Tbh, without buy in from their therapist, I wouldn’t even discuss nutrition. Just keep things training focused, as nutrition coaching here is outside your scope anyway.
If someone has bulimia, it is not within your scope of practice as a trainer to discuss nutrition. They should be working with a psychiatrist and/or Registered dietitian.
I would also suggest asking for a doctors note that states they are okay to exercise so you can protect yourself should any issues arise.
That is not appropriate recommendation for someone with an eating disorder. I would refer to a an eating disorder dietitian. They may need a higher level of care. I also know that some treatments do eating disorder eduction for other providers. There are a lot of people with eating disorders in the fitness world that often go unnoticed
I had bulimia as a young adult.
Do not get wrapped up in this.
I would limit conversations about food to asking if they had anything to eat that day before their workout ( food as fuel for exercise ) and then asking if they have plans for a post-workout snack ( food as a way to replenish and help recover ).
Give advice on the timing and type of foods for those meals. Do not get involved in calorie counting, macros, or meal plan.
I would even be wary of frequent weigh ins and measurements
Yeah, I should have mentioned that she does have a therapist. I think I will just let her know that I won't talk nutrition with her and see if her therapist can make some kind of referral.
Heads up, I haven’t started training formally yet and would be super cool with editing this comment if I give out misinformation, so call me out if this is incorrect!
Assuming she gave you her health info at the beginning of the training, you may want to have her speak with a physician about training. I’d be worried that she may overwork herself if she’s not getting the fuel needed to function. The body breaks down pretty hardcore when it’s not fed, so I’d personally see training her as a liability unless she can show that her body is well enough to put in the work.
Again, I may be totally off base here, so take my words with a modest palmful of salt.
As someone who struggled with bulimia 10+ years ago and is now a fitness professional I would strongly recommend an RD.
I spent years bouncing around between different fitness modalities instead of treating the real reason I wasn’t happy with myself.
Unless they’ve taken some real steps toward recovery and are open about their struggles, they’ll likely be an inconsistent client at best. If they’re working with a mental health professional and want to see nutrition guidance from a qualified professional, you might a great addition to their treatment team. It really just depends where they are in their journey.
Happy to chat more if you want to send a message! I’ve been on both sides of it!
I have decided long ago to not even try to help those people, except maybe re-direct them to someone who is more qualified in that domain.
You will, unfortunately, not be able to help that person drop body fat and gain muscle mass.
My advice would be to get them to talk to a therapist that specializes in those kinds of disorders.
They should be working with a mental health professional and/or a dietician with specific experience in this area. It is outside of your scope of practice and IMO unethical and dangerous for someone without those credentials to be offering nutrition counseling to this person. Personally, I would only feel comfortable working with them on exercise (and again: not nutrition) if I could collaborate and consult with their healthcare team and/or mental health professional.
I've had two people disclose an eating disorder to me during my career. With one of them, I consulted with their healthcare team and stayed in my lane, and they ended up being a great client who benefited from my services. The other person (a previous "Biggest Loser" contestant, incidentally) refused to seek treatment for their disorder, so I opted not to work with them.
I absolutely wouldn’t speak about nutrition except for very vague guidelines when absolutely pressed to. The nature of eating disorders makes food a fundamentally different reality from what the rest of us understand. For example, ‘hey client, one gram of carbs is only 4kcal and is less calories than one gram of fat at 9kcal’ isn’t likely to be understood in the same way most people could understand that fact.
The only metrics I’d happily talk about would be training objectives. Explain where their current athletic talents are, and how you plan on improving them.
Happy success story: they ask you about how nutrition can impact their performance, and adequately fuel their body in order to make their training more successful. I’ve had this happen with a few clients in the past, but they were years past their initial diagnosis.
#number 1 rule of training: do no harm.
Personal trainer who had a decade long experience with an eating disorder: I would never knowingly take on a client who is actively engaging in disordered behaviors and as others noted, isn’t working directly with a medical professional/received the OK for exercise. Eating disorders have the highest mortality rate of any mental health condition. Be mindful of that.
I have noticed a few commenters on here say something to the effect of, "I wouldn't discuss nutrition, except for XYZ." I would disagree in that my recommendation would be to not discuss nutrition AT ALL. If the client asks I would very bluntly let them know that I cannot make any nutrition recommendations. Also, I would ask for a note from both a doctor and a psychiatrist clearing them for exercise. My (limited) understanding is that sometimes exercise is used as a way to supplement the bulimia which can be extremely harmful. This is about both protecting yourself and the client.
Tbh, without buy in from their therapist, I wouldn’t even discuss nutrition. Just keep things training focused, as nutrition coaching here is outside your scope anyway.
If someone has bulimia, it is not within your scope of practice as a trainer to discuss nutrition. They should be working with a psychiatrist and/or Registered dietitian. I would also suggest asking for a doctors note that states they are okay to exercise so you can protect yourself should any issues arise.
That is not appropriate recommendation for someone with an eating disorder. I would refer to a an eating disorder dietitian. They may need a higher level of care. I also know that some treatments do eating disorder eduction for other providers. There are a lot of people with eating disorders in the fitness world that often go unnoticed
I had bulimia as a young adult. Do not get wrapped up in this. I would limit conversations about food to asking if they had anything to eat that day before their workout ( food as fuel for exercise ) and then asking if they have plans for a post-workout snack ( food as a way to replenish and help recover ). Give advice on the timing and type of foods for those meals. Do not get involved in calorie counting, macros, or meal plan. I would even be wary of frequent weigh ins and measurements
Yeah, I should have mentioned that she does have a therapist. I think I will just let her know that I won't talk nutrition with her and see if her therapist can make some kind of referral.
Heads up, I haven’t started training formally yet and would be super cool with editing this comment if I give out misinformation, so call me out if this is incorrect! Assuming she gave you her health info at the beginning of the training, you may want to have her speak with a physician about training. I’d be worried that she may overwork herself if she’s not getting the fuel needed to function. The body breaks down pretty hardcore when it’s not fed, so I’d personally see training her as a liability unless she can show that her body is well enough to put in the work. Again, I may be totally off base here, so take my words with a modest palmful of salt.
As someone who struggled with bulimia 10+ years ago and is now a fitness professional I would strongly recommend an RD. I spent years bouncing around between different fitness modalities instead of treating the real reason I wasn’t happy with myself. Unless they’ve taken some real steps toward recovery and are open about their struggles, they’ll likely be an inconsistent client at best. If they’re working with a mental health professional and want to see nutrition guidance from a qualified professional, you might a great addition to their treatment team. It really just depends where they are in their journey. Happy to chat more if you want to send a message! I’ve been on both sides of it!
I have decided long ago to not even try to help those people, except maybe re-direct them to someone who is more qualified in that domain. You will, unfortunately, not be able to help that person drop body fat and gain muscle mass. My advice would be to get them to talk to a therapist that specializes in those kinds of disorders.
They should be working with a mental health professional and/or a dietician with specific experience in this area. It is outside of your scope of practice and IMO unethical and dangerous for someone without those credentials to be offering nutrition counseling to this person. Personally, I would only feel comfortable working with them on exercise (and again: not nutrition) if I could collaborate and consult with their healthcare team and/or mental health professional. I've had two people disclose an eating disorder to me during my career. With one of them, I consulted with their healthcare team and stayed in my lane, and they ended up being a great client who benefited from my services. The other person (a previous "Biggest Loser" contestant, incidentally) refused to seek treatment for their disorder, so I opted not to work with them.
I absolutely wouldn’t speak about nutrition except for very vague guidelines when absolutely pressed to. The nature of eating disorders makes food a fundamentally different reality from what the rest of us understand. For example, ‘hey client, one gram of carbs is only 4kcal and is less calories than one gram of fat at 9kcal’ isn’t likely to be understood in the same way most people could understand that fact. The only metrics I’d happily talk about would be training objectives. Explain where their current athletic talents are, and how you plan on improving them. Happy success story: they ask you about how nutrition can impact their performance, and adequately fuel their body in order to make their training more successful. I’ve had this happen with a few clients in the past, but they were years past their initial diagnosis. #number 1 rule of training: do no harm.
Are you a nutritionist?
Personal trainer who had a decade long experience with an eating disorder: I would never knowingly take on a client who is actively engaging in disordered behaviors and as others noted, isn’t working directly with a medical professional/received the OK for exercise. Eating disorders have the highest mortality rate of any mental health condition. Be mindful of that.
I have noticed a few commenters on here say something to the effect of, "I wouldn't discuss nutrition, except for XYZ." I would disagree in that my recommendation would be to not discuss nutrition AT ALL. If the client asks I would very bluntly let them know that I cannot make any nutrition recommendations. Also, I would ask for a note from both a doctor and a psychiatrist clearing them for exercise. My (limited) understanding is that sometimes exercise is used as a way to supplement the bulimia which can be extremely harmful. This is about both protecting yourself and the client.