How or should I approach someone who may have a binge eating disorder?

I am a fitness trainer. Some of my clients I only see in the gym and not out and about or socially. When I consider the amount of exercise they do over the amount of time (a year or so) and see that they have either gained or not lost weight, it's obvious there is an eating problem. I am hired to help them get fit. So far, I do what I do for them in the gym. Am I obligated to make someone face their inner demons? How?

Then, there are people in my family and social life that I am NOT hired to train. They haven't asked or presented me with their reality, but again, it's CLEAR there is an over eating problem because when they're with me, the eat tiny portions and IMO outright lie about their food consumption - not that I even asked about it!! So I know there is an amount of shame if they are hiding it.

What should I do? Or more like, if you were approached about binge eating and didn't ask to be, how would you want the nosy person (me) to say or do? I want to be as respectful yet as effective as possible. I love these people.

Wow, ok – this is a tough one. For me, I was VERY much in denial about what I was doing. I would binge about 3x a week and during the day (at work) I ate fruit and salads. I started to gain and gain. And did you know that I still didn’t understand why?? I even went to the doctor and got every blood test known to man to help me understand WHY I was gaining weight. Seriously, I was that much in denial. So if someone approached me back then and asked me flat out or in a round about way if I was a binger I’d lie. It’s bad enough being called out about gaining weight but then to add an eating disorder on top of it?!? So I would admit to gaining weight (can’t hide that fact!) but I’d tell you that I have some other disorder such as hypothyroidism and the medication I was taking wasn’t working.

So unless you catch this person in the act you probably wouldn’t get a straight answer out of them. At least, not until THEY admit they have a problem. But if someone comes to you and asks why they aren’t losing weight then start to ask probing questions about what they eat when they are alone and not accountable. Ask if they have been tested for any medical conditions – because it’s very possible it IS a medical issue, not an eating disorder.

Bottom line, it’s so difficult to confront those that binge. Just as difficult to confront a person who doesn’t drink Monday through Friday but goes on a drinking binge “only” on the weekends. We perceive ourselves as functional. We tell ourselves that we eat healthy between binges so what’s the big deal? And we aren’t hurting anyone, right? We live our lives through denials and excuses and we’ll dole them out when confronted.

Binging is different for a lot of us. So when I used the words “we” and “ourselves” above, please understand that it’s pure conjecture based on my own experience.

Whether or not these people in your life know it, they have a wonderful friend in you. It's great how much you care!

I don't think as a trainer you are obligated to make them change their eating habits. You are there to show them how to work out properly and give them a good workout. If they ask for more by all means help them!

When I had my first trainer I BARELY lost any weight- I was going through a hard time- I lost my job- I was depressed- but I faithfully went through all my training sessions. And while my body did look better I can say I probably lost like 10-15 lbs that year training with her- not much when I was 235 lbs.

NOW that I don't have her I've lost at least 30 more lbs but what I took away from her was the proper way to work out (like lifting weights, getting my heart rate up, etc, and not injuring myself).

If I was frustrated and wanted weight loss advice I'd definitely ask her. So just from my experience I'd say unless a client tells you they are unhappy with their results, I wouldn't do anything but continue to give them a good workout and help them improve their strength training or whatever else you show them. Then if they ask the first thing I'd say is "bring me a food journal with everything you eat, starting from today to the next time I see you, we can go over it and see what's wrong, make sure you write everything down, I can't help you if you aren't 100% honest."

I won't lie- if my trainer started questioning my eating back then I'd have just gotten embarassed and probably MORE depressed.

Then if the person is binging and all these things, suggest slow changes, don't overwhelm them with a super strict plan because they may give up. Teaching them small things like "hey let's cut out all soda this week and see what happens" then the next week say "add some more veggies to dinner, don't eat after 8 pm, etc" will help them out because most of the time it's hard to go cold turkey from binging.

For those that you train - I would just ask if they want help evaluating their eating habits to achieve better fitness results (but I would probably ask all of your clients that, not just ones you suspect have a problem). Then you can have them keep eating logs, ask them about binging, etc. If they say no thanks, then you should MYOB.

For friends and family, those that you aren't paid to help with their fitness, you really should MYOB unless they ask for help or give you some indication that they're open to hearing your advice/opinions. I can't see any circumstances under which confronting someone about binge eating, even in a gentle, kind, concerned manner, would turn out well or be at all helpful.

I would never approach anyone regarding binge eating if they did not ask for my help. I am a former binge eater, but not every overweight person is.

I agree with this 100%. Also i would add that not all binge eaters are overweight either.

If you are hired to help someone get fit and they are improving their fitness capacity (ie strength, cardio, etc) then you have done your job. If they ask you about eating, then counsel them about nutrition, but remember that not all people with a weight problem have binge eating disorders, which is a specific psychiatric diagnosis. Many people with weight problems have them as a consequence of living in an obesegenic environment. Some people with binge eating disorders also purge so may appear to be a "normal" weight or even be underweight. Even if someone you are training has a binge eating disorder, no you are not the right person to help them "face their demons". But if they ask, you could recommend they see a professional counselor who specializes in BED.

As for your family members, you cannot change them. It's probably best to mind your own business unless or until they ask. Especially if you are convinced they are lying. Maybe they are, maybe they aren't---but I cannot see how such a conversation would be productive unless you are very, very close, and he or she is ready to change.

If your clients don't open the door, I wouldn't approach it. I've struggled with binge eating and if someone approached me about it I have probably lost it.

I'll also agree with those who said there are overweight people who exercise and don't binge eat - and there are people with binge eating disorder who aren't overweight. It's hard (maybe impossible) to judge just by seeing the person's physical appearance and I wouldn't want to risk getting it wrong and really upsetting someone!

Seems to be some different opinions here, but I agree with the point eclipse was making regarding those you train. I'd tell all your clients that your primary purpose is to help them become more physically fit, but that if weight loss is also part of their goals, you'll be happy to help them with occassional weigh-ins to track their progress. If you see that weight loss isn't occurring despite work-outs, encourage them to start keeping a food log, one that they can share with you for advice if they feel comfortable.

However, if you get to the point that they're lying about what they eat (either verbally or in a food log) I'm not sure there's much you can do for a binger in denial until they realize their problem and want to receive help for the problem. This was the case I was in when I had a trainer for a few months about two years ago..I was becoming quite physically active but not losing weight due to binging - I was not ready to admit my food problems yet, but I did feel that my trainer approached the situation in a way that was appropriate.

In terms of the friends and family, I agree that it's something best left alone unless someone asks for your help. If they're not ready to ask for help, they're likely not going to respond well with someone else trying to intervene, especially because that could involve making incorrect assumptions. Best of luck!

I'd be careful with this. Honestly, professionally, it's not part of your job to deal with that end of it. Unless you are also trained as a therapist or eating disorder specialist I think it's not in your job description.

There is quite a difference between those who overeat frequently and those who suffer from binge eating disorder, and I don't think you can easily tell which behaviors these people are engaging in -- at least, not based on the limited interaction you've described. The problem is compounded by the secrecy & shame that customarily surrounds true bingeing behavior.

Your job is mostly training and educating. While I don't doubt that being a really good trainer involves having psychological insight into a client & teaching them to overcome mental limitations they set for themselves, the kind of counseling & therapy sessions that I, personally, required to help me cope with my eating disorder could only have been provided by a mental health professional.

What I'm saying is you're probably better equipped to deal with ignorance than with personal unhappiness or anxiety or obsessive-compulsive behaviors, which often are what lie at the root of many people's tortured relationship with food.

If your clients just don't know (or aren't used to tracking) about calories, food groups, all the nutrition stuff that so many of us on 3FC know & are constantly learning about -- & which knowledge we often take for granted -- then you can be a great help to them. That's what you have to find out first, I think: Their level of knowledge. Offering them a "fact of the day" or "tip of the day" about food, just offhand, in a nonjudgmental way, may get them thinking about what they're eating.

If they have the knowledge, but aren't able to act on it, then we've entered new territory, in which coaching, advice & etc. only can help if they're receptive.

Really, though, I'd try swapping facts & maybe giving a little fun pop quiz or test. You might be surprised how little some of them know. I'm constantly taken aback by this, because as I said, it's pretty much the air we breathe around here. My mother's not dumb, but she has never thought about her intake of grain or noticed till it came up during my recent visit with her, when she asked me some nutrition-related questions. She's eating eight to nine servings of bread & pasta a day, but never really **saw** that before.

And there's a major difference between my mother's behavior with food & mine as it was during the blackest depths of my eating disorder, which would be waking up at 4 a.m. & creeping downstairs & pouring cereal straight out of the box into my mouth, then eating molasses out of the jar with a spoon -- and then going out & exercising for an hour straight. ETA: And my mother probably weighs over 260 pounds at 5'2", but at the time I was doing what I described, I weighed 114 pounds at 5'3". So who between us would have looked like she had it all under control?

I think if you have any suspicions about your clients, then I would suggest directing them towards someone qualified and then end it at that. Same with a family member although even that I would hesitate.

I struggle with binging now sometimes. And I'm 130lbs. Sometimes you really just can't see it. It's not about the outward appearance at all, as all of us can probably tell you, that's only one small piece of the puzzle.

I'd just remind them once in a while that losing weight is 80% what you eat and 20% exercise. Unless you know they are trying to lose weight or they are asking you for diet advice thier weight shouldnt be your issue.

Thank you times ten!!

Very good point about binge eating disorder VS over eating in general. You can't judge a book by it's cover. Also a great point that psych (although an unofficial minor of mine in college) is NOT my area of expertise and I should leave that to the professionals.

Lastly, excellent suggestion to approach the topic by offering an example of what "normal" portions are. The person could be enlightened without being accused.

I think I know exactly where all of you are coming from, but in the opposite sense. I wrote this before in the featherweight thread - I have many times in my life been questioned if I am anorexic. I feel totally offended. I can see how someone being confronted about their eating habits would be offended in the same way.

I have also had my best friends defend me by saying, "Have you SEEN her eat?? I don't know where she puts it! She puts ice cream on her oatmeal for gosh sake!". So the fact that an obese person can be eating normal without hiding anything could be true, too. However, for all my friends know, I could still be purging. Which I most definitely am not, but for all I know, my obese loved ones could also be binging in secret.

I guess the part that still bothers me is that society continues to neglect to see the real math here. I'm thin because I train 5 times a week and I have always had a healthy eating regimine. Calories in = calories burned. The opposite is, we gain weight because we consume more than we burn. Not because we are on meds or we have a hormone problem. The meds or hormones may make us hungry so we eat more, but unless the meds have 3000+ calories in them, there is no way they cause that much weight gain.

But back to point...I will keep my nosy nose to myself. I thank you all again for your perspective and I wish you well.

as someone who struggles with binge eating I can only advise that the person who you are supporting will speak to you when they are ready. I have binged for the last 25 years but it is only recently that I have been able to speak about my problems. binging has never seemed like a disorder to me it has always seemed something shameful that normal people dont do. I have not binged for the past 104 days and this is because I have visited this site and found forums that have understood my behaviour. binging is a very secretive way to stem your emotions and it is not noticable to other people like anorexia or other eating disorders. I have recently spoken to close family and friends about my problems and have been relieved that they are not disgusted and only want to help me get better. Binging for me is a lot about my state of mind and the only thing that could have helped me is someone who would be non judgemental and recognise that the food is masking a lot of hurt and emotional pain.
It is nice that you want you want to help someone that is obviously struggling. keep at it