If you are concerned you may have an Eating Disorder, or developing habits and thoughts that could lead to disordered behaviour, please do not hesitate to ask for help. “Beat” is the UK’s eating disorder charity, and helplines are open 365 days a year from 1pm–9pm during the week, and 5pm–9pm on weekends and bank holidays. “NEDA” is the USA equivalent to “Beat”. The Eating Recovery Center is an international center for eating disorders and mood, anxiety and trauma-related disorders recovery. They have collated these eating disorder resources.
I recently received an interesting question via email, and thought I would reply as an article.
I saw on your website that you do make a point to highlight that you do not necessarily work with people who have been or currently have a diagnosed eating disorder. However, how does this translate within a discipline like bouldering or climbing, where people may not have a clinical diagnosis but the whole weight-strength argument gets thrown up, especially when people want to do body recomp in the form of fat loss? I imagine through the very nature of addressing their nutrition and focus on eating that they may either already come with some disordered tendencies or develop them during the process. How do you as a coach negotiate and intervene in a process that essentially enables a level of orthorexic or disordered behaviour?
“Unordered”, “disordered”, and a “Disorder”
I cannot work with anyone who has an existing Eating Disorder. Clients are screened through my Coaching Profile, and during the initial 70-minute video call, where I can understand if they are better served by clinical dietary and counselling support. This assessment continues throughout the coaching process, and I will always refer out a client if they require specialist support. Any questions about any of this, email@example.com
For the purpose of answering the question, I will delineate between “unordered eating”, “disordered eating”, and an “Eating Disorder”.
The majority of clients fall outside those definitions. These are climbers who simply want to understand climbing nutrition—how much and what to eat to support their climbing sport. They are interested in understanding if and how they can optimize their body composition—improving their ratio of body fat to muscle mass, and how to diet (energy management) without hampering their performance and recovery. Some climbers are eating specific diets (e.g., vegan, vegetarian, low FODMAP, low histamine), and/or come to me with existing long-term health factors (e.g., IBS, PoTS, PCOS). They have already worked with a dietitian, and are now wanting to work with a sports nutritionist specifically experienced with climbers, and climbing sports.
Some clients need help with “unordered eating”. These are climbers who may be avoiding eating carbohydrates or fat because they believe they are inherently fattening or unhealthy. They may also be restricting energy, using fasting, time restricted eating, and take numerous supplements without a clear understanding of their purpose and efficacy. They may have tried numerous diets such as low-carbohydrate, Paleo, or ketogenic diets. These are clients who are actively interested in nutrition, but need educational guidance to understand and apply what is useful in the best context.
Someone with “disordered eating”, may want to work with me as part of their wider support network. These are clients who may have previously (but not always) been through the medical system and worked with a registered dietitian for an “Eating Disorder”. Years later they are now asking for help in supporting themselves physically and mentally for their climbing sport. This often includes helping them gain muscle mass more effectively. They may still have anxiety around certain foods, struggle with eating disciplines, and the view of their changing body composition. They are asking me for help knowing full well I am not a registered dietitian. Almost always they are still working with a psychologist or counsellor, and may be on medications (e.g., antianxiety, SSRIs, SNRIs).
An eating disorder is a serious mental illness characterized by highly distressing attitudes, beliefs and behaviors related to one’s food intake, body shape and weight. Eating disorders have one of the highest mortality rates of all mental illnesses.
I cannot, and do not work with someone who has an existing “Eating Disorder”. An “Eating Disorder” refers to a mental health condition characterized by abnormal eating habits and a preoccupation with food, weight, and body shape. It involves a range of behaviours and attitudes towards food, such as restrictive eating, binge-eating, purging, and excessive exercise, which can have severe physical and psychological consequences.
Disordered eating refers to behaviors and beliefs surrounding food/exercise that can negatively impact an individual’s health – but are often less severe/frequent in nature, without completely impairing their daily functioning . Disordered eating behaviors are typically less rigid, less consuming, and often fluctuate in severity.[2:1]
In my opinion, using my definitions, “unordered eating” and “disordered eating” are education, understanding, and implementation issues, unlike an “Eating Disorder” which is a serious mental health condition.
There is a subtle overlap between what I call “disordered eating” and an “Eating Disorder”, but I believe they can be identified through asking someone to change their typical pattern of eating, and noting their immediate reaction.
For example, if someone gains an understanding of the rationale for eating more dietary fat, and immediately explores eating more fatty foods with little to no hesitation, this is an indication that it is an education, understanding and implementation issue, not that they are struggling with an extensive negative mental and emotional developed framework.
Importantly, since I hold hour video calls with clients every week, there is ample time for discussion, feedback, and identification of whether someone is at risk of an “Eating Disorder”, and would be better served by a specialist.
Signs of disordered eating
These are behaviors that are signs of disordered eating that may lead to an eating disorder.[2:2]
- Skipping meals
- Avoiding certain food groups (e.g., carbohydrates, fats)
- Limiting eating to only certain times of day
- Using exercise as a means of “burning” or “earning” food
- Assigning moral value to food choices (“good” or “bad”)
- Frequently dieting
- Imposing food rules
- Avoiding events involving food
- Feeling anxiety surrounding food choices
- Restricting certain food choices to specific days/times
- Eating large amounts of food at one time
- Being rigid about exercise routines
- Preferring to eat alone
Could someone develop “disordered tendencies” during the coaching process?
… people may not have a clinical diagnosis but the whole weight-strength argument gets thrown up, especially when people want to do body recomp in the form of fat loss? I imagine through the very nature of addressing their nutrition and focus on eating that they may either already come with some disordered tendencies or develop them during the process. …
The short answer is of course it is always possible, but I believe it is very unlikely for someone to develop “disordered tendencies” during the coaching process. They may already come with misaligned health behaviour and nutritional understanding, which I focus on identifying from the start, but they would not develop these during, as it is antithetical to the actual coaching process.
The question is a little ambiguous [further clarification from author will be posted once received], as I am not sure if the emailer is stating that someone’s desire to change their body composition through fat loss, even for the purpose of lowering body weight, is inherently disordered?
It can of course be an indicator, but does not necessitate one.
And that any focus on nutrition and lifestyle practices for the purpose of fat loss (and lowering body weight) is, or may lead to orthorexic or disordered behaviour?
Again it could lead to disordered behaviour, but it is not disordered behaviour in of itself.
For clarity’s sake, here is the definition of orthorexia…
Orthorexia refers to an unhealthy obsession with eating “pure” food. Food considered “pure” or “impure” can vary from person to person. This doesn’t mean that anyone who subscribes to a healthy eating plan or diet is suffering from orthorexia. As with other eating disorders, the eating behaviour involved – “healthy” or “clean” eating in this case – is used to cope with negative thoughts and feelings, or to feel in control. Someone using food in this way might feel extremely anxious or guilty if they eat food they feel is unhealthy. (Beat: What is orthorexia?)
It would be nearly impossible for someone to develop orthorexia as a consequence of my coaching, precisely because the coaching is so focused on removing negative emotions and misunderstanding around food choice. In fact, I actively encourage the consumption of foods that would be seen as “impure”, or even “unhealthy” such sugar. This is a matter of context education, understanding, and implementation.
The purpose of “useful.”
The primary goal of my coaching services, is facilitating freedom. To work together to identify limitations, educate for understanding, explore courses of action, and adjust based on feedback and discussion.
The act of paying closer attention to what you eat: source, quality, composition, macro/micro-nutrient, and energy values, is not disordered behaviour, any more than paying closer attention to your training method, form, sets, repetitions, and intensity is disordered behaviour. Nor is energy management to lower body fat inherently disordered, any more than eating in excess to increase muscle mass is disordered.
Both can become disordered behaviour when used in a context that leads to poor physical, mental, and social health—our interaction and relationships with other people. This is prevented through education, instruction, and monitoring by a professional. In fact this is the key reason someone should work with a nutrition coach, strength coach, and sports coach. This is especially important in the context of fat loss.
The desire to change your body is not disordered behaviour. However, it has to be understood within the boundaries of physical, mental, and social health. What is actually appropriate, physically possible, and the means for change, all have to be rooted in those health contexts, which themselves are informed by the context specific scientific literature.
Climbing is a sport known to have a troubled relationship with body weight, body composition, and dietary practices. As a nutrition coach working with climbers, my first priority is to understand where someone is in their current health, training, and life.
This includes assessing the language they use to describe themselves, and reading between the lines. Gaining an estimation of their current body composition with more or less accuracy (e.g., estimated from circumference measurements, or DEXA assessment). And a number of days food journaling to understand what their current pattern of eating, and food choices are.
From these data, and continued conversations, I can establish what course of action would be most suitable for someone, and whether there is a disconnect between their desires (e.g., their want to get leaner), and athletic health. Quite often someone comes to me wanting to lose body fat, and through the coaching process, they understand this is not only counterproductive for their health, but actually the opposite means of improving their climbing performance.
For all of my clients, eating more and strategic dietary patterning (e.g., protein spread, carbohydrates and energy availability around training windows), results in an improvement in body composition and athletic health. For a small handful of specific clients, we specifically focus on gaining weight, which includes increasing both muscle and body fat.
But for many of my clients we look at what is both healthy and realistic in terms of lowering body fat, and increasing muscle mass. These two outcomes cannot typically be separated. However, it is quite possible and often necessary to focus on increasing someone’s muscle mass without a concurrent lowering of body fat. They may already be in an optimal body fat range, and reducing it would not only provide little benefit, but be futile for performance development. They would be restricting energy and thus lowering available energy for athletic improvements.
How do you as a coach negotiate and intervene in a process that essentially enables a level of orthorexic or disordered behaviour?
The coaching process does not essentially enable a level of disordered behaviour. In fact it does the opposite, it enables someone to be more relaxed around food, eating, and their body composition through education, understanding, and implementation.
If you would like to ask any further questions, or would like more clarification on the coaching process, and if coaching would be suitable for you, firstname.lastname@example.org
Why work with Tom Herbert? ↩︎
Wu, Zeina. (2024). Disordered Eating vs. Eating Disorders. https://www.eatingrecoverycenter.com/blog/disordered-eating-vs-eating-disorders ↩︎ ↩︎ ↩︎