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Addressing Eating Disorders with Clients

All eating disorders involve food, but they are really addictive behaviors that help people cope with stress and low self-esteem. You can encourage your clients with eating disorders to get professional help.

"She told me she had been trying to lose weight for years, and that her dieting efforts had come to dominate her life," you tell your coworker. "She writes down everything she eats, figures out how many calories she has consumed and then tries to expend that many calories with exercise. She says all she thinks about is food: what to eat next or how to avoid overeating. And she weighs herself at least five times a day. I think she might be depressed. She said she doesn't have energy for anything except exercise. She just dropped out of school - she was taking classes at the community college. She asked me what she should do, but I wasn't sure what to say."

Most personal trainers are familiar with disordered eating behaviors. Most are variations on the themes of restricting, binging and purging. Eating disorders often begin as very-low-calorie diets as the client attempts to lose weight. Successful losers may gain pride in their conquest over their hunger and appetite, and feel a powerful sense of control over their lives. Anorexia nervosa may develop as controlling food and weight become the primary focus of a client's life. Clients with binge eating disorders consume large quantities of food when the hunger and cravings that arise with food restriction drive them to overeat. Binge eaters may also overeat in attempts to reduce feelings of anxiety and stress. People with bulimia follow binge eating with attempts to purge themselves of the extra calories.

How to help

All eating disorders involve food, but they are really addictive behaviors that help people cope with stress and low self-esteem. Clients with these complex psychological disorders require long-term support from knowledgeable, experienced professionals. You can encourage your clients with eating disorders to get professional help, but you can't just "talk some sense into them."

Model healthy behaviors. Education is not always helpful. Ironically, talking to your clients about eating disorders can make things worse. Instead, model healthy attitudes: Food is delicious and nutritious; food is fuel, and healthful eating supports exercise and sports performance. Model a balanced attitude about weight, as well. Healthy, strong bodies allow us to enjoy workouts and participate in challenging and rewarding activities. Focus on performance, not weight.

Pay attention. Don't ignore eating disorders. They have the highest mortality rate of any psychological illness. Your feedback may help get your client into treatment.

Take a team approach. Work with other trainers and managers on this issue. Your fitness center should have guidelines and procedures in place for referrals for eating disorders.

Respect clients' privacy. Speak to your client in private. Express your concern, and cite specific, objective, observable behaviors that worry you. Encourage the client to meet with a counselor. Be ready with names and contact information. If your client is a minor, speak to their parents, as well.

Keep your distance. Don't counsel your clients about eating disorders. Offer sympathy and a referral. Avoid discussions about food and weight. Your client needs help "changing the channel"; don't get drawn into the obsession.

Be patient. Eating disorders are difficult to overcome, and recovery may take a long time. Be tolerant, respectful and supportive. Your client is going through a very difficult time.

More information

For more information on how to help a client with eating disorders, consult the references below. Keep in mind, however, that referring someone with an eating disorder to websites can do more harm than good, as they may use the sites to "improve" their abilities to control food and weight. Chat rooms can create opportunities to talk with other disturbed people and reinforce obsessive thoughts and behaviors.
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