What is this client asking for? Why does he or she want that? With personal issues such as health, fitness and appearance the client’s expression of his or her needs can easily be distorted by anxiety.

The woman in the above example who wishes to get a satisfying relationship by losing fat is unlikely to give this initially as her reason for seeking help. If she is partially aware of and embarrassed about her insecurities, she may deny this even if you ask directly about it. You need to take some care in considering what the initial request for help really represents.

What are his or her strengths and weaknesses? Consider what the client is and is not capable of achieving. Sometimes you can teach the skills and knowledge required. Sometimes the client already has these, so they can be left out of the program. Sometimes you can refer them to someone else who can offer better help or modify your approach accordingly.

What are the probable consequences of this client successfully losing fat? Of staying the same? You should consider whether the gains that can be reasonably expected would be a worthwhile return on the effort and cost involved. You should specifically take into account potential unwanted effects, particularly if the fat loss efforts are unsuccessful. This should include some thought about how the client and other important people in her life are likely to respond to the client losing fat and how they would respond if she regained it. The responses will not always be entirely positive.

What is this client’s history of obesity management? How have these past efforts affected them? Most clients have already made many efforts to lose fat. This history of efforts to lose fat makes up a powerful set of learning experiences that shape what clients expect of you and of themselves. Unless there is good reason to expect a different outcome, it may be unethical to repeat things that have been unhelpful in the past. It is almost certainly unethical to re-expose the client to something that has already been found to be harmful.

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