Health and fitness professionals most often approach health care for large
people in the context that health improvement can only be attained through
weight loss. Unequivocal acceptance of the notion that thinness equals heal
th and fitness presents an obstacle for large people who want to improve th
eir health through lifestyle changes in eating and activity patterns and al
so weakens the working relationship between the health care professional an
d the large client. Since the health benefits of exercise and sound nutriti
on are significant for people of all sizes, the strategy for health care pr
ofessionals should be to assist people of all sizes in eating healthier and
becoming more active. Because large people face even more barriers to exer
cise than smaller people, we address the special needs of large people tryi
ng to become more physically active, outline an approach sensitive to their
needs, and suggest how health and fitness professionals can improve their
effectiveness with this population.