When I set up live online classes I thought long and hard about what to call the classes. Shouldn't be hard you might think🙄 I knew from over 30 years experience that most clients wanted to manage their weight or lose weight and that was appropriate for them.
On the other hand after working as a Physiotherapist within a great multidisciplinary team helping women affected by past trauma with and without dissociative identity disorder and/or eating disorders I knew there are also women, and men, who suffer severely from eating disorders. Most of whom were extremely and dangerously low weight. For some of these people even the phrase “weight loss”, “BMI” or simply commenting on a persons appearance could be triggers that could bring up negative thoughts or past events.
I had to remember that for some of our clients weight management might actually be about gaining weight and monitoring and recording a consistent weight gain. Working with these women taught me more than I could have read in a book. Despite being a Fitness Professional for over 30 years and a Physiotherapist for 7 I can honestly say that I would not have had the skills to help these clients alone because of the very complex health background and behaviours that maintain the eating disordered cycle of behaviour and ill health. It was essential to work closely in an interdisciplinary way with the lead Psychiatrists, Occupational Therapists, Psychologists, Mental Health Nurses and Support staff who are all equally important members of a complex care team.
The Priory Group report between 1.25 and 3.4 million people suffer from eating disorders in the U.K. of whom 25% are male (priorygroup.com).
As fitness professionals and health and care professionals I feel we have a responsibility to see every client as an individual, being prepared to chuck out a standard approach to working with clients when necessary (staying within professional guidelines of course). Only through a thorough Assessment, seeing our client and listening to what they are saying can we ask the right questions and establish trust enough for our clients to tell us if they have problems such as eating disorders. It can take months for people with these problems to develop trust and many people will not want to declare these problems at venues on health declaration forms at places such as gyms.
Understanding how complex eating disorders are, that those who do exercise excessively have learned ways of hiding this and that there can be severe health complications that can occur should help us to understand that an interdisciplinary approach is likely to be the best for our client. Also by understanding that long term eating disorders can lead to osteoporosis, heart problems and other severe complications even in young adults we can begin to understand that even with experience we need to show that we are willing to work with a clients healthcare team. Sometimes this might mean advice from their medical professional leads to strong advice that a client withdraws from exercise until their medical team agrees it is safe for them to return to supervised graded Physical Activity.
I hope this just reminds us all that not everything is about weight loss and fitness. I hope by writing this we are reminded that there are a very vulnerable group of people out there for whom our motivational approach to physical activity will have the opposite effect. I hope by writing this I also remind myself that every person, every client I meet is an individual who is wonderful in their own way.