Support and Awareness of Eating Disorders: The Role of the Fitness Professional

There are an endless number of healthy reasons why someone may seek out a personal trainer; however, the reasons for wanting to engage in exercise are not always healthy, and the signs and symptoms of eating disorders are not detectable by the majority of fitness professionals when compared to medical professionals (Manley, O'Brien, & Samuels, 2008). Missing from the core education and training of fitness professional certifications is the troubling topic of eating disorders and exercise preoccupations– how they affect the body, and how to help someone who may be dealing with them (Canadian Society for Exercise Physiology, 2015; CanFitPro, 2015). I argue that by adding a mandatory component of eating disorder education to personal training certifications, fitness professionals can better act as supports for those affected by these mental illnesses, alongside medical and psychological professionals.

The Difficulty in Identifying Problematic Exercise
Due to the common association of exercise with health promotion, it can be difficult to identify if and when exercise becomes problematic. Freimuth, Moniz, and Kim (2011) conducted 49 studies and analyzed various forms of exercise preoccupation. They noted that exercise can be measured as problematic depending on the level of negative consequences it creates, and how they increase in occurrence. They also acknowledged that there are still difficulties present when identifying unhealthy exercise. Some components of exercise preoccupation may blend with the behaviours and experiences of high-level athletes who must commit to extensive training schedules and intense bouts of exercise (Freimuth et al., 2011, p. 4077). In short, the activities, practices, training schedules, and/or sport participations that are healthy for one person may be unhealthy for another. One cannot simply observe a person’s exercise regimen to diagnose the presence of an eating disorder or exercise preoccupation.

Eating Disorders Among Athletes
It is common for athletes to work with personal trainers to enhance their physical or sport-related performance. While there’s no question that eating disorders can affect a wide variety of people (Chatterton & Petrie, 2013; Greenleaf, Petrie, Carter & Reel, 2009), it is important for fitness professionals to be aware of the possible prevalence of eating disorders among athletes. Together, the combined studies of Galli, Petrie, Greenleaf, Real, and Carter (2014), and Greenleaf et al. (2009) provided evidence that overall, athletes are not immune from developing eating disorders, and in some cases (Thiemann et al., 2015) may actually be at higher risk. It is also important to note that while current evidence makes it appear that male athletes may be at lower risk of developing eating disorders, they are not immune (Chatterton & Petrie, 2013; Galli et al., 2014).

The Health Risks of Exercise on an Affected Person
A specific duty of a personal trainer is to provide exercise prescriptions (Canadian Society for Exercise Physiology, 2015) to what are described as “apparently healthy individuals” (CanFitPro, 2015).  If disordered eating and exercise preoccupations are not always easy to identify (Freimuth et al., 2011), this makes them harder to screen for in an individual. Without knowing that a client is affected by an exercise preoccupation, it is possible that a personal trainer may be unintentionally contributing toward the harm of a person, rather than helping them to promote physical health.

So, What Can Fitness Professionals Do?
While the research on personal trainers relating to eating and exercise preoccupations is limited, there is growing information about how coaches may help or hinder their athletes’ chances of developing these mental illnesses. The results of a 2013 study by Shanmugam, Jowett and Meyer help to highlight these impacts; this study consisted of 411 athlete participants, 159 males and 252 females. The eating disorder examination questionnaires (Shanmugam et al., 2013, p. 26), in addition to five other questionnaires evaluating sport-specific relationships, tendency of perfectionism, dysfunctional attitudes, self-esteem, and depression suggested:
“...good-quality relationships characterized by high levels of perceived support and low levels of interpersonal conflict with parents and coaches are related to healthy eating psychopathology, while poor-quality parental and coach relationships characterized by lack of perceived support and high conflict are related to elevated eating psychopathology.” (Shanmugam et al., 2013, p. 33)

A 2012 study by Arthur-Cameselle and Blatzell was conducted to further explore the topic of the role that coaches can play for those affected by eating disorders. The study’s participants consisted of 16 female college athletes who had recovered from having had an eating disorder. Regarding coaching behaviours, the participants recommended that coaches become more educated in eating disorder awareness, emphasize proper nutrition, promote sport skill rather than body weight to achieve performance goals, and avoid singling out athletes regarding weight or body shape (Arthur-Cameselle & Blatzell, 2012, p. 4).

The Bottom Line
Eating disorders and exercise preoccupations are complicated matters that seem to have very individualized answers as to exactly how and why they occur in each individual. The same can be said about the process of recovery. Through education, specifically a change in attitudes around fitness and body image, we can actually promote health, rather than cater to a body-dysmorphic standard. If fitness professionals are given basic education about eating disorders and exercise preoccupations, they will be better prepared to identify, instruct with caution, and provide referrals to the appropriate medical and/or psychological professional(s). With added education, this will also help reduce the stigma around mental illness, and increase the chances of those affected by eating disorders in speaking up and getting help.

References

Arthur-Cameselle, J. N., & Baltzell, A. (2012). Learning from collegiate athletes who have recovered from eating disorders: Advice to coaches, parents, and other athletes with eating disorders. Journal of Applied Sport Psychology, 24(1), 1-9. doi:10.1080/10413200.2011.572949

CanFitPro. (2015). Personal training specialist. Retrieved October 20, 2015 from http://www.canfitpro.com/pts

Canadian Society for Exercise Physiology. (2015) CSEP certified personal trainer (csep-cpt) core competencies. Retrieved October 20, 2015 from: http://www.csep.ca/CMFiles/CSEPCPTCoreCompetenciesforwebsite.pdf

Chatterton, J. M., & Petrie, T. A. (2013). Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eating Disorders, 21(4), 328-341. doi:10.1080/10640266.2013.797822

Freimuth, M., Moniz, S., & Kim, S.R. (2011). Clarifying exercise addiction: Differential diagnosis, co-occurring disorders, and phases of addiction. International Journal of Environmental Research and Public Health, 8(10), 4069-4081. doi:10.3390/ijerph8104069

Galli, N., Petrie, T. A., Greenleaf, C., Real, J. J., & Carter, J. E. (2014). Personality and psychological correlates of eating disorder symptoms among male collegiate athletes. Eating Behaviors, 15(4), 615-618. doi:10.1016/j.eatbeh.2014.08.007

Greenleaf, C., Petrie, T., Carter, J., & Reel, J. (2009). Female collegiate athletes: Prevalence of eating disorders and disordered eating behaviors. Journal of American College Health, 57(5), 489-496 8p. doi:10.3200/JACH.57.5.489-496

Shanmugam, V. v., Jowett, S., & Meyer, C. (2013). Eating psychopathology amongst athletes: The importance of relationships with parents, coaches and teammates. International Journal Of Sport & Exercise Psychology, 11(1), 24-38. doi: 10.1080/1612197X.2012.724197

Thiemann, P., Legenbauer, T., Vocks, S., Platen, P., Auyeung, B., & Herpertz, S. (2015). Eating disorders and their putative risk factors among female German professional athletes. European Eating Disorders Review, 23(4), 269-276. doi:10.1002/erv.2360

Jay Walker is a personal trainer at Totum Life Science. He is currently pursuing his Masters Degree in Counselling Psychology with plans to work as a Therapist specializing in the treatment of eating disorders. You can contact Jay via email.