Over 80% of healthcare costs in the United States are attributable to chronic disease, which is significantly tied to lifestyle factors, such as nutrition, physical activity, substance abuse, inadequate sleep, and poor stress management. Yet even those with financial means and access to services struggle to make sustainable habit changes in these areas. As healthcare continues to move toward value-based care, this industry needs to take a more preventative approach in order to decrease costs by finding ways to integrate fitness and behavioral health into traditional medicine.
Fitness Needs to Sit at the Healthcare Table
Fitness and healthcare continue to move closer together from both sides. Mount Sinai has Off the Scale, a behavior-change intervention program focused on “lifestyle-driven chronic disease care”, while AKTIV Against Cancer focuses on integrating physical activity into cancer treatment. The American College of Sports Medicine (ACSM) has its Exercise is Medicine (EIM) course, which “strives to make physical activity a ‘vital sign’ that is routinely assessed at every patient interaction with a health care provider."
As guest writer David F. Brand discussed last week, exercise serves as a valuable therapeutic tool in a wide variety of health-support services, including social service programs. Studies continue to demonstrate the effectiveness of exercise—including progressive resistance training—in reducing depression and enhancing quality of life, as well as building physical strength. However, we need to continue shifting fitness conversations away from weight-loss-specific if we want to use it to benefit clients and patients with a range of physical and mental health conditions..
Shifting the Fitness Conversation
The focus of the fitness and nutrition industry on improving physical health and appearance often ignores the importance of mental health in one’s overall well-being. Usually unintentionally and unknowingly, professionals may use language that contributes to stress, shame, and confusion about what it means to “be healthy”.
A hyperfocus on aesthetics and weight loss can inhibit clients from reaping the self-care and mental health benefits of physical activity and nutrition. As a result, clients are often set-up for failure and may even experience more negative outcomes due to low self-efficacy and continual cycles of extreme behaviors.
We need a more open view of “progress”—from a “no pain, no gain”, aesthetics-based (and often ostracizing) framework to a more therapeutic, supportive, and inclusive dialogue around exercise as a helpful coping mechanism that also benefits physical health. We need collaborative goal-setting between patients/clients and providers open to the idea of non-performance or non-aesthetic-based outcomes.
In short, we need to shift the conversation around fitness so that we can "upgrade" the collaboration between fitness and the greater healthcare system in order to enhance client/patient support and improve health outcomes.
"Upgrading" Collaboration Between Fitness and Mental Health
Not only do we need better collaboration between patients/clients and their providers, we also need stronger partnerships across the spectrum of healthcare that include medical, mental health, and fitness professionals.
Fitness professionals typically remain low on the totem pole of health support. Personal training is often considered a vanity or luxury, rather than a legitimate healthcare field. This is not entirely unwarranted, as many personal trainers lack sufficient knowledge to support clients with medical conditions or mental health diagnoses. While the industry is moving in a more holistic direction, with personal trainers incorporating a wider breadth of more individualized support, fitness professionals and healthcare professionals do not always collaborate on client/patient treatment, and, thus, miss opportunities to provide valuable input in their respective areas of expertise.
If members of the fitness community want to play a more significant role in improving public health, they need to collectively "Raise the Bar"! It’s time to increase the integrity of coaching and treatment by developing an approach that integrates fitness and mental health. As wellness professionals, we owe it to ourselves and to our clients and patients to educate, support, and understand their individual needs and address health through a wide-angle lens.
Raising the Bar of the Fitness Profession
There is great opportunity for fitness professionals in healthcare, but we need to elevate ourselves to a more rigorous standard if we aspire to be deemed trustworthy enough to work safely with vulnerable populations. The Raise the Bar campaign promotes awareness of the crucial link between fitness and mental health—because both are necessary to achieve a true state of “wellness”.
The Oath consists of four pillars of unconditional support that fitness professionals can strive to maintain:
Compassion: Creating a safe, non-judgmental, shame-free space, that empowers and supports physical, emotional, and mental health
Mindfulness: Focusing on behavior-focused, collaborative goal-setting that emphasizes mind-body connection and increased awareness of behavioral patterns and triggers
Neutrality: Practicing a flexible, anti-prescriptive, “one-size-fits-none” approach and honoring individual differences by not imposing personal values and aesthetic preferences
Credibility: Upholding high professional standards through continual education, collaboration, and encouragement of sustainable health-promoting habits
Our Walnut Health team consists of former and current fitness professionals, behavior change specialists, and mental health professionals. We have been there, as both fitness professionals and as women, witnessing and adopting disenfranchising methods of coping that stemmed from hurtful relationships with our bodies and with “health”. We experienced “health” at its worst, and we know that there is a better way.
Learn more about our Raise the Bar campaign and raise awareness of the crucial link between fitness and mental health by sharing your #whraisethebar pledge and story on social media!