Recognising eating disorders in clients and
how you can help
The prospect of talking to clients about eating disorders may be daunting, but recognising the signs and knowing how to broach the subject could be life changing.
As a fitness professional, you’re in a good position to notice if someone is developing an unhealthy relationship with their body, exercise, or food. You might find yourself dealing with clients or colleagues with an eating disorder, and be unsure of what to do.
Understanding the early warning signs of an eating disorder will help. Once you know what to look for, you will have a better idea whether you should talk to someone about your concerns. You aren’t expected to have all the answers: if you’re worried about someone, you can help them get the support they need by connecting them with the right services as early as possible.
Eating disorders, compulsive exercise and negative body image frequently co-occur, so it’s helpful to know what to look for in each of these situations.
What are eating disorders?
Eating disorders are serious mental illnesses that occur when eating, exercise and body weight or shape become an unhealthy preoccupation of someone’s life. They affect approximately 9 per cent of the Australian population, with only one in six sufferers getting treatment. It’s important to understand that an eating disorder is not a lifestyle choice, a diet gone wrong or a cry for attention.
There are four main eating disorders:
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
- other specified feeding and eating disorders.
What classifies as compulsive exercise?
Everyone is different, and what might be a healthy amount of exercise for one person will be an unhealthy amount for someone else. If someone is exercising despite illness or injury, or experiencing anxiety and distress over missed workouts, they may be displaying signs of an unhealthy relationship with exercise. Compulsive exercise is not an eating disorder, however people who are compulsively exercising often experience a range of eating disorder-related symptoms, like unhealthy eating patterns, social withdrawal and body image concerns. Sometimes people engaging in compulsive exercise have poor body image, so language and behaviour suggestive of such a perception is also something to look out for.
Positive and negative body image
Body image refers to the way you see, think and feel about your body. Your body image can be positive, negative, or a bit of both. It can also change over time. If you have a positive body image you accept, respect and celebrate your body. You’re more likely to have a healthy, balanced lifestyle, without spending too much time worrying about the way you look. If you have a negative body image, you might think of yourself as being larger than you really are or you may fixate on a particular body part, seeing it as being very unattractive.
What to look for
As a fitness professional, you have probably been in the situation where you suspect that one of your clients, students or team members may have an eating disorder. Maybe they have lost an excessive amount of weight, perhaps they are taking supplements for weight loss or gain (or even steroids), or they might be attending too many classes or exercising excessively. You can’t always tell if someone has an eating disorder just by looking at them, so it’s important to be aware of the signs that may indicate someone is developing or experiencing an eating disorder.
Look out for:
- Preoccupation with weight, body shape or composition
- Sudden or frequent changes in weight
- Taking supplements for weight loss/gain, or performance enhancement
- Becoming anxious about missed sessions or disruption to exercise
- Training despite illness or injury or to the point of exhaustion
- Experiencing dizziness, lightheadedness, or disorientation during or after exercise
- Weighing themselves frequently
- Unwillingness to take rest days.
How to approach someone
It can be hard to know what to say to someone who might be struggling with food, exercise or body image. It is a sensitive topic, but one that is of real importance to fitness professionals in promoting the health and wellbeing of clients and colleagues. Some tips include:
- Be prepared: read up about eating disorders, body image and other mental health issues (howfaristoofar.org.au)
- Pick an appropriate time and place for the conversation, being mindful of confidentiality
- Be calm, open and honest and use specific examples of things you have noticed
- Listen to their response and don’t take it personally if they get angry or upset
- Have contact details for organisations such as Eating Disorders Victoria (eatingdisorders.org.au) at the ready in case they are ready to seek support.
What help is available?
Encouraging someone to contact the Eating Disorders Victoria Helpline on 1300 550 236 or firstname.lastname@example.org is the best starting point to help them access more specialised and tailored support, wherever they may live. Helpline volunteers can talk through the options for treatment and explain the different services available, as well as provide a listening ear and confidential support.
If someone does need ongoing help, the first point of contact for a full assessment and referral to a treatment team for many people will be a GP. A GP can refer on to a psychologist or other allied health professional such as a psychologist or dietitian.
‘How far is too far?’ – an early intervention site for eating disorders
Evidence suggests that the earlier someone gets treatment and support, the better their chances for recovery, so it is important that people working in professional roles can identify warning signs and start conversations with people who might be struggling. In this context, Eating Disorders Victoria has been funded by the Victorian Government to develop a mobile site to facilitate early intervention for eating disorders.
'How far is too far?' is a simple website and campaign that explores some of the everyday behaviours and attitudes that can be early warning signs of something else going on. 'How far is too far?' provides basic, clear and practical information about how to identify the warning signs of an eating disorder and how to support someone to get help. The website is targeted at people without training in eating disorders or mental health, but who, like fitness professionals, might be in a position to initiate a conversation with someone.
'How far is too far?' has just launched, so keep an eye out. You can use it to become familiar with some of the early warning signs of an eating disorder, and to get practical tips about how to talk to someone that you’re worried about. It gives an overview of what help is out there, and how to support someone to get help early.
Loren Byford, MPsych, BPsych (Hons) is an experienced psychologist working with Eating Disorders Victoria. She treats a wide range of issues, from anxiety to sleep problems, but has a special interest in treating and preventing eating disorders and related issues in young people. Visit howfaristoofar.org.au or eatingdisorders.org.au