Ci: We know there is a national crisis with the obesity problem. How can health clubs can be a part of a solution?

Brownell: Health clubs can participate in a number of ways. One is to make themselves more appealing to the deconditioned, overweight individual. From the health clubs I've been involved with it is not uncommon for them to have some sort of weight or nutrition program, but they generally do not advertise them and they don't extend themselves into the community as a way people can come in and get their weight under control.

Ci: There is a little shift there now. I think clubs see the success of the weight loss centers and more clubs are trying to incorporate them into their clubs.

I think that represents a positive trend then. Because the more that health clubs pop into [people's] minds when they are struggling with their weight as a possible solution to a weight problem, the better.

Ci:: This industry has struggled for a long time with becoming more attractive to the deconditioned market. What can clubs do to change that image?

There are some things health clubs can do to make them friendlier for people who don't feel good about their bodies. One think I can think of is to have staff sensitized to the special psychological needs of the individual.

Ci How would clubs go about doing that?

Most people in our society have a strong bias against overweight people. Just like race bias or gender bias and things like that, but stronger. And the reason people have this bias is because being overweight is an unacceptable condition in our society, and you're blamed for it. People might have a bias against individuals of a certain race, but not blame them for being that race. But in this case, there's a bias because being overweight is considered bad and people blame the individuals that have it. It's like a double whammy.

For example, if club staff is circulating around the health club, they will stop and help someone who is using the equipment incorrectly, but they may do that less with overweight people. And when health club staff go through the initial run through of the club as part of the sales promotion, maybe they are acting in some biased way that they don't recognize. Being sensitive to that population would be a good initial step for health clubs.

Ci: In your book, “Food Fight,” you look at some key points that contribute to obesity like school food and super-sizing at restaurants. Do you think the education is out there for people to combat this problem?

For people to control their weight ultimately they have to make fundamental changes in their behavior. And some things folks like to do interfere with this. For example, most health clubs that I know of are selling supplements of one type or another. And some of these supplements have weight loss in their description and that gives people the sense that the way you lose weight is by a powder or a pill. So that's one area where the clubs are probably doing something that might hurt themselves. But then another thing they could add on would be lifestyle change classes. Not just nutrition, but more how you change lifestyle, how you change the way you think about food, think about your weight, how you establish goals, how you handle relapse when it occurs and things like that.

Ci: That's interesting. So health clubs should focus on lifestyle issues?

People who are struggling with their weight have issues they face, and it's important that if a health club can combine a weight program that covers these issues, it could be a big help.

Ci: It's tough out there because if you go on the Internet or to a Barnes & Noble, there are hundreds, if not thousands, of weight-loss and diet plans out there for people to follow. It gets confusing.

The nutrition business is confusing. But I think the popular diet books contribute to that because there is absolutely no screening that goes on for these books to be published. An author can say just about whatever he or she wants and the public can have no confidence that these diets have even been tested.

Ci: In reading your book — especially looking at schools and nutrition, which you take a hard stand with — what can be done to change things there? You have the president and president's council preaching better diet and nutrition and exercise, but on the federal and state levels schools can't get budgets for PE classes or bring in healthy foods.

Exactly right. The focus of my book is on this toxic environment. You can imagine how toxic the environment is overall if even health clubs have candy machines. This is a sign of how bad the environment is in general. How everybody wants to make money by selling bad food.

CI: What else can clubs focus on?

Another thing health clubs might be able to do is to find this market by focusing on prevention of weight gain. Once obesity is established in a person it is pretty hard to change. It is not the kind of problem our society will ever treat away. Because for every person you can help by providing some treatment, there are 10 or 100 or 1,000 more becoming overweight. So most of this is more readily prevented than it is treated. With that in mind there's a whole group of people out there who are only a little overweight who would like to keep from getting worse. And if health clubs can reach out to that group and market themselves as a means for preventing weight gain, then I think they have a potential new audience.

Ci: That's a great point. If you look at healthcare trends in general, preventive medicine and complementary solutions seem to be the way people are looking as opposed to treatments. That would be a great way to capitalize on that.

I think that's an interesting part of the market for the health clubs to explore.

Ci: You mentioned the toxic environment. Look at how powerful the food groups are — the lobbyists, the restaurant groups. An industry like the fitness industry is relatively small. Is there a way that they can be an influence on a bigger level as opposed to maybe just on each individual person or each individual club?

People can be advocates themselves for a healthy environment. It's a good thing to do because you are being a good citizen. You are focusing on something most health club people are focused on anyway, which is the health of the population. But also ultimately would be good for business because as the population becomes more health conscious, more people will join health clubs. When I talk about being an advocate, what I mean is as a parent working with your local PTA to get snack foods and soft drinks out of schools. You can write to companies like Disney and Nickelodeon and ask them to not use their characters to promote unhealthy foods.

Ci: Taking that one step further to the industry as a whole, is it possible for health clubs to promote these goals?

Can the industry speak as one voice? Yeah, it can. Taking part in any national effort to improve diet or physical activity would be helpful. There is an interesting program called America on the Move. It was started by a guy in Colorado, named Jim Hill at the University of Colorado Medical Center. What the program involves is people get a pedometer, and they can go to the Web and get information on walking programs and they can set goals. The idea is to get people out there walking. It worked well in Colorado. That might be the kind of thing that the club industry can endorse or learn more about or be in support of. Initially, somebody might think that might hurt the industry because people are going to walk around the block rather than come in and work out at the health club. But my guess is that this is probably not true. Instead, this will help people get into better condition than they were and they will think of joining a health club.

Ci: It seems that when people start working out, they feel healthier and tend to make wiser food choices. I think that will help influence what corporations are doing.

You can get a positive spin going as you said. As people do a little exercise, it tends to improve their diet, then they can exercise more and then they get things moving in a positive direction.