is, but I will regard progress over time. So progress is indicated if the first day of training it reads 30 %, and the next month it reads 25 %, and the client has pulled off several lbs.   Maybe the client is actually 23 or 27 % body fat, but the important thing is that we are seeing progress.

Body Measurements - I like these in general. If people lose flab, they will lose fat around the midsection. Measuring the hips of a woman can sometimes be unproductive because women come in different shapes and sizes.  Some store more fat than others under the belt while others have a weak posteriors that would benefit aesthetically and anatomically from an inch or two of muscle development in the hips. High waist to hip ratios (beer belly skinny legs) on men, should send a red flag to most health professionals. The "apple shape" is associated more with heart attack than the pear shape.

Bodyweight Exercises - If men are lean they can do pull ups, if women are lean they can do strict pushups. An obese man could add 5- lbs to his bench-press but still struggle to do pushups.  After training for a period of time with a client who has changed body comp, I might have them try a wall supported handstand, dips, pull ups, or any exercise that was impossible a few months earlier at a different body composition.  Obese people are more likely to complete marathons than they would be adept at holding a handstand against a wall for 10 seconds. There is a tendency for people who need to lose fat to pursue long bouts of cardio when strength training and a nutritional makeover would get better results.  In the fitness industry we call these people "cardio jockeys".  The "cardio jockey"  is convinced that excessive bouts on the treadmill is all they need to get fit.  If you are at a good bodyweight and body composition, you will be able to handle your body.  For those of you who are skinny but you can't do the bodyweight exercises it might be a matter of improving your overall fitness.

The Mirror - If you go from a no pack to a two pack,  if you have to buy new pants, if you can see your jaw line more clearly, -  then  you are making progress. Fat takes up more space than muscle and you will notice it in the mirror. The mirror doesn't lie. Often people get in good shape for a reunion, wedding, etc . only to rest on their laurels,  stop exercising and start eating like crap. The first place they notice it is the mirror. Of course it is important to maintain some body fat. Women especially, should be at least 16- 18 % body fat. Body fat does serve a function and although the mirror is a good tool be aware of the overall results and don't be too hypercritical.

Over the last two years I have used the last three tools to help clients get in better shape.  If clients seriously engage in proper nutrition and exercise they will get results. BMI is outdated. People come in different shapes and sizes. It's about being relatively lean and robust.  You can track your progress by using a variety of tools, and by monitoring your overall health.  So if your doc is telling you that you are overweight according to BMI see if you can get a consultation from a trainer, nutritionist, therapist, etc. Somebody who can give you an idea of where you are.  I've seen some weekend warriors who have been told they are obese when in truth they are overweight due to BMI. Of course it only takes short period of time to go from overweight to obese. People need to know where they are at on the body fat scale. Just comparing yourself to the "really fat" person you saw on the electric wheelchair at Walmart, isn't  an indicator of YOUR FITNESS.  For most of us, there is a fitter person who's being suppressed by a vicious circle of poor nutrition, lack of will power, discipline, bad habits, etc.  Some of us are aware, and others go through life thinking french fries are veggies and a bottle of wine a day must be good because it contains antioxidants. This is where a fitness professional can help.

Dr Plankenstein Fitness Training.

Too busy to exercise = exercising is not enough of a priority.

Too injured = sore muscles.

I want to weight to lose weight before I workout = I'm never going to work out until I lose fat, and I have no clue as how to lose fat.

I don't want to deprive myself = I like to eat sweets all the time and drink copious amounts of booze and I kind of ignore the repercussions.

I need to find a workout partner = all my friends are couch potatoes too.

Hyperthyroidism = 1 out of 300 have hyperthyroidism, 1 out of 3 people are obese. 1 out of 3 obese people will tell you they have hyperthyroidism.

My friend is doing P90X, insanity, cross fit, etc. = I'm not going to do your program but I probably won't do theirs either - but I like to talk about it while I put off getting serious about my fitness.

I can't do the things at 35 that I could when I was 20 = Because when you were 25 you stopped doing the things you did at 20.

Kids = I tire around the kids because I don't have enough energy to keep up with them, so I plop them down in front of the TV with some candy.

More to come...

When Is Boot Camp Really Boot Camp?

Over the last several  years there has been a movement towards boot camp like training in the fitness industry.  "Boot Camp" is a great marketing term,  and it sounds like a great adventure when you here a "stay at home" mom or "insurance" salesman tell you they are doing a boot camp. I run a "boot camp" myself and we have a lot of fun, we work out hard and I have seen many people transform their level of conditioning in a few months time. But just how real is "boot camp" in comparison to military "boot camp" training?

First off, I have never been in the military and I cringe to a certain extent when I tell people that I'm running a "boot camp". In my opinion, "boot camp" in terms of the fitness industry is a "marketing term" used by trainers to get people outside, running, doing pushups, partner exercises, etc. Maybe the term "outdoor fitness" or "group fitness" might be more appropriate, but from a business perspective most people are Googling "boot camp" when looking for such a program. So, I run a boot camp.

It is safe to assume that no drill instructor would tolerate "no shows",  "whining",  and the less than mediocre exercise form that comes along with fitness industry boot camps. To the drill instructors advantage, when you sign up for the armed forces, being fat or out of shape is a liability. Sharing  fox holes with those prone to pass out in situations of physical exertion isn't good for moral.  From what my military friends have told me, the out of shape, overweight, or underweight recruit are segregated and put in a separate group. Their food is rationed and they are put on a training regimen that will bring them up to speed with the other recruits. For these people, there is nobody who is going to tell them that it is "okay",  and that they "will get in shape with time".  Nobody is going to give them a seminar on "emotional eating" or "motivation".  The bottom line is they aren't up to the cut, and they will have to get their stuff in order eating the quantities of food that the military provides for them, and exercising on the militaries watch. 

Honestly, if I had as much control over my clients eating and schedule as the armed forces does, my success rate would skyrocket. I wish I had a dime for every time I heard somebody tell me that they had some chocolate cake, ice cream, desert coffee , six pack of beer, because they felt they earned it after doing a few "boot camp" workouts.  I doubt many overweight recruits in the military get rewarded "treats" for doing 10 pushups, and losing a lb of water weight. But left to their own devices, most of us "treat" ourselves to things we don't need. This is a weakness.  It would be fun to go into people's houses and burn all their doritos, and oreos cookies. I'd love to watch them have to deal with a plate of broccoli and some lean meat for their daily ration.  This would help them develop some real will power.    

As far as exercise goes, I think everybody should be able to run a few miles,  and do at least 20 pushups but depending on the group that signs up for "boot camp" it's hard to get everybody up to this standard. Some trainers have had success running "harsher" boot camps that cater to the fit, and let the unfit fall by the wayside.  A lot of this depends on the demand. If you have a decent size group of fit and committed people, you can let the slackers get in line, or go back to their TV sets, facebook pages and Ben and Jerry's.  Then you will have a boot camp that can wave it's flag high. On the other hand, from a trainers perspective, you have to make a living. So if  you have a group of semi committed people you give it your best shot, knowing that some of them may drop out, or skip a few workouts if the last one was too intense. You also know that a few of them will exercise intensely but never really get their nutrition house in order. You can let them know that their sore knees, or their inability to plank for a good period of time has to do more with their nutritional habits, and less to do with their natural ability but a lot of times that falls on deaf ears.

The bottom line is if you want a "real experience" with boot camp,  join the military or make it a point to push yourself harder. Do yourself a favor, next time you see your Navy Seal cousin at the family reunion, tell them you are doing a "boot camp" style training.

Tom Pollard

Dr Plankenstein's Fitness Training.

Having some "skin in the game" is an expression used in the finance world implying that if one is to advise a financial client to buy stock XYZ, then the advisor in turn should own a little XYZ to give his recommendation credibility.  Often times in the financial world, or in the world in general, people will tell anybody anything in an attempt to make a buck.  If a stockbroker is shortsighted he might tell his client to buy "risky" XYZ because it is a "hot" stock and one that is getting all kinds of press.  The stockbroker will make a commission regardless of what stock XYZ does for the customer.  If the stockbroker doesn't own XYZ he doesn't suffer the loss only the commission. So a good question to ask a stockbroker who recommends that you buy a stock is "how many shares do you have?". You want to see that your broker has some "skin in the game" before you take his advice. This is true outside the world of finance and the broader world of sales as well.  The fitness world is full of trends that are pushed by us fitness people that are credible or not so credible.

Take the toning shoe craze that Skechers pushed a few years ago.  Wearing these shoes was supposed to help "tone" your legs. However, wearers of the shoe ended up having similar injuries and discomforts that perpetual wearers of high heels have. Eventually Skechers parent company Reebok faced lawsuits.  Maybe Reebok should have had some of their employees walking around in toners for awhile before they were brought to the market. Having their employees, or better, the CEO and board walking around in the toners might have shown more "skin in the game".

I have seen a few personal trainers who spend too much time on up selling their clients on supplements. These supplements can be expensive and I doubt that many of the trainers who sell them consume them on a regular basis. Personally, I wouldn't have a problem selling a multivitamin, b12 complex, or protein powder because these are all things that have worked for me. I have "skin in the game" with these nutrition aids.  On the other hand, if I were to push a client to buy "white bean extract" because it's the latest and greatest in weight loss supplements, I'd be full of it.  I've never used the stuff, so I have no clue if this stuff works or not. However, I have managed to keep decent body fat level, eating well most of the time, controlling portions, and exercising,  so that is what I preach. There's 1000's of supposed weight loss products at the health food stores and I get emails every day from supplement companies who recommend that I push their product on my clients.  Now, other trainers might look at these supplements as opportunities to up sell their clients and create bigger "revenue streams". 

The health and wellness world is full of people pushing you something. I had a chiropractor propose a $1600 plan for each of my kids that addressed every health issue that we addressed on the waiting room forms. Do they do $500 adjustments on each other for runny noses, attention problems, etc?

How about the constant pharmaceutical ads that show you some sad face turn into a happy face, and that you should ask your doctor about their drug.

Another area where people in my profession should have some skin in the game is in prescribing exercises. If a trainer is going to charge you $70 an hour to improve your golf swing, they should know the actual mechanics of hitting a golf ball. I don't golf much but I know there is a lucrative market for trainers who work on exercises that improve the golf swing. I could prescribe a couple rotational exercises that might help somebody get "torque" on their swing, but I don't think it would help my credibility if I worked with a golf pro and after a couple of months the golfer saw no real difference in their game. So anybody, charging a customer $70 a workout to improve their golf game, should know the mechanics of the different swings, know where to see the imbalances in the swing, and where weaknesses can be improved. Charging somebody $70 an hour to do a couple sets of woodchoppers isn't legit.

Also,  if I were to make my clients do 1000s of pushups and burpees until they puked while walking around with a beer belly and bull horn, I'd have a credibility problem. Sure some clients will get progress in this environment, and they might not question the trainers girth. However, at some point they might question the trainer  if every workout they are so drained, or hardly drained at all, and they might look elsewhere. If you don't know what a workout "feels like" yourself you could run your client into the ground. Running  50 yard dashers in a 15 minute period might not sound like much on paper but if you done it before you know that you can be exhausted at the end of the workout. Watch out for the trainer with no "skin in the game". The trainer who runs you into the ground while the text to their buddies about what night club to meet up at night. So, iIs the trainer able to do the workout they prescribe? Or has the trainer lost all interest in health and is just going through the motions throwing routines at clients to pass the hours?

 I have seen some popular fitness programs that utilize the Olympic lifts, but after watching some of the videos on you tube you'd question if any of these programs spent any time going over proper form with a client.  Telling a 45 year old woman, to power clean 95 lbs as many times as possible in a minute because it's intense and will build up explosiveness isn't smart training.   I love the Olympic lifts but I wouldn't spend too much time doing them with novice clients who are just looking to get in shape.  If you're going to teach the lifts, you should know how to do them right, otherwise your clients will end up with degenerative injuries over time.

The most important thing I can do as a trainer is to show observable progress with every client. If I wanted to just sell whatever to make money, I'd sign up with Amway. I love seeing people push their limits, turn back the clock, and get in tune with healthier way of living. I try and follow this myself, when I'm not training I'm working out, trying new exercises to see what works and what doesn't.  I look forward to training more clients down the road.

Tom Pollard

Dr Plankenstein

All one needs to do is walk around Wal-Mart, or eat at a fast food restaurant, to see that obese people are everywhere.  The citizens of the USA spend about $40 billion a year on diet products. That is about $130 a citizen. Judging by the muffin tops and crammed airplanes, these diet products aren't doing the job.  Adding confusion to the issue is the fat acceptance movement which wants obese people accepted as if they're a minorities with rights who have no choice in their body make up. This is a flawed movement because it doesn't address the health problems that accompany obesity, i.e.,  type II diabetes, high cholesterol, high blood pressure, arthritis, poor posture, heart disease, etc. It is accepted that some people have higher amounts of fat cells than others, and that they might be more inclined to put on weight, but few people get obese eating a healthy diet and exercising. The truth is too many people are fat, and a lot of these people aren't doing enough in terms of nutrition and exercise to make a big change. You can watch all the Dr Phil shows, read all the books, sign up for every exercise group and nutrition seminar, start a "pat yourself on the back" support group,  but if you're not burning more calories than you're consuming you will continue to be fat, or worse - get fatter.

What is obese?

The National Strength and Conditioning Association defines obese for a male at 30 percent BMI(body mass index) and 35 percent BMI for women. However, BMI is not the best indicator of body composition given that muscle weighs more than fat. A Football player could be classified as obese by his BMI and actually have a low percentage of body fat. A body composition analysis is the most effective way to measure body fat. This can be done with a variety of methods as simple as a body fat measuring hand held device, or as complex as being weighed underwater on an expensive scale. All body composition measurements have their limitations but if you use the same devices to track body fat percentage over time you will be able to track fat loss.  

I've tried many things but have not had results.

So you have the total gym in the garage, the p90X dvd's in the closet, a juicer in the cabinet, and a shelf full of trendy or once trendy diet books.  You are making the fitness industry rich but not having any success.  Most neighborhood fitness facilities survive on having about 3000 plus members but about half or more rarely workout. These people who slip through the cracks of fitness are a huge part of the fitness industries financial success.  A lot of these people are dipping their toes in the water of fitness but never diving in. A lot of times they are looking for "fast food" fitness. At worse, they end up with "shake weights" or other meaningless contraptions.   There are some great workout videos, books, and exercise classes available to everyone but if you have a history of dropping out  or "just putting your foot in the water" you will never have any success if you don't change the pattern.  If you have gotten to this point, I recommend sitting down with a fitness professional for a consultation.  A good consultation consists of going over exercise and nutrition habits. The consulted should also be weighed and measured for body fat composition. Finally, if the consulted wishes to hire the trainer, they should set some mutual goals. The client and the trainer both accept that being in the obese category is a problem that needs to be solved. You agree to track weight loss and the trainer will make it a point to inquire about daily food consumption. This is why one on one training is more successful  than group training in helping a client get off the obese list.  Often in a group setting, everybody is made to feel accepted in order to keep the group working out together.  Trainees are more likely to skip group workouts, and be less committed to maintaining a good nutrition plan.  From a trainers perspective, it is easier to spend 5 to 10 minutes with one client going over what they should and shouldn't be eating, or how they might have strayed from the plan, than it is to discuss those topics in a group setting.  One on One training is going to cost more than group training but the success rate is higher which might make it more cost effective in the long run.

So if I'm obese, what is the first step in losing 50 lbs?

So if you need to lose 50 lbs, and you've tried many different things with no success,  hire a personal trainer.

You Need to Get the Nutritional Plan in Order.

Someone who is 50 lbs overweight needs to cut out sugar (alcohol included) and flour consumption. Initially, They need to get their calorie consumption under 2000 a day and more depending on their target weight.  They need to learn how to measure their food. If a serving is one cup, then they need to make one cup. They need to start looking at the labels on the food.  The need to go into a restaurant prepared.  The trainer can help them with this.  If a new client gets their calorie consumption down, and drops the flour and sugar, within a week they will start losing weight. It's not uncommon for a client to lose a few lbs between the consultation and the first workout  on diet change alone.

Start Walking

The average person burns about 100 calories a mile. If you walk briskly you can burn up to 400 calories in an hour. For an obese person, walking to burn calories is a low impact no brainer. To lose a lb of fat you need to burn 3500 calories. So you've removed the junk from your diet and that amounts to about 500 calories a day or 3500 calories (1 lb of fat) a week, now throw in four hours of walking a week minimum to burn another 1600 calories.  Now you're burning about 1.5 lbs of fat a week.

Working out with the trainer.

For an obese client, I recommend working out three times a week. If the intensity level is right, the client will burn about 600 calories or more a workout. You do this by mixing different exercises with small rest intervals. Weights and bodyweight exercises are all done with good form. (Another reason why people fail with the videos is form).  A good trainer enables the  client to execute the exercises with good form without killing the intensity of the workout.

Muscle

The trainer is going to help you with your workouts by making sure that you maintain good form, intensity, and focus. The trainer should also see signs of when the body might need a break from the intensity and modify the workout as needed. These are all aspects of training that are harder to do with exercise dvd's  and group training classes.  The trainer needs to  get you to confide in your daily caloric intake. It does the trainer and the client no good for the client to lie about what they don't eat. Often times confiding in someone else helps a client avoid eating crap food and gets them to realize just how much junk makes up their daily caloric consumption.  The client needs to be held accountable if they are not sticking with the plan. You cannot out workout bad nutrition.

As the client progresses, the trainer will increase resistance and intensity during the training sessions. The trainer might also prescribe more intense cardio exercise for the client to do on their own time.  The healthier the client gets the more likely he or she is to pursue more productive hobbies. Choosing to do a home project over sitting on the couch gets a lot easier when you're fit.  The trainer should measure the clients success, through body comp analysis, and the clients own greater satisfaction with body image and general health. The client needs to be reminded of how they felt and looked then and how much better they feel now.

What is the Bottom Line?

If you have every exercise gadget, tried all the dvd's, purchased all the fad diet books and you still need to lose 50 lbs, something needs to change. How much would you spend if your roof had a leak, or the tires needed to be replaced on your car? How much do you spend at fast food restaurants when you could be making healthier meals for half the price. What do you need to change in your life? What if hiring a personal trainer, and working out hard for a half year to burn 50 lbs of unhealthy body fat makes you less risk averse to colon cancer, type II diabetes, heart diseases, arthritis, etc.  The risks definitely outweigh the costs.  
Tom Pollard