The Dangers of Disordered Behaviors
Personal trainers are uniquely positioned to contribute to—or dismantle—the diet culture that negatively impacts their clients’ mental and physical health and contributes to the development of eating disorders.
Thankfully, awareness around eating disorders such as anorexia nervosa, bulimia nervosa and binge-eating disorder continues to grow. Unfortunately, research has shown that fitness professionals are not good at recognizing signs of these disorders in their clients.
Learning what to do if you suspect your client is suffering from an eating disorder is essential for all personal trainers. The truth is that while eating disorders are serious, they affect a smaller portion of the population when compared to lesser known, but far more common, precursors. These precursors are a spectrum of unhealthy habits that are often referred to as disordered behaviors.
Eating disorders don't develop in a vacuum, so it's essential to recognize the early signs. Severely dysfunctional relationships with food, exercise or body shape are common and dangerous. Identifying these unhealthy behaviors, and learning when and how to intervene, are crucial to the long-term health of your clients.
It's essential to note the term “disordered behavior” is descriptive, not diagnostic.
As such, there is no singular definition. This article does not criticize any assessment tool, training program or diet. Instead, it is a call to think critically about how you interact with clients and how you choose to confront concerning behaviors when they arise. It is also necessary to recognize your limitations in this space, as personal trainers are not mental health specialists or medical professionals.
That said, personal trainers are uniquely situated in many ways to recognize patterns in their clients that others may overlook. Most people see their doctor once a year for 30 minutes, if they're lucky. By comparison, trainers typically see their clients several times a month in a setting that allows them to engage with clients in ways that may reveal potentially disordered behaviors.
According to the Academy of Nutrition and Dietetics, the traits of disordered health behaviors include the following:
Health and fitness become compulsory: Far beyond an admirable dedication to health, a disordered relationship with food or exercise often takes up a considerable portion of the client's life at the direct loss of other things, such as time with family or relaxation. As a result, missing a workout becomes unthinkable, and adherence to their nutrition plan is pursued with an almost religious fervor.
Food or exercise becomes compensatory: When their relationship with food has become unhealthy, some clients use restriction as punishment when they've eaten foods they label as “bad,” “unhealthy,” or “off-plan.” Clients may slash their calories to make up for a single meal at a restaurant or train excessively to compensate for a missed workout. Food becomes something you must “earn,” and exercise is often used as a punishment.
Fitness or nutrition become inflexible: Another hallmark of someone suffering from disordered behaviors is that they are unwilling or unable to adjust their training and nutrition plan despite circumstances that warrant changes. For example, these clients may quickly return to working out despite being cautioned by a healthcare provider to rest due to injury or illness or refuse to partake in holidays or social gatherings for fear of deviating from their strict diet plan.
Their body image or relationship with food becomes overwhelmingly negative: Clients train for different reasons, but most clients take some measure of pride and enjoyment in completing a workout, learning a new exercise or mastering a complex skill. In contrast, those suffering from disordered behaviors often demonstrate consistent negative self-talk and report feeling shame regarding food, exercise or their bodies.
They're willing to do anything to reach their goals: While most trainers appreciate dedicated clients willing to work hard to achieve their goals, clients who become desperate risk being taken advantage of by fitness hacks and uneducated fitness influencers. So, if your client shares that they have started crash dieting, extreme calorie restriction, diet pills, or other unhealthy and unnecessary fads like sauna sweating or detoxes, it’s within your scope of practice to have a conversation about those disordered behaviors. That said, it’s vital that you never diagnose, treat or counsel a client, as doing so is outside your defined scope as an exercise professional.
This list is far from exhaustive and is meant only to demonstrate how some behaviors have the potential to become problematic. When a client's relationship with food, exercise or their body starts to take on obsessive, harmful or unyielding qualities consistently—it's time to check in.
Important Communication Considerations
If a client is exhibiting behaviors that concern you, you must approach them with empathy, compassion and tact. Keep in mind that you are not there to diagnose or pathologize them. However, if they're consistently exhibiting behavior that concerns you, it is your responsibility as an exercise professional to address it.
Know Your Role
We've discussed the limitations in our scope of practice as personal trainers, but what is your role in identifying unhealthy, disordered behaviors in your clients?
- A subject matter expert
- A role model
- A trusted source of information for your clients and your community
Therefore, it is your responsibility to conduct a preparticipation health screening before you start working with someone and understand how their health concerns may affect your programming, their goal setting and how you monitor progress.
If your client divulges a history of disordered eating or compulsive exercise, you must advocate for programming and goal setting that are not damaging to their health. This can include deemphasizing scale weight, offering alternate assessments focused on fitness instead of physique change and educating them on the importance of rest.
Stop Contributing to Diet Culture
Disordered behaviors thrive where diet culture lives. Diet culture is a social phenomenon that glorifies thinness, assumes that thinness equates to health and morality and demonizes certain foods. It is pervasive in the media and the fitness industry.
Here are some key “do’s” and “don’ts” for you to consider:
Model healthy relationships with exercise and food for your clients
Make exercise fun
Collaborate with your clients to set realistic goals
Educate them on the benefits of exercise and the risks of quick fixes
Provide compassion and understanding if they miss a workout
Teach your clients about body neutrality
Focus on the tremendous mental and physical health benefits of exercise and proper nutrition that have nothing to do with weight loss or fat loss
Use guilt- or shame-based coaching
Moralize health choices by labeling them as good, bad, healthy, unhealthy, naughty, etc.
Use exercise as punishment, or tell them they're “earning their meal”
Make derogatory comments about anyone's body, including your own
Cultivate a Strong Referral Network
Despite your knowledge and expertise as a trainer, there will be times when your client requires a referral to other professionals. When it comes to referring clients because of disordered eating, you must walk a fine line.
Remember that you can never diagnose someone with an eating disorder as a personal trainer, so it's best to refer them to a registered dietitian with experience in disordered eating or recommend they see their primary care provider. Their doctor will have the knowledge and expertise to diagnose them and refer them to the best support services.
The Bottom Line
Disordered behavior is not a clinical definition but instead refers to a continuum of behaviors that can become unhealthy when taken too far. Personal trainers need to know the signs and symptoms of eating disorders and be aware of the ways in which diet culture influences clients and how that can show up in disordered relationships with food, exercise or their body.
To learn more about how diet culture may be affecting your clients, read It’s Time to Ditch Diet Culture for Good. Or, check out Strategies for Coaching Clients Toward a Healthier Body Image and Is Body Love Realistic?