We must admit that we are a body-obsessed nation, always working towards that perfect body or at least are thinking about it. But how do you know when your client isn’t like everyone else and is possibly suffering from an eating disordered or disordered eating? As a fitness professional it is your responsibility to identify red flags that could indicate a problem. The two most commonly known eating disorders are Anorexia Nervosa and Bulimia Nervosa, but disordered eating may fall into many categories in between.
ANOREXIA NERVOSA
Someone suffering from Anorexia Nervosa will have an obsession with thinness. Even if their weight is below normal (below 85% of normal weight standards), she is still determined to lose more. She will have an irrational fear of fat and weight gain. Her body image and body perception will be distorted. A woman with anorexia will suffer from Amenorrhea - the absence of at least three menstrual cycles (not from pregnancy).
An anorexic might just restrict caloric intake and increase caloric expenditure (through exercise), or they may also use diuretics, laxatives and diet aids to aid their weight loss.
It’s difficult to recognize anorexia by looks alone as it is not unusual in Western society to be extremely thin. Someone who suffers from anorexia might complain of headaches, tiredness and anxiety. As a fitness professional, your client may not share these symptoms with you, as there is much shame with their illness. You might notice that they try to disguise their weight loss with oversized clothes or that they have very low blood pressure due to a dehydrated state. They may be seen exercising to extremes and exhibiting strange eating patterns in front of others.
BULIMIA NERVOSA
Bulimics find themselves in never ending cycles of binge eating followed by purging. They feel out of control while eating and will purge the meal using any combination of vomiting, laxatives, diet pills, exercise or diuretics. People with bulimia find self worth in being thin and are extremely concerned with body weight. Their weight may be normal but their eating behaviors and thoughts are most definitely not. A person with bulimia may suffer from headaches, fatigue and depression. A classical sign of bulimia nervosa is the presence of bruises or calluses on the thumb or hand, which comes from self induced vomiting. Erosion of dental enamel on the surfaces of the teeth, as a result of damage by recurrent vomiting, is also characteristic in bulimia nervosa. As a fitness professional, it may be even more difficult to recognize if your client has bulimia as their weight may be normal and they may eat normally in front of you.
DISORDERED EATING
If normal eating meant what was the statistical norm, than normal eating may be a state of constant dieting. In fact, normal eating is more realistically defined as eating for fuel and for pleasure and not spending an abundance of time thinking about food. Eating at regular times, three meals a day and possibly a few snacks in-between to satisfy hunger is characteristic of normal eating. Normal eating comes from following the body’s signals of hunger and fullness. We should be eating for health and energy. Eating should be a pleasurable experience and not tied up with a hurricane of emotions. Someone with normal eating patterns will only think about food and weight a small part of the day, maybe 10-15%. A person with disordered eating will find much of their day consumed with thoughts of food, calories, fat and thinness. Someone with disordered eating will usually eat more or less than the body wants or needs. Instead of feeling fueled by food, they feel worse. A person with disordered eating obsesses about diets, what they can eat, what they can’t eat. You know you’ve crossed over the line from normal to disordered eating when food in itself becomes stressful. You may find that you’re always on a new diet, counting calories or weighing fat grams. If we can identify the initial signs of disordered eating than we may be able to stop it from getting to the next step.
When you think your client may suffer from disordered eating or an eating disorder…
- Know your limits as a professional. First, remember that you are not a psychologist. You can help someone with exercise but you should not be counseling them through an eating disorder. If you work in a health club, I recommend you speak to your manager first. Many clubs have standard procedures about how these situations are to be handled.
- Build rapport and trust. Your client is not likely to easily admit they have an eating disorder. They must first believe that you care and that you are there to help. They don’t want to be criticized or judged.
- Walk the talk. Your job as a fitness professional is to present healthy images of exercise and eating. You should promote the fun aspects of exercise and should not focus on number of calories burned or weight on the scale. Help your clients with body image by focusing on looking at the whole and not at the parts.
- Be appropriate. If you are going to talk to your client about your concern, do so in a private relaxed manner. Suggest that you are concerned about their behavior or something they said. Do not accuse them of having a disorder.
- Suggest Professional Help. I always suggest that you have a nutritionist AND a psychologist whom you like to work with. Eating disorders are best dealt with by a comprehensive professional approach. Even if you can get your client to START seeing a nutritionist or therapist, he/she may help your client on to the next level.
Your client doesn’t need to fall into one of the above descriptions to need professional help. There are a whole range of eating disorders that fall in between. Anyone who is plagued daily with stress about food or their body image should take it seriously before it is too late. By creating a positive environment to experience health and fitness, YOU may be the key to preventing eating disorders as well as helping them.