Expert Advice On Training Clients With Eating Disorders

When working around personal training clients with eating disorders, you must adapt your training to suit the needs of your clients both in terms of the exercise you choose and for changing their mentalities.

To help adapt your training to better suit particular clients, this guide will cover:

• What You Need To Know About Personal Training Clients With Eating Disorders
• 7 Tips For Personal Training Clients With Eating Disorders
• 5 Skills You Should Prioritise When Personal Training Clients With Eating Disorders

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What You Need To Know About Personal Training Clients With Eating Disorders

The Eating Disorder Association of Ireland, Bodywhys, estimates that around 188,895 people will experience an eating disorder at some point in their lives.

This means that it’s likely you’ll be working with, or have worked with, a client who’s suffered with the condition.

Eating disorders as a term includes a wide range of conditions, but this article will focus on those that are associated with undereating and food restriction. 

Our article regarding personal training overweight clients can help with those who suffer from eating disorders on the other side of the spectrum.

Some of the most common types of eating disorders associated with under-eating or restricting food intake you should know about as a personal trainer for eating disorders include: 

• Anorexia Nervosa
• Bulimia
• Orthorexia Nervosa

Let’s break these down!

As a personal trainer working with clients with eating disorders, it’s likely you’ve heard of, or have some understanding of, anorexia and bulimia. 

Orthorexia is a relatively ‘new’ name for an eating disorder that may seem slightly confusing at first glance.

This eating disorder becomes a problem when a fixation on healthy eating turns positive lifestyle changes into a dangerous obsession with the ‘purity’ of food.

Orthorexia is harder to spot than the other two in our table. However, it’s still important to be aware of the condition so you can recognise the signs, and provide for clients who may be suffering from it.

Now you know the difference between these disorders, it’s time to understand what exactly puts people at a higher risk of developing them.

Key Information A PT Should Know About Common Causes Of Eating Disorders

The causes of eating disorders vary for individuals, and their onset can be influenced by a range of factors. 

Reasons can often be complex and, when working with clients with eating disorders, you shouldn’t assume each person shares the same mentality about their disorder.

These factors may include:

• Genetics
• Personality Traits
• Emotional Trauma
• Societal & Cultural Pressures

Three personality traits commonly associated with a higher risk of developing an eating disorder include:

• Perfectionism
• Neuroticism 
• Impulsivity

This is often the result of a person feeling powerless in situations going on in their lives. These eating disorders may become a coping mechanism, and a way to establish a sense of control over a situation.

Emotional trauma can often be linked to this, as someone controls what they eat as a way to deal with painful memories or traumatic experiences.

Another major factor in the development of eating disorders, and one that has increased further over the past decade with the advent of social media, are cultural and societal pressures to be slim.

All of these factors may contribute to a person being at a higher risk of developing an eating disorder.

However, working as a personal trainer for eating disorder clients means not assuming everyone has the same reasons for developing one, and treating them on a case by case basis.

7 Tips For Personal Training Clients With Eating Disorders

When working around personal training clients with eating disorders, it’s important you do everything you can to help them both during and outside of sessions.

#1 - Put Emotional Health First By Identifying Causes of Eating Disorders

While helping a client manage their eating disorder is crucial, it’s important to understand what factors may have led to the development of their condition.

Now, it’s worth mentioning here that this should only be done if clients feel comfortable talking to you about it. 

As discussed earlier in the article, there are many different factors which can lead to the development of eating disorders and these reasons can often be traumatic.

The last thing you want is to open a client's first personal training session by trying to psychoanalyse them, especially if they aren’t open to discussing this topic with you. This is especially important if they haven’t confirmed they actually suffer from an eating disorder.

Eating disorders are often symptoms of something else that has occurred in a person’s life, and has been developed as a coping mechanism. 

Understanding what may trigger a particular client to engage in damaging behaviours can help you train them more effectively.

While eating disorders are complex illnesses and their causes are still not clearly understood, you can at least gain insight into an individual’s reasons for why they developed their condition.

#2 - Design Engaging & Fun Workouts For Clients With Eating Disorders

Eating disorders often take the joy out of exercising, replacing it with an obsession to be a certain way. 

It can even be viewed as a form of self-punishment or self harm, resulting in a person pushing themselves beyond their body’s limit.

Some clients may have come to you for help, knowing a personal trainer will push and challenge them with workouts. If you know or suspect a client has suffered with an eating disorder, this is where you need to tread carefully.

Make sure to keep the focus on having fun and getting the most enjoyment out of exercise. While this doesn’t mean you have to give these clients a light and easy training session, ensure your workouts aren’t always focused on results.

You should do your best to associate exercise with something positive and enjoyable, not an excessive form of self-punishment. Ease clients in gently by having them work out to music, or engage in exercises they’re unfamiliar with.

For example, if a client with an eating disorder used to excessively run on the treadmill to cope with their condition, you may switch to strength training and weightlifting to avoid triggering negative behaviours.

The aim is to keep the focus on how exercise makes them feel mentally and physically, instead of focusing solely on results and performance. Someone recovering from an eating disorder may not think they’re pushing themselves hard enough if they aren’t seeing quick results.

#3 - Set Healthy Goals For Clients With Eating Disorders

The main three things you should focus on offering personal training clients with eating disorders are:

• Improved energy
• Increased physical and mental strength
• Overall better health

For clients who are recovering from an eating disorder, the first few sessions will likely be the most challenging, both for them and for you as their trainer. 

The reason for this is because they may be using their sessions as a way to cope, and are at a greater risk of relapsing.

Even if a client is used to fitness and working out, you should still ease them in gently. Pushing them too hard could trigger negative thoughts and feelings, and drive them right back to square one.

Just like any other client, personal trainer clients with eating disorders need goals to keep them progressing towards something.

However, you should avoid setting goals that only focus on:

• Weight loss
• Calories
• Kilograms/pounds
• Fat burning

All this does is reinforce the idea that exercise and working out is only centred around losing weight and burning calories. By extension, this makes it largely about appearance, which is a dangerous mindset to suggest to personal trainer clients with eating disorders. 

Instead, centre these goals around the client’s individual capabilities, such as:

• Strength 
• Energy levels
• Flexibility
• Aerobic capacity
• Mood

When it comes to personal training clients with eating disorders, the main focus should be on their overall happiness. While you need to tread carefully when setting goals, you may ask them to keep a record of their general mood and energy levels before and after exercise.

For clients recovering from anorexia, their energy levels will often be low and they’ll usually suffer from tiredness and fatigue. 

Having them focus on their mood and energy means they can see an increase in how long they can train for, and a visible record will keep track of these changes.

#4 - Watch Your Language Around Clients With Eating Disorders

Certain words or phrases you could use with other clients may be particularly triggering when working with clients with eating disorders. 

This means paying attention to how you communicate as a personal trainer, and considering what may be potentially damaging to clients.

Some harmful phrases may include:

• Blasting fat
• Cheat meals
• ‘Earning’ food 
• Feeling the burn

Although these may seem like phrases most clients would shrug off, they can be very damaging to those who have suffered with eating disorders. 

Certain phrases may cause a relapse or have a negative effect, even if you think you’re being positive.

Labelling certain foods as ‘bad’ or discussing ‘cheat meals’ may reinforce negative attitudes for personal training clients with eating disorders. 

This perpetuates the idea that enjoying certain foods is wrong or shameful, which can be particularly damaging to those prone to binge eating.

If someone asks you not to use certain words or phrases, the worst thing to do is label them as ‘oversensitive’. Eating disorders can be life-threatening illnesses and affect a person’s development, leading to years of mental and physical deterioration.

You should also try and avoid only celebrating clients on their weight loss. Although you may see this as something positive, this can reinforce negative mindsets that positivity or praise can only come from being slimmer.

Instead, focus on their determination and hard work by mentioning how far they’ve come and how motivated they are. This could be by celebrating how long they can train for without having to rest or pause the session.

The bottom line is to simply be aware of the things you say and adjust your behaviour accordingly.

#5 - Encourage Clients With A Non-Diet Mentality

Western culture often links being thin with:

• Happiness
• Health
• Attractiveness
• Value 

With this in mind, it’s no surprise eating disorders have been on the rise for years, worsened by the onset of social media and diet culture. With personal training clients with eating disorders, it’s important to educate clients about the importance of nutrition.

Even clients without eating disorders are prone to falling into negative mindsets about food and begin crash diets, believing these restrictions and choices are sustainable ways to lose weight. 

A poll of over 2,000 participants mentioned in an article by the Independent found the average person will typically embark on at least 2 fad diets a year, usually abandoning them after six days.

Similar to the point above, you need to watch your words and avoid pushing the idea your client is on a ‘diet’ by encouraging them to make a lifestyle change. 

Refrain from labelling certain foods as ‘bad’ or telling people they’re ‘allowed’ to eat something they enjoy. The more people feel they can’t or shouldn’t have something, the more likely they’ll want it.

Avoid using the word diet, as this can often be synonymous with ‘restriction’. Instead, enforce the idea that there are no bad foods and most food groups serve a purpose, even if it’s just to give a client joy - only if it’s in moderation!

- - - - 

If you’d like to continue expanding your knowledge for working with personal training clients with eating disorders, these articles can help:

• The Key Skills Needed To Become A Nutritionist
• Can Personal Trainers Give Nutritional Advice?
• How To Make A Meal Plan For Beginners

#6 - Voice Concerns When Working Around Clients With Eating Disorders 

It isn’t your job to start diagnosing clients with eating disorders. However, you should raise any concerns you have about a client if you start noticing a clear difference in their appearance and attitude.

For those suffering with eating disorders, they may be in denial about their overall condition or if they’ve relapsed. 

If you voice your concerns in a serious or worrying way, they may become defensive and react negatively to what you’re saying.

To avoid making them uncomfortable or a situation awkward, you may use phrases such as:

• ‘How’s life outside of training been lately?’
• ‘I’ve noticed you’ve been training a lot harder than usual - are you alright?’
• ‘Your body’s been changing quicker than I’d expect it to, is everything OK?’

This makes it more casual and is less likely to make them feel like they’ve done something wrong. 

If you’ve built up a trusting relationship with particular clients, they’ll be more likely to open up to you, especially if you address them in an easy-going way.

However, if a personal training client with a past eating disorder does react negatively to your concern, simply apologise but keep a close eye on their behaviour. 

Reduce the intensity of the training if you feel it’s too much, or try different exercises if you think they’re becoming too obsessive over certain ones. 

#7 - Suggest Additional Support For Clients With Eating Disorders 

Eating disorders are life-threatening and very complex illnesses that still aren’t fully understood. Those who suffer with them may need more support than what you can offer. 

Now, this doesn’t mean you’ve failed if you don’t think you can truly give them the support they need.

If you feel you don’t have the necessary skills or knowledge required to truly help clients with eating disorders, you may find the best option is to refer clients to a specialist, such as a councillor or dietician.

With personal training clients with eating disorders, you may find they’re more open speaking to you about it than they would a doctor or health care specialist. However, you don’t want to become the only person they can talk to about it.

This can put enormous pressure on you to give them the best advice, or lead to you constantly worrying about their safety and health outside of sessions.

You should ask and encourage them to utilise other support methods such as:

• Nutritional Support
• Therapists
• Family
• Friends
• Doctors & Psychiatrists (if necessary)

You can even suggest services and charities such as Bodywhys. 

This is great for those who may not feel comfortable speaking to someone close to them and wish to remain anonymous. Talking can help a person make sense of their problems and understand them better.

Any form of relapse or disordered eating occurs as a consequence of other issues happening in a person’s life. While it’s not your job as a PT to treat an eating disorder, helping people build healthy relationships with their body and food is crucial to help them recover.

5 Skills You Should Prioritise When Personal Training Clients With Eating Disorders

Although many of the qualities listed below are typical skills required to become a personal trainer, these should be prioritised when working with clients with past eating disorders.

Show Compassion When Working With Clients With Eating Disorders

This is probably the most important skill to have when working with clients with eating disorders. It can take a lot for someone who has suffered with disordered eating to step back into a gym, especially to work with a personal trainer. 

These are lifelong illnesses that always run the risk of relapse, meaning you need to do whatever you can to reduce the chances of this happening.

It’s unlikely a client who has suffered from an eating disorder will respond well to a personal trainer who acts like a drill sergeant and shouts at them to ‘feel the burn’. This kind of attitude can reinforce negative behaviours for them.

If they’re being shouted at or made to feel like they’re not working hard enough, this could cause them to feel worse about themselves, or that they aren’t self-punishing enough. 

This may then result in clients restricting food intake or bingeing and purging as a consequence.

As mentioned earlier, it’s best to ease clients in during their first few sessions until you get to know them better and build a trusting relationship. After a few sessions together, you’ll be better at understanding their limitations and how they react to training.

Showing sensitivity to clients with eating disorders and accommodating to their needs is crucial for helping them recover. 

To avoid relapsing, the most important thing is getting rid of toxic behaviours and situations or triggers. 

This is why you need to be a compassionate personal trainer as you can help keep them on the right track. Having an abrasive or dismissive attitude around clients who are particularly sensitive can make you a negative person in their life and increase the risk of relapsing.

Practice Active Listening With Your Eating Disorder Clients

Listening is one of the most important skills when working with clients with eating disorders. If clients aren’t responding well to your training, you need to listen to their concerns and adjust workouts accordingly.

When you aren’t working around personal training clients with eating disorders, you may find you can push them further even when they don’t believe they can do this themselves. 

However, you need to be a lot more sensitive with personal training clients with eating disorders.

Not only should you listen to their concerns or worries during workouts, but also certain phrases you may not pick up on at the start of sessions that can act as warning signs.

Subtle phrases will differ depending on the individual and their condition, but some common examples include:

This doesn’t mean clients with eating disorders will necessarily use these phrases but there might be similar ones that aren’t as obvious. 

If clients begin using language in regards to being overweight when they’re healthy, or seem to be obsessing over calories and nutrition, be sure to pull them aside to check if everything is alright.

Effectively Communicate With Your Eating Disorder Clients

Similar to our point earlier in the article about watching your language around personal trainer clients with eating disorders, you need to understand the importance of making people comfortable in your presence. 

Working with a trainer after suffering with disordered eating can bring a lot of anxiety so making a client as comfortable and relaxed as possible is key. 

While this may seem like a basic skill for anyone hoping to become a personal trainer, it’s vital for those specialising in clients with eating disorders.

Effective communication isn’t just based around words - your body language is vital, too. Crossing your arms and looking down at the ground when someone is voicing their concerns to you isn’t going to make them feel relaxed or like you’re even listening to them.

If you’re a personal trainer for eating disorders who comes across as distant or cold, clients will be less likely to open up to you and may not return.

Instead, adopt a more open, welcoming stance. Easy-to-implement examples of positive body language include:

• Maintaining eye contact
• Nodding your head
• Upright posture
• Leaning in while speaking

While these actions may seem trivial, they can mean a lot to the client you’re interacting with. Most people who have suffered from eating disorders may feel they can’t open up about their issues, but by showing them you care, it can encourage them to do so.

Create Bespoke, Adapted Sessions When Training Clients With Eating Disorders

As mentioned earlier in the article, workout sessions will need to be adapted to the individual and what may trigger a negative reaction.

Whether you suspect a client has suffered with an eating disorder, or if you know they are in recovery, you should ask them about any past exercise and what they used to do during workouts.

Introduce new kinds of exercise or gym machines to them as this may avoid opening old memories, many of which will be negative. 

You could have clients begin with cycling or resistance training to slowly build up their strength and energy, especially in those who have suffered from anorexia. This eases them into working out again, reducing the risk of obsession.

Be Patient Around Your Clients Who Have An Eating Disorder

Patience is extremely important for personal trainers working with clients with eating disorders. You have to adjust the intensity of your sessions and be more accommodating as they will require more care than your average client.

Clients who are recovering from eating disorders, especially anorexia, will likely become tired easily and require more rest time as they build their strength up.

If they tell you they can’t carry on, or that they need to stop and rest, you must allow them to do so. 

While it may be different from what you’re used to doing with regular clients, the last thing you should do is make them feel bad about themselves, or draw attention to the pause in your session.

Recovery will take a long time, especially if someone has suffered severely with their disorder. Understand that it’s not their fault and ensure they keep hydrated and have adequate rest before continuing.

Before You Go!

Now you know the best way to run sessions when it comes to personal training clients with eating disorders, it’s time to get out there and put your knowledge to the test.

To help you train every individual client in the best possible way, our range of personal training courses are here to do just that! 

From courses in Level 5 Advanced Sports Nutrition, to a specialised Level 5 Obesity and Weight Management Control certification, you’ll have the knowledge to help your clients live healthier lives.

Download our course prospectus today or simply enter your details below!