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Eating Disorders: Implications for the Fitness Industry


By Columnist Eleni Psillakis – Eating Disorder Educator: 



Photo CreditCeleste Pascual, 2008 – Finding Yourself – 

I had the honour of presenting a 90min lecture at Filex 2017 on “Identifying and Managing Eating Disorders in the Fitness Industry”. One of the participants at the end of the session asked why every trainer was not in the session. Her daughter had signed up for a 12-week body transformation challenge, and was told that dairy and carbs were evil. She was instructed to do an extra hour of cardio on the treadmill because she had eaten these. Her daughter is in a clinic suffering Anorexia Nervosa.

There are so many risk factors that contribute to the development of an eating disorder. Fitness professionals are in a position to identify a person who may be displaying signs of these serious mental health issues. A duty of care exists for physical injuries and so a duty of care with these issues needs to be considered.

We are health professionals. The World Health Organisation’s definition of health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” All these components are not independent of one another. Just as we hope that we are treated as a whole person by others, our management of clients should consider all these factors if we are to be effective in improving HEALTH and not just influencing body shape.

Team Approach

Just as we refer clients to other health professionals for physical injuries and chronic diseases, we can work alongside allied health professionals to be part of the solution, not only for our clients but for our colleagues and ourselves. Fitness professionals are not expected to offer psychological help but we can work as part of this team to offer a holistic approach. In an industry that seems to have become so ‘body shape’ orientated, we may have lost sight of total health. Eating disorders, disordered eating and excessive exercise certainly result in serious negative consequences for physical, mental and social health.


We screen for physical injuries, chronic physical health conditions, medications and recent surgery. We also need to know how to screen for mental health issues, especially eating disorders, which are associated with unhealthy diet and exercise behaviours. Determining the appropriate questions to include and having some understanding of the possible responses is required to determine if there is a risk of a problem developing.


To start a conversation with someone who you may be concerned about can be difficult.

Many fitness professionals may avoid these conversations for the following reasons:

  • They think they may upset the client
  • They do not know how to address this
  • They may not be able to recognise that there is a problem.

Research shows that dieting is the single biggest predictor of an eating disorder developing. Women 18-25, who diet severely are 18 times for likely to develop an eating disorder within 6 months. This alone shows that having this initial conversation sooner rather than later is crucial. A person may deny that there is a problem at first, but showing that you care, with constant appropriate support can mean a turning point for them. There are two key factors for this initial conversation.

  1. Express concern about the person’s health and not their body weight or shape.
  2. Be non-judgmental and be empathetic, considering the impact of the language that is used on the client.


If we are only focused on shape and have unhealthy means of attaining this, we may not be aware of the damage done to our bodies. There are contraindications for certain forms of exercise because of the health risks associated with certain eating disorders. Some of these include osteoporosis, cardiac complications, electrolyte imbalances and hormonal deficiencies as a result of dangerous compensatory behaviours.

Exercise Prescription

The value of physical activity on mental health is well documented. Eating disorders are serious mental health issues. Depending on the medical complications, and physical health consequences, the type, frequency and intensity of exercise programmed needs to consider achieving a balance for optimal health. Rigid regimes are not helpful if they result in an obsessive, compulsive need to exercise in which anxiety is increased.

Diet Recommendation

Certificate III and IV trained personal trainers are not qualified to write meal plans unless they have appropriate nutritional qualifications. Advice given should be based on the Australian Dietary Guidelines.  https://www.nhmrc.gov.au/guidelines-publications/n55

This applies to advice given to any client let alone those at risk of an eating disorder. A registered nutritionist and dietitian are qualified to do this. Providing rigid meal plans may not be helpful for a person suffering from eating disorders or disordered eating as they already base their sense of worth around adhering to their own, often unhealthy, strict rules. There are dietitians and nutritionists who can specifically assist with the nutritional needs of these clients.

Progress Measures

There are so many other improvements for measures of health other than the number on the scale and body composition. To focus on these for a person at risk of an eating disorder may not be helpful as these things are often their only focus already. It may be more helpful to use measures such as:

  • Improvement in strength and flexibility
  • Enjoyment of movement rather than a compulsion to exercise
  • Eating meals with others
  • Eating meals that they have not prepared
  • Decrease in binge episodes
  • Decreased anxiety around diet and exercise behaviours
  • Increased rest
  • Improved mood

REGISTER NOW!  Gain a better understanding of all the above-mentioned points to help to identify and assist people that may be struggling with these issues. The next 4-CEC approved workshop details are:

Venue: Virgin Active, 567 Collins Street, MELBOURNE, VICTORIA

Date: June 25, 2017

Time: 10:30 – 4pm

Register at: www.brazengrowth.com.au/shop

About Our Eating Disorder News and Review Columnist – Eleni Psillakis


Combining over 27-years experience in the fitness industry, education and a lived experience, Eleni Psillakis is raising awareness of eating disorders as serious mental illnesses. In this time as a group fitness instructor, personal trainer, secondary and tertiary educator, she is aware of the fine-line that may be crossed from healthy to unhealthy diet and exercise habits.

Using resistance training to gain weight to her 39kg frame at age 19, Eleni physically recovered and went on to compete in women’s bodybuilding. However the underlying emotional issues and thought patterns resurfaced 25-years later when her marriage broke down and she was diagnosed with clinical depression. Antidepressants and 8-years of psychological counselling, assisted with unlearning of negative thought processes that Eleni had of herself for most of her life. These were nothing to do with body image, but self-worth.

Resistance training again helped the process of stopping her thoughts racing during this time of depression and she stepped back onto the competition stage gaining a top 3 place in her division for each of the 5 competitions since. It was the psychological help that has made the difference this time around.

An Insight to Anorexia and Other Eating Disorders for Fitness Professionals”, a seminar that Eleni has written, has been approved by Fitness Australia for continuing education.

Eleni Logo

Disclaimer: The information published in this column are based on the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.

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