Hey all ... I have a new client starting next week who is very morbidly obese. She is looking to lose some weight before bariatric surgery (stomach stapling I think) or possibly delay/avoid surgery. Although I have trained very overweight persons, I have not had anyone who was this far "gone". She gets VERY short of breath with minimal activity, and I'm just not sure where to start her. If I were in the PT clinic I know what I'd do, but since she is paying me out of pocket, it seems silly and I want her to feel that she is getting her money's worth.

Any tips on where to start?
Thanks in advance for your help! I'd love to help her learn a healthy lifestyle and avoid the surgery ...

Julie