According to the U.S. Department of Health and Human Services, the average U.S. woman is 5’ 3.7” tall and weighs 152 pounds. The average U.S. male stands 5’ 9.1” tall and weighs 180 pounds. However, with the increasing popularity of super-sizing everything so too does weight. While weight gain is a delicate issue it has to be addressed so that the much larger client does not feel embarrassed by having too small of a robe given to her or be forced to wear what is obviously a man’s robe. One client was quite distressed when she overheard a therapist comment his dismay that he was going to have to work on the cow in the lobby and realized that she was who he was talking about. She quickly informed the attendant that she wasn’t feeling well and left and never returned…. to any SPA. Is this the type of experience that we want ANYONE to receive in our establishments? For those who are horizontally gifted many will not complain about such service and will just seek the safety and shelter of the comforts of their own home. While this in itself creates self-doubt and continues the cycle of the battle of the bulge for them. This is not the environment that a spa should foster nor should cruel remarks be tolerated from staff towards guest or other employees. In fact, there should be a written policy about such misconduct.
Dr. J. Michael McGinnis, senior vice president of The Robert Wood Johnson Foundation’s health group, said the current weight statistics foreshadow future problems. “Obesity now will lead to increased deaths from diabetes, heart disease, stroke, and certain types of cancer, and increased prevalence of osteoarthritis years down the line,” he said. Cardiovascular disease, cancer, and injuries -- the kinds of things listed on autopsy reports -- are usually cited as the leading causes of death.
While tobacco use has declined and alcohol consumption has stayed about the same over the years, diet and exercise behaviors are getting worse. McGinnis said we’re bigger because of problems on both sides of the simple equation of weight maintenance: calorie intake equals calorie output. Many spas offer detox programs, nutrition counseling and personal training, and a savvy therapist may want to inquire if the guest is familiar with all the programs and treatments that are offered at the spa. Or the guest themselves may ask questions so it is important that the therapist be aware of the other departments and what they have to offer for a more comprehensive package. Being given the right opportunity with a well thought out answer can make an enormous difference in the clients future but remember tact is imperative. Don’t berate, belittle, or judge the guest’s health issues no matter what they are.

The purpose of the National Association to Advance Fat Awareness mission is to:
• Work towards providing equal opportunity for large people wherever obstacles and/or discrimination exist.
• Disseminate information about the sociological, psychological, legal, medical, and physiological aspects of being overweight.
• Advocate and sponsor responsible research about the various aspects of being large.
• Empower the large number of people regarded by the medical profession as "obese" to accept themselves, to live more fulfilling lives, and to promote acceptance of heavy people within society.
• Serve as a forum where issues affecting large people can be discussed in an unbiased setting

The NAAFA also has a brochure which outlines the Guidelines for therapist who treat obese clients. This brochure goes over the assumptions based on myth rather than fact, which many members of our society believe to be true about fat people. These myths affect how therapists view and work with overweight people. It is important for therapists of these clients to recognize and clear out misinformation and bias in order for them to be most supportive and effective with their clients.

The Ideal SPAce according to the National Association to Advance Fat Awareness for a large client includes:
• Handicapped accessibility
• Several sturdy armless chairs in your waiting area.
There should be six to eight inches of space between chairs.
• Sofas should be firm and high enough to ensure a client can easily rise.
• Few or no stairs
• Wide doors
• Large restrooms
• Sturdy, armless chairs or couches
• Adequate air conditioning

A spa should take inventory on their size of towels, robes, and slippers to ensure that they are able to accommodate all sizes. Blankets and sturdiness of treatment tables are also important. You also want to make sure you have enough product in the treatment room so you will not run out and be embarrassed.
Lori Nestore, President of Eva’s Esthetics (AKA The Waxing Queen) offers waxing tips for all sizes:
The most important thing we can do is get comfortable ourselves with the situation. So often what holds us back professionally is our own fear and uncertainty. So a large client comes in and wants a Brazilian or any other body part waxed and it is up to us to get the service done in a reasonable amount of time. What to do?

1. Get over tiptoeing around moving their body so you can ‘see’ the area you are working on. Get hold of a leg, move it just like ‘so’, ask them to please put their hand ‘here’ and pull the skin tight and keep pulling until you tell them to let go. If you try to be nice you will end up being vague. Clear, concise directions make the service better for client and professional.
2. Address their comfort plainly, have a step stool if your table does not move up and down to make it easy for them to get on the chair/tables without concern of your table tipping.
3. When they are up on the table ask if they are comfortable, but don’t spend too much time worrying about it. You need, as with all clients, to get down to business and start ripping their hair out! Comfort is all fine and dandy, but get to work.
4. Charge them extra if it takes you extra time. While this may seem harsh to some of you reading this, if it takes longer you must charge more.
Lori’s final advice is to leap in and go to work. Do a great job and charge accordingly, so at the end of any given service, even if you say “whew!” that was hard, you felt as if it was worth your time and effort.
Sharon Krout, Key Account Manager for Oak Works states that although you cannot tell it from trade magazines and advertisements, the average spa client is not a pencil thin super model. To avoid extra costs there are some important things to consider when purchasing a table for your business. Krout emphasizes that there are several key items to review when purchasing treatment tables such as:

Safety:
This is not a place to cut corners for you or your clients. Why open your business up to expensive liability and a ruined reputation? Less expensive tables are usually manufactured in under-developed countries in sub-standard conditions. They are made with low grade materials and have no commitment to safety testing. What kind of warranty does the manufacturer offer and how do they back it up? Who will I call to enforce this warranty?

Client Comfort vs. Treatments Offered:
If your table is not accommodating it will create a poor experience for your guest. A comfortable table enhances the treatment. You must consider the following when making a table selection:

Is it multi-purpose… will it grow with my menu offerings?
Is it strong… does it creak or groan with movement or weight?
Does it have quality padding… does it allow for breast comfort… does it bottom out with extra weight?
Is it the proper width and length…will my clients feel like their bodies are supported?
Is there ease when getting on and off the table… or does your client struggle?

Staff Ergonomics:
When selecting a table you need to consider one of your most valuable assets- your staff. You must consider the clinicians/therapists weight, height, and skill set when making your equipment purchases. The wrong table can wear on their bodies, cause repetitive injuries, shorten their career, and cause staff turnover. Remember, no matter how beautiful your facility, the real key to success is client and staff retention. Your clients bond with your staff… and if they leave, so does the client.
Purchasing the best table option is an investment into the health of your business.
According to the Americans with Disabilities Act (ADA) website more than 50 million Americans have disabilities – 18 percent of our population. This group has $175 billion in discretionary spending power, according to the U.S. Department of Labor. That figure is more than twice the spending power of American teenagers and almost 18 times the spending power of the American "tweens" market. Accessibility attracts not only people with disabilities but also their families and friends. Like others, these customers often visit stores, restaurants, movie theaters, and other businesses accompanied by family or friends. This expands the potential market exponentially! This market is growing fast. By the year 2030, 71.5 million Baby Boomers will be over the age of 65 and demanding products, services, and environments that address their age-related physical changes. The ADA says people with disabilities are entitled to “the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations” that a public accommodation provides to its customers. In other words, every type of good or service a business provides to customers is covered plish goals in your life. With the sudden awareness from Hollywood on such shows as Nip/Tuck or Boston Legal the spa has to be prepared to have amenities for such clients.
Little People of America (LPA) defines dwarfism as a medical or genetic condition that usually results in an adult height of 4'10" or shorter, among both men and women, although in some cases a person with a dwarfing condition may be slightly taller than that.
In some circles, a midget is the term used for a proportionate dwarf. However, the term has fallen into disfavor and is considered offensive by most people of short stature. The term dates back to 1865, the height of the "freak show" era, and was generally applied only to short-stature persons who were displayed for public amusement, which is why it is considered so unacceptable today.
Such terms as dwarf, little person, LP, and person of short stature are all acceptable, but most people would rather be referred to by their name than by a label.
One spa has such a client and when given a robe it just engulfed her and it was quite obvious it didn’t fit her. The quick thinking locker room attendant asked management if she could pull a child’s size robe off the rack from the gift shop to accommodate the guest. The guest was very pleased to have a robe that didn’t drag and that fitted her quite well. It’s not that as spas we don’t want to consider all aspects of clients of all shapes and sizes it is just there are times that we forget the special needs of others. Being prepared for all situations will set your spa apart so you can accommodate clients of all shapes and sizes and word of mouth will spread that your spa is the best spa for everyone to go to!

Denise R. Fuller is a Licensed Aesthetician and Beauty Therapist Consultant, Educator, and Author for the aesthetic industry. Fuller is also the CEO of International Spa Importing Specialists. For more information please contact her at 888-566-4747.