Every year, headlines are made when Men's Fitness magazine publishes its list of Fittest and Fattest Cities. The list is compiled by the staff that takes into account different factors ranging from number of homes with televisions to air quality to amount of open or green space. Of course, also included on the list of equally weighted factors was the amount of overweight and sedentary people, the amount of available junk food and the number of fitness facilities.

This year, the Club Industry editorial staff decided to find out what local clubs in some of the fattest cities thought about the rankings and what they may be doing to help change the status — granted they may not have much control over air quality, commute or the climate, but they can do their part to get people active and moving.

To do this, we scientifically put the cities from the Top 25 list in a hat and randomly drew them out; then we hit the road and visited some clubs to get the real story on the fitness scene in some of America's fattest cities.

Detroit No. 1

Being named the fattest city in America is one “honor” any city would prefer to live without, but it's an “honor” that Men's Fitness magazine has bestowed on Detroit, which came in third on the list last year.

To improve its citizens' health (and possibly reverse its climb on the list), Detroit Mayor Kwame Kilpatrick unveiled a program called Movement for Life, a yearlong initiative with four areas of focus — preventive health care, physical activity, nutrition and sleep. The program will bring together many health and fitness initiatives under one umbrella, says Tyliha Stewart, project manager at the City of Detroit.

The Detroit mayor spearheaded and participated in a walk in April to make people aware of the need to exercise. He and his wife are on an exercise program, too.

However, the city isn't partnering with any health clubs on the initiative, which may not be surprising considering there are so few health clubs within the city's limits. The city is even doing without a YMCA since the old one was torn down to make room for a ballpark. A new Y will open in 2005. Most of the health club facilities in the downtown area are corporate facilities for downtown workers (most of whom actually live in the suburbs). It's no wonder Detroit found itself sitting on top of an unenviable list.

Bill Soens, general manager at Fitness Works in downtown Detroit, isn't sure if Detroit's status as fattest city is deserved, although he acknowledges that the city does have a large population of overweight people.

“A lot of it is the socioeconomic situation in Detroit,” says Soens. “A lot of it is lack of education, which can lead back to socioeconomic.”

Lack of funding has caused budget cuts at the city's two activity centers for adults and children. Detroit's lack of quality grocery stores with availability of fresh fruits and vegetables contributes to the problem, he says. In fact, one of the dietitians from the health care facility visited schools to talk about nutrition and found that some of the children had never seen some of the vegetables she brought with her — not even commonplace vegetables such as broccoli.

“We're typical of most cities where you have a population within the city that are elderly, fixed income, unemployed who don't have the access or aren't motivated to get up and start moving,” says Soens. “Most corporations, such as GM, have a suburban workforce — they leave, go home, have more access to different facilities outside Detroit. That's a problem. All of those things combined have led to where we are.”

But even in the suburbs getting out and exercising can be an effort. The city is not conducive to walking, says Julie Levinson, a yoga instructor at Franklin Athletic Club in Southfield, MI, a suburb of Detroit. Harsh winters exacerbate the problem.

“In the winter months, people work hard, it's dark and they want to go home and put on their bathrobes and be done for the day,” says Levinson.

Still the two health clubs are doing what they can to educate the deconditioned about exercise. The 42,000-square-foot Fitness Works is situated in a 70,000-square-foot building owned by Henry Ford Health Services. When opened in 1996, the fitness center, which is managed by TCA, was for Henry Ford Health Services employees who worked in the doctors' offices and clinical parts of the building. Today, 35 percent of the 3,000 members still are employees of the health care provider, but now the facility is also open to employees of about 300 companies in the downtown area.

Soens is working with Henry Ford on a weight management task force that the company is developing for its employees, 65 percent of which the company estimates are overweight to obese.

“As a whole, the health system is a very fat business,” says Soens. “Although they are working with people who are sick and they see these diseases, they don't practice the same things they preach.”

Fitness Works is also working with Henry Ford's nutrition program, an extension of the healthcare provider's cardio rehabilitation program. The fitness center will try to pull those participants into the club for the activity portion of the program. The club previously had a weight management program of its own that involved nutrition and fitness education and exercise, including a half hour a week with a personal trainer. However, the cost was a little steep for many members so the club is reworking the program in hopes of revitalizing it soon, says Soens.

Franklin Athletic Club also offers a nutrition program. The club emphasizes the importance of exercise and healthy eating habits, especially since the climb in obesity rates partially stems from a busy society where both parents work more than 40 hours a week and need quick meals for their families, says Lana Phelps-Coxton, who is a nutritional counselor at the club. Phelps-Coxton also leads a six-week circuit-training program that involves nutrition education.

Efforts to reach out to the deconditioned include involving doctors and nurses, according to Soens. Fitness Works is working on initiatives with the doctors and nurses in the Henry Ford system to teach them about exercise.

“Most of them are schooled to treat illnesses and that's the way they think,” says Soens. “To get them to think above and beyond that is kind of hard. But, especially the younger doctors and nurses, they really embrace what we are trying to do.”

The club has given doctors at the facility a mock prescription pad on which they can prescribe exercise to patients. And Fitness Works hopes those prescriptions will lead the patients to the fitness center.

“We've seen a fair amount of people come in here because a physician says you have to do something,” says Soens. Often, it takes the urging of a doctor to get someone through the door of a gym for the first time — or another life event such as a heart attack, a class reunion, or a wedding, he says.

Not only is it difficult to get people to consider joining a gym, but once they decide to do so, competition for members can be fierce, particularly in the suburbs. Franklin Athletic Club is a multipurpose, family-oriented club that's been around since 1969 and now has 5,000 memberships. The club offers a full-service restaurant that serves lunch and dinner, 13 tennis courts, a Pilates studio, seven racquetball courts, a North American double squash court, steam room, sauna, whirlpool, showers and outdoor pool.

The club targets the family market — median age of 43-44 with kids, says Kelley Verbeerst, director of sales and marketing for Franklin Athletic Club. To reach the family market, the club offers everything from aqua aerobics classes for seniors to summer camps and yoga classes for children. The summer camps are one way to attract nonmembers and a way to expose children to exercise early.

Despite everything Franklin Athletic Club has to offer, Verbeerst acknowledges that many overweight and obese people find it intimidating to walk into any health club for the first time. That's why once they've taken that first step and joined, making them feel welcome is key to retaining them, says Verbeerst, which is why the club offers a thorough orientation, encouragement to talk to a personal trainer and a follow-up call in the first week.

“If they feel comfortable within the first three months of membership, you can check back in five years and they will still be members,” says Verbeerst.

Perhaps through efforts such as these — and more intense efforts in the future — health clubs in Detroit will be able to persuade residents to trade in the comfort of a warm house on long winter nights for the warmth of a health club where they feel welcome.

Houston No. 2

After spending a couple of years atop the Fattest City list, Houston has shaped up and gotten lean. Ok, it is just the start as the city slimmed down to the No. 2 spot on the list — now trailing only Detroit — but with Houstonians eating out more than residents of any other city and indulging in one of the more than 11,000 restaurants ranging from award-winning and upscale to deli shops, that drop is no small feat.

Combine that with an intricate highway system, little in the way of sidewalks and maybe even less green space, the slim-down is all the more impressive, even with the 181 health clubs and gyms that show up in a Superpages.com search of the city.

Part of the city's move toward getting lean is attributed to the Get Lean Houston initiative. Put in place last year by Mayor Lee Brown and headed by the city's fitness czar, Lee Labrada, Get Lean Houston was a multifaceted campaign to take care of some of the problems that helped land Houston the fat cat position on the annual list.

“We launched the Get Lean Houston program in June of 2002 as an 18-month program. Mayor Lee Brown and myself launched it partly as a response to Houston's place on the top of the “Fattest Cities” list in Men's Fitness,” Labrada tells Club Industry during a visit at his nutrition company headquarters. “But it was also a way to address the issue of obesity in the city of Houston. We wanted to do what we could here on the local level to raise awareness and educate people on how to get into shape.”

Among the many components of the campaign was a grassroots and all-out media blitz to increase the awareness of the need to exercise and eat properly, according to Labrada.

“I have always contended that obesity is not one city's problem but it is America's problem. We wanted to do what we could here on the local level to raise awareness and educate people on how to get into shape,” Labrada says. “We even worked with McDonald's and the Houston Restaurant Owners Association, where several restaurants included lower-calorie and lower-fat items on their menus.”

Additionally, Labrada says local health clubs were instrumental in helping move the program along.

“Health clubs did get involved as well, such as the Houstonian whose president sits on our advisory board. We have a 17-member fitness council consisting of nutritionists, dietitians and medical doctors,” Labrada explains. “24 Hour Fitness was active with a program called the Great Houston Melt-down. A lot of mom-and-pops jumped in as well. I think everyone took that title as the fattest city pretty seriously.”

While the Get Lean Houston program received a lot of publicity for the city's shape-up, Vicki Williams, assistant general manager for Houston's Memorial Athletic Club and Aquatic Center (MAC) believes the city's ranking had just as big of an impact.

“When we were rated the fattest city the first time there was very little notice,” she says. “But the second time Houston ranked first, there was a lot of media attention. We saw a spike after that and I think that helped drive a lot of people into the club. More so than some of the other efforts.”

Another thing that Williams says is luring more people into the clubs — the MAC's two clubs claim about 4,800 members — are the educational efforts put forth — especially to the aging population.

“We also do lots of seminars and outreach stuff to get to the people of Houston that may not be coming to a club. We try to band together with a lot of clubs around here and work together and help each other get the fitness message out to the city,” she says. “We find that the more educated people are the better they understand how to get to the next step. That is the real way to keep members involved in the club — give them the education to reach their goals.'

But Williams feels that despite the best effort of the clubs, the city rankings are hurt due to some of the other criteria.

“There are so many health clubs around here. I think a lot of why we rank so poorly is because we have no sidewalks and not a lot of green space. We really just get in our cars and drive everywhere,” Williams laments. “There are plenty of health clubs for people to join to get fit, we just need to keep getting them in.”

In addition to getting them in — which is no easy task anywhere, but especially in a city that ranks second on a magazine's Fattest City list — is keeping them once they are in.

“We are in a great business. We provide a product that really helps people. I want people to use the club every day. I want them to feel great, look great and rave about it to their friends,” says Greg Nielson of the Houstonian. “People join clubs to get a result — whatever it may be. Those results only come about from using the club over and over again, and spend time while they are here.”

Nestled on an 18-acre wooded campus that includes the Houstonian Hotel, Neilson admits that the Houstonian has an advantage over other clubs when it comes to providing what he calls the wow factor to perspective and current members — even though the opulent Houstonian draws from a smaller segment of the community. But, he feels that if other clubs would pay attention to the members, Houston and the nation may see gaudier membership numbers and dropping levels of obesity.

“We are a niche club because of our pricing structure and the way we are set up. We are drawing from a smaller section of the pie, which is why it is important for us to be very tight with our service. We aren't drawing from the mass market. Like a Mercedes Benz customer our members expect a special experience,” he says. “There is a whole spectrum of things that aren't costly that can make a difference. The way the staff handles members is key — we have staff that will go change a tire if needed. You need to do a real good, hard check on character when someone comes in. You have pockets of inspiration and pockets of desperation — the goal is to reduce those pockets of desperation for your members and your staff can go a long way toward that end.”

He feels this is important whether your club is ornate or not.

“It is all about people. You don't always remember things but you remember people that you interact with. The things from design to equipment are all just enhancers; it's the people that make the impression,” he says. “When we walk into a place we have all kinds of questions firing through our subconscious from do they like me? Are they friendly? Is it comfortable? And if the answer to too many of them is no, then you're going to lose that person.”

While not every aspect of Houston's ranking can be affected by the Get Lean Houston program or clubs working individually or together, to educate, acquire and retain members, the city is on the right track and may be able to set an example — along with Philadelphia — on how to move down the list.

“Clubs in general across the country could potentially be in a leadership position if they approach this thing from the bigger picture,” says Labrada. “Those clubs that are running to truly help people and not just sell memberships and doing the membership mill are going to be the winners in this. [Clubs] are in the position to take a leadership role and provide people the education and the means to fight this obesity problem we are facing.”

New Orleans No. 22

For a city known best for Fat Tuesday, Po-boys and Hurricanes on Bourbon Street, the fact that New Orleans ranks at No. 22 on Men's Fitness' Fattest City list is impressive. The fact that it is 11 spots better than last year is down right amazing.

Much of the credit for the improvement goes to air quality and access to health care, according to the magazine. But, although health club and exercise/sports participation are ranked dismally by the magazine (D- and F, respectively), there is hope that these aspects will pick up speed in the Big Easy. (After all, the magazine did say that the city has the highest participation in high-impact aerobics, although four out of 10 people didn't exercise in the past month.)

“I think New Orleans residents are getting a little more aware of the need for fitness and improving the quality of their health,” says Tony Rodriguez, general manager of the St. Charles Avenue Athletic Club. “New Orleans and the state of Louisiana are always 10 years behind the country's trends and when it comes to fitness we are probably 20 years behind.”

Perhaps that explains the high rate of high-impact aerobic participants?

But Rodriguez and the St. Charles' new owner — who purchased the club after losing 100 pounds under Rodriguez' tutelage — realize there is a long way to go to get their club and all of the city up to speed.

“We have traveled around the country to see what is working out there and bring it to New Orleans and improve on what we have here, not just continue copying what hasn't really worked in the past,” Rodriguez says. “We already know what the guy down the street is doing so it is a question of what can we do differently and better than they are.”

The hope is to bring more of the metropolitan area's 1.4 million residents (484,674 within the city limits) into the clubs on a regular basis. And Rodriguez is starting to see a positive trend in this once hardcore bodybuilding gym in the city's Garden District and plays host to about 800 members.

“On the East and West Coasts you see people in the gym on the weekends. Here the gyms are empty as members are nursing hangovers and still out partying,” says Rodriguez. “We have extended the hours and people are starting to come in more often than our usual crowds. Now we just have to keep it up and spread the word.”

Just outside the city — about a 40-minute drive north — in Slidell, LA, Crossgates Athletic Club has managed to pull in about 12,000 members between its two clubs in town.

Crossgates owner, Larry Welch, believes that the New Orleans area is not alone in having to improve the health of its community and attract more people into clubs.

“There are plenty of non-conditioned prospects in every city. We have plenty of prospects out there,” says Welch. “It is just how good each of us do our job of attracting them. We have a gym full of regular people made up of people from all health, age and economic levels — we even have a scholarship program for people who can't afford a private club. We try to reach the whole spectrum.”

Unlike Houston and others, New Orleans area clubs are left to combat the obesity problems alone, often while competing against the emotional lure of the city's eat, drink and be merry message.

To help combat this, Crossgates has made its pitch an emotional one as well.

“We are hitting people when they come by selling them on emotions. That is what is being sold, not equipment. Ten pounds of weights is 10 pounds in every club, so we need to sell what is different about us,” says Dion Grossnickle, general manager of the 22-year-old club. “The people that run this industry are healthy and we take that for granted, but there are a lot of people out there that can't do some of those simple things. We had a member who had been there for about two months and told us how thankful he was that he could do his grocery shopping without using one of the carts and actually walk the whole store — that is what we are selling.”

But getting them in is only half the battle for clubs around the county not just in the New Orleans area; keeping them is another thing.

“We have kept our attrition at 30 percent, which includes all cancelled memberships; it would be in the low 20s if we eliminated people that have moved, etc.,” says Grossnickle. “In other industries the attrition rates that health clubs have would be horrible and unacceptable. Imagine if restaurants lost 100 diners for every 100 they added because the food was bad.”

To help keep attrition rates as low as possible Crossgates uses a multipronged approach to keep the members active and motivated, with staff being the lynchpin.

“We have completely focused our departments on keeping our members happy and keeping them coming back,” says Stephanie Howell program director.

Additionally, the club has focused its energy on attracting families that are moving to the suburbs from New Orleans.

“We have people transferring out of New Orleans to the suburbs so we have to appeal to families and get them to either keep up their workouts or start,” says Grossnickle. “If moms and dads can bring their kids to the club for activities like Tae Kwon Do it allows us to not only keep their parents involved, it builds the next generation of members.”

And maybe help that next generation move New Orleans further down the Men's Fitness Fattest City list.

Cleveland No. 9

Cleveland, home of the Rock and Roll Hall of Fame, has become famous for something less fashionable — being fat. Dropping from sixth to ninth on the Fattest Cities list, the city has efforts in place to mitigate the “weighty” problem.

The Kaiser Foundation gave the city a grant to do workplace wellness for its 6,000 plus city employees, all of whom must live within the city limits, says Wendy Johnson, medical director of the Health Department in Cleveland.

The city is also partnering with two initiatives: Active Living by Design and Clevelanders in Motion. Active Living was developed by one neighborhood with the goal of making the urban environment as conducive as possible for physical activity. Clevelanders in Motion involves a 120-person think tank that draws broadly from the community but doesn't have any health club representatives on board. However, Barb Clint, head of the group, hopes to approach some Curves about participating since the club has moved into two neighborhoods in the program's targeted areas. In the urban population where there are serious obesity issues in play, the Curves clubs have struck a chord with women while men seem to be drawn to the city recreation centers that offer organized sports leagues, she says.

Clevelanders in Motion will perform assessments at participating recreation centers, YMCAs and health clubs to show individuals their baseline and how much they can improve if they do a certain amount of exercise and eat right.

Despite these city efforts, many health clubs in Cleveland aren't involved with the efforts. However, Doug Cohen, general manager at Tower City Fitness — a corporate facility in an office park downtown — made the most of the city's ranking last year by printing VIP cards that pointed out the ranking and suggested that Tower City Fitness was the card holder's solution to this problem. While some people were insulted when he handed the cards to them, others took it in stride.

Cohen says that Cleveland does have a weight problem.

“When you look around, it's noticeable,” says Cohen, pointing through a glass wall to the lunchroom of a business across the hall. “They always have cake day, brownie day. They are always eating over there. When you see their people in the halls, you can tell. That's the same with a lot of the corporations.”

He says that companies need to be more proactive in making getting in shape a part of the corporate culture.

“In the long run, it decreases their health care costs, but all they see is the upfront costs and it's almost pushed aside,” Cohen says. Companies that approach Tower City Fitness for a wellness program often don't budget enough or any money for the wellness programs making it difficult for them to succeed.

Brad Calabrese, GM at HFC Athletic Club in downtown Cleveland, agrees.

“If every employee in America has something available to them, then this obesity epidemic has nowhere to go but down,” says Calabrese, whose 45,000-square-foot, 900-member club is also a corporate facility.

“It's just getting out there — doing outreach, maybe going to the home level or even going to an empty meeting room and doing a quick session with therabands,” says Calabrese. “You aren't going to turn average Joe into Hercules by tomorrow, but you can at least take baby steps and say if you apply these to your everyday life, then you are going to take care of this epidemic.”

However, fear grips many of the deconditioned. To calm their fears, clubs are doing more hand holding, says Calabrese. The HFC fitness specialists work with new members to familiarize them with the club and to establish a relationship.

Calabrese says the majority of new members at HFC are average to moderately overweight. Cohen estimates that 60 percent to 70 percent of those who come into Tower City Fitness are at least 20 pounds overweight. When he spends time on the floor, he specifically looks to help the overweight members.

“Being overweight and losing weight is 99 percent mental and the rest is coming in and working out,” says Cohen. “So we try to make those people feel as comfortable as possible and make sure they stick with their programs.”

Visuals and prizes seem to help keep some people motivated. Tower City Fitness displays a board of before and after pictures to motivate members. Fitworks Fitness and Sport, another corporate facility in downtown Cleveland, does the same. However, Fitworks also rewards its 1,600 members for working out. The more a member uses the gym, the more points that member accumulates. The points can be turned in for different prize levels ranging from a t-shirt to a Sony CD player. The club picks a daily winner from someone who used the club the day before. The winner is listed on the board and receives a prize. Every winner is then entered into a drawing for a cruise.

“We let them know that their health is not a matter of chance; it's a matter of choice,” says Chas Comparato, general manager at the 18,000-square-foot Fitworks. “The main thing we get across is that Fitworks is dedicated to helping members achieve their desired results and with the right support, education and motivation, everyone can live a healthier and more fulfilling life.”

New members get two free sessions with Body of Change, the company that provides the personal training for Fitworks members. It's up to each individual to decide whether to continue at a fee. During the first session, members receive a fitness evaluation to determine their baseline. Then, the personal trainer talks to them about the different aspects of a total fitness program — cardio, nutrition, weight training and resistance — and how those work together.

Results from workshops and fitness days have been spotty. Tower City Fitness has hosted fitness days for some of the businesses in the building in which it is situated, but so far, attendance has been lacking. Fitworks tried a nutrition workshop in March and drew about six people.

“You do what you grew up doing and were taught,” Drew Koler, manager of Body of Change at Fitworks, says about diet and exercise. Most health club members were involved in athletics in junior high and high school, but there is a large segment of the population that has never been introduced to that or never got excited about doing it. The sooner children are involved with exercise, the more likely they will stick with it, he says.

“If they don't find out about it (exercise) until later in life or until there's already a problem and they're already obese, that's a lot harder issue to deal with,” says Koler. After all, as the saying goes, the boy is the father of the man, and the girl is the mother of the woman.

Considering Cleveland's ranking and city budget cuts to physical education classes, that may not speak too well of the future here in the city with an affection for the past.