As a healthcare professional, regardless of your area of expertise, you have likely encountered a patient or client with an eating disorder. Whether you treat them yourself, or refer out, it is important to be able to recognize the signs of an eating disorder. And to approach the conversation in a beneficial way. It is not just eating disorder specialized providers that see clients with eating disorders. And even if working with eating disorder clients is not your jam, the first conversation you have with them could be one that gets them started on their path to recovery. In this blog, we will cover what to say to and what to do with a client with an eating disorder as a provider at various points in their recovery journey.
Situation 1: You Suspect a Client May Have an Eating Disorder
“I’m not specialized in eating disorders, but I think my patient/client might have one. What should I say?”
If you have been in a place where you suspect a client might have an eating disorder, and they are not aware of the issue, you know it is a tricky spot to be in. On one hand, you want to get your client help. And on the other hand, you don’t want to rock the boat and might be worried about saying the wrong thing. Both are valid.
The best way to approach this is with curiosity. Ask questions and utilize screening tools to gather more information. You can find screening questions and screening guides for various professions in our previous blogs here (therapist), here (physician) and here (dietitian).
Be prepared for your client to resist, deny and push back. Using “I” statements to express your concerns for your client will go further than using “you” statements. Eating disorders are not our client’s fault. And they did not choose this. They might not be ready to hear the word “eating disorder” right off the bat either. You can use your own judgment with your client when choosing how to express concern. But what we want to be sure to avoid is labeling or judgemental language. Terms like “anorexic”, “bulimic”, “overweight” and “obese”, amongst others, are not helpful to use.
Situation 2: Your Client Tells you They Have an Eating Disorder
“My client confided in me about their disordered eating patterns. I want to help them, but this is not my area of expertise. What should I say?”
If your client chose you to confide in about their disordered eating habits, this says a lot about the relationship and rapport you have with your client. And this can go a long way. If a client opens up to you about their eating disorder, you can start by thanking them for trusting you with that information. Recognize their bravery and vulnerability in sharing something that is probably really scary for them. Validate their experience. Truly listen and let them know that you believe them. And are here to support them.
Saying things like “let’s do ___ together” or “I’m here for you and I’m not going anywhere” can be super impactful. Opening up about disordered eating can be exhausting, and really overwhelming. Having a trusted provider to navigate it with them can make it feel even a little bit easier.It’s okay to not have all the answers yourself. This is when having a list of trusted eating disorder specialized dietitians, therapists and doctors can be helpful.
Situation 3: You’re New To Treating Eating Disorders
“I’m new to the field of eating disorders, and I’m worried about saying the wrong thing to my clients. I’m worried that what I say will not actually help them”
Whether you are new to working in the field of eating disorders, or have been in it for decades. So many professionals are worried about saying the wrong thing. Or not getting through to their clients. As helping professionals, we often feel that it is our job to “fix” things. And this pressure can get in the way of some really meaningful, powerful work. You are a human; you will say things wrong. And you will not get through to everyone. But switching from a mindset of trying to fix things to trying to understand your client can make a world of difference.
Start by validating what your client is saying. And remember, validating their experience is not the same thing as agreeing with them. Oftentimes, clients just want to feel heard. And might not be looking for a “fix” right away. While eating disorder treatment does involve behavior change, a client is a lot more likely to engage in behavior change when they feel heard, understood and supported, rather than forced.
Ask them questions to better understand their point of view and where they’re coming from. And reflect back what they said to you. This gives them a chance to tell you you got it right, or correct you and share what they are actually feeling. If giving a suggestion or advice feels appropriate, ask your client before doing so.
Final Thoughts on What to Do With a Client With an Eating Disorder
Treating patients/clients with eating disorders is not a one person job. It is best done as a collaborative team involving a medical doctor, therapist, psychiatrist and dietitian. Each member of the treatment team has their own role and their own unique way of supporting a client in their recovery journey. Whether you are the first person to detect your client’s eating disorder, or brought in as a member of the treatment team later on. Whether eating disorders are your specialty, or you just want to be more aware and knowledgeable, your role is important. Your conversation with your client could be the one that leads them to the path of recovery.
Contact Us
Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.
Contact us for more information. And to schedule a discovery call. Also, sign up for our client or clinician newsletter!
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Kathryn is a weight-inclusive, anti-diet eating disorder dietitian at Courage to Nourish. She specializes in working with adolescents and families, athletes, and individuals recovering from ARFID. Kathryn sees clients in person at the Columbia, Maryland office and virtually throughout Virginia, Pennsylvania, DC, and Maryland. To schedule a discovery call with Kathryn, click here.
