Most PTs will have come across clients who are struggling with anorexia, bulimia, binge eating and various eating disordered behaviours. Some clients may be open with you about it and others may be more secretive. Due to the nature of their work, PTs will often find themselves on the front line when it comes to working with people with eating disorders. For this reason, Sarah Dosanjjh has compiled her top tips for training someone with an eating disorder or who is in recovery.
Set healthy goals
Most PTs choose this job because they get satisfaction from helping people improve their health and reach their fitness goals. For many clients, the desire to change their body composition is motivated at least partly by health but, if your client has an eating disorder, then they may be using their training sessions to get sicker and drive themselves deeper into their disorder. They may not know when enough is enough. Be clear on what you are offering your clients – better health, increased strength and improved energy.
Focus on having fun
Eating disorders sap the fun out of exercise. Worse than that, sufferers are often self-punishing when it comes to working out. They can become very adept at ignoring their body’s signals. Many clients choose to work with you because they want someone to push them beyond their usual limits but, if you know a client has, or is in recovery from, an eating disorder then tread cautiously. You may need to keep bringing their focus back to connecting with their body and finding ways to exercise that feel good. Reassure them that working out should be enjoyable. When you focus on performance, someone with an eating disorder may take this as “you’re not pushing yourself hard enough”. This is a dangerous message for someone who is already highly self-critical.
Watch your language
Consider some of the things you may be regularly saying to your clients; do you ever talk about ‘earning’ food, ‘burning’ calories or ‘blasting’ fat? This kind of talk can be very triggering for someone with an eating disorder. Some of my clients have been accused of being over-sensitive when they have asked people not to say certain things around them. Words can hold enormous emotional power over someone whose relationship with food and their body has deteriorated to the point of developing an eating disorder. If you know your client has (or has had) an eating disorder, then avoid praising weight changes, even if you believe it is a positive thing.
Voice your concerns
When you know words can be triggering, it may feel easier not to talk about it at all but, especially if your client has been open with you about their eating disorder, don’t shy away from asking questions or voicing concerns. When you express your concern, they may not be ready or willing to hear it, but they might. You never know. It’s not your job to be diagnosing anyone with an eating disorder but you may be able to simply say, “I’m concerned that you seem to have a lot of anxiety around food – what do you think?” Or even, “Your body seems to be changing faster than I would normally expect. Is everything OK?”
Suggest additional support
Eating disorders are complex and deadly and your client will need more support than you will be able to offer. PTs have an important role but, for your own sake as well as your client’s, you don’t want to become the only person they can talk to about it. Ask about and encourage them to utilise other support such as therapists, nutritional support, friends and family and, if necessary, doctors and psychiatrists.
It’s not unusual for clients to be more open about their eating disorder with their trainers than they are with doctors and therapists. You build real relationships with your clients and they come to trust you have their best interests at heart. It’s not the job of a PT to treat an eating disorder but your attitude towards helping people build healthy relationships with food and their body can play an important part in someone’s recovery.
If you are concerned that you or anyone you know is struggling with an eating disorder, help and support is available via the National Centre for Eating Disorders: www.eating-disorders.org.uk/
Sarah Dosanjh is a psychotherapist, speaker and author of the book I Can’t Stop Eating. Based in West London, she works with clients on a one-to-one basis, as well as in groups, helping them overcome binge eating and body image issues. To find out more about her work and upcoming events, visit thebingeeatingtherapist.com