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Rose is a 26-year-old female and is currently not showing any signs or symptoms of any medical illnesses. However, Rose is overweight, has a family history of Type 2 diabetes, and has not seen a practitioner for ten years. It is for these reasons, that I feel it would be in the best interest for Rose to undergo clinical exercise testing before she began her exercise training program. If Rose were to start a training program at this point in time with the lack of professional knowledge in her current health status it could greatly increase Roses risks for potential injury.  
Role and duties:
Good afternoon Rose, it is so nice to meet you. I would like to take this time now to explain to you what to expect here under my care. As a non-physician It is my role to administer to you clinical exercise testing while monitoring your performance, this will take place under the supervision of a physician so there will be another person in the room with us at all times.  I am professionally trained and certified in exercise testing, I have experience and knowledge in exercise physiology and know how to properly operate each testing equipment to the best of my abilities. I will select a few different tests that I feel are best for you to perform that will give me the necessary information I need to help understand where you are currently at in your current health. Please know that these tests are strictly informative and you should not feel pressured to push yourself beyond your limits.  These tests are all individualized and will be based on your weight, height, age , sex, history of illness, and current fitness level.
Risks:
We will now go over the risks associated with the clinical testing. Rose, although you are young and not currently in any pain or have any known medical problems there are always risks associated with exercise such as irregular heartbeat, heart attack, stroke, or even death. (American College of Sports Medicine, 2013). Although the likeliness of these incidences occurring are slim, we will be taking great caution while evaluating you during and between your testing periods. If at any time during your testing you feel dizzy, fatigued, light headed, chest pain, muscle cramping, abnormal blood pressure, or shortness of breath you need to inform us immediately as these are also possibilities during the testing period.
Exercise recommendation:  
(Assuming Roses testing results were normal and there were no immediate risks)
Rose, based on your current health status and the fact that you have never participated in physical exercise I am recommending that you start out at a low intensity low impact exercise program for the first two weeks of your fitness plan.  I admire your desire to participate in five days of exercise a week, I understand that you would like to also participate in group fitness classes at your gym.  It is important for you to utilize both aerobics and anaerobic exercises in your training plan. The group classes are a great form of aerobics training (depending on the class), I’d like you to start out with classes that do not utilize weights or any equipment other than a mat or sticks (pound class) to minimize improper form and injury. Please know your modifications in these classes, as when you first start out you will need to listen to your body and take it slow. It is also important to participate in anaerobic training and utilize weights to support healthy muscle growth. Due to your lack of knowledge on weight training, it would be in your best interest to only utilize machines as “machines will stabilize the weights for you.” (Frederick C. Hatfield, 2015).  
Utilizing the above information, I feel it would be best to partake in three days of cardio exercise of either classes or using a treadmill to do intervals of a slow speed for five minutes and a moderate speed for three minutes, utilize these intervals for an hour. For the other two days, you should focus on strength training and utilize machines to stress the upper, lower, and core body. It would be beneficial for you to work with your trainer Jake as he can configure you a workout and guide you through them to ensure you are preforming them properly.
Dietary changes:
Two diary changes you could make to your diet that are relatively easy Rose, that will promote healthy weight loss would be to drink plenty of water, and reduce your carb intake. By making sure you are taking in plenty of water it will promote healthy digestion as well as healthy weight loss. You can begin by drinking a glass of water fifteen minutes before and after each meal as well as in between each meal. Reducing your carbohydrate intake will reduce the insulin in your body and your kidneys will begin to shed excess water, your body at this time will begin to pull form fat storage to provide more energy and result in weight loss. (Frederick C. Hatfield, 2015). You can do this by making healthier choices: cutting out chips, cakes, and cookies, using brown rice instead of white, and cutting back on breads.  
References:
Frederick C. Hatfield. (2015). Fitness: The Complete Guide. Carpentaria, CA: International Sports Science Association.
American College of Sports Medicine. (2014). ACSM’s guidelines for exercise testing and prescription (9th ed.). Baltimore, MD: Lippincott Williams & Wilkins

 

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