I wanted to write this post because I’ve had several clients come to me saying their relationship with food has gotten worse after working with a nutritionist, or that disordered eating habits have been triggered by a certain approach their nutritionist has recommended (such as intermittent fasting or following a rigid, calorie-controlled diet plan).
Having worked in the fitness industry, I’ve noticed these consequences are particularly prevalent amongst nutritionists who specialise in fat loss or who work with physique athletes such as bodybuilders and bikini competitors. The recommended diets and ways of eating recommended have a tendency to legitimise unhealthy eating behaviours such as severe food restriction as healthy.
This influences what is considered ‘normal’ within the fitness industry which ripples out to the rest of society. It is therefore important to discuss so that we can gently shift fitness norms away from restrictive dieting focussed on fat loss and towards a more all-encompassing view of fitness involving nourishment, body kindness, and overall wellbeing.
Another reason it’s important we start discussing this issue more openly is because research suggests the prevalence of orthorexia, exercise addiction, and disordered is higher amongst those studying or working within nutrition, exercise science and other health-focussed career paths than in the general population.
We can only take our clients as far as we’ve taken ourselves. As practitioners, we have a responsibility to reflect on our own relationship with food and exercise so we can coach others in a way that truly serves them.
In What Ways Could We Be Harming Clients’ Relationship With Food?
From speaking with clients there seems to be two main reasons as to how, as practitioners, we could be impacting clients’ relationships with food in a negative way.
1. Lack Of Understanding
Jenny* came to me because of her struggle with binge eating. She was already working with a nutritionist who was helping her ‘lose a few pounds’ so she just wanted some weekly counselling to help her stop bingeing. She told me that the binge eating only started a couple of months ago and had slowly increased in frequency and the quantity of food she was eating each time. At first, the binges happened once a week at weekends, but they had now started happening 3-4 times a week and she was eating more and more at each binge.
I asked Jenny if anything stressful or upsetting had happened around the time the binges started and she said no – she was very happy in her work, had a partner she was in love with, and had a great group of friends.
And then I asked her what her nutritionist had said about the binge eating. She told me that he asked her what she would binge on, and then he would calculate the calories and subtract that amount of food off her next week’s calorie allowance to ‘compensate’ so she would still hit her ‘weight loss goals’ each week.
Completely innocently, Jenny’s nutritionist was setting her up for a binge-restrict cycle because his main focus was to get her to her goal weight. I explained to Jenny, that because the bingeing had started a couple of weeks after she started dieting (i.e. restricting her calorie intake), the urges to binge were her body’s way of telling her that she needed more food. If she wanted to stop the binges, she would have to put her weight loss goals on the backburner, get herself out of a calorie deficit, and begin nourishing herself in a way that didn’t phsyiologically set her up to binge.
This is such a sensitive topic to broach because there are a lot of really great evidenced-based nutritionists out there who know a lot about fat loss and muscle gain and will definitely help you get to your weight loss goals through a carefully calculated calorie plan, but at what cost long-term?
2. Practitioners Have An Unhealthy Relationship With Food Themselves
I started working with Lucy* after she felt herself slipping back into anorexia. She had previously been working with a nutrition coach for a couple of months as she wanted to ‘lean out a little’. She had a history of anorexia as a teenager and hadn’t had a period in six years. She also knew that counting calories triggered her anorexic thinking so she asked the nutrition coach not to include calorie counts on her meal plan. Despite this, her coach used a database for her meal plan which showed the calorie count of each food item. He also told her that her ‘ideal weight’ would be 2.5kg lighter than she was (although her lack of periods showed that Lucy’s weight was probably lower than it needed to be for her to be healthy).
Her nutrition coach advised Lucy to weigh herself daily, fast three times a week until lunch time, and stick to the meal plan rigidly. He said to aim for a weight loss of about 0.35kg a week. I spoke directly to Lucy’s nutritionist and during the course of our conversation he told me, “you need to count calories or you’ll just overeat”. I asked him if he had heard of intuitive eating and he said it’s healthier to track calories because even he, as a professional, “wouldn’t know what to eat or how much to eat if it wasn’t for MyFitness Pal”.
To me, this highlights how we can, quite innocently project our own relationships with food onto our clients. We can read all the research papers in the world and use the most detailed tools to calculate calories and predict weight loss, but if we haven’t put the work in to understanding and healing our own relationships with food, this can impact our client’s progress (and even cause them to develop their own issues around eating).
Questions For Self-Reflection
As professionals working in nutrition, it’s important to regularly reflect on the dietary practices we are promoting by asking ourselves questions such as:
- Could my relationship with food and my own body be having a harmful impact on the dieting practices and ways of eating I promote to clients? For example, because you find counting calories and tracking macros an effective way to ‘control’ your weight, are you encouraging all clients to count calories and track macros too? Or, because you have a neutral relationship to nutrition and intuitive eating comes naturally to you, do you assume intuitive eating is appropriate for all your clients too?
- Do I have appropriate screening methods to identify eating disorders or disordered eating in clients before I begin working with them? If you don’t screen clients for disordered eating, then I would highly recommend using the SCOFF Questionnaire and the Orthorexia Self-Test.
- Do I know enough about the psychology behind disordered eating to confidently work with clients who may be suffering from it in full confidence that the diet and nutrition practices I recommend won’t increase their suffering long-term? For example, you might be able to help them reach their weight loss goals in the short-term, but this might leave them having to maintain a weight which is lower than where their body naturally wants to be, leading to an unhealthy relationship with food long term.