Throughout this blog we have spent time unpacking many of the psychological factors that underscore our struggles with food. Obesity and sustained weight loss are multifaceted problems that require intervention at multiple levels in order to create a true external and internal transformation that lasts.
To truly address these levels during a drastic weight loss transformation it often takes a collaborative team approach from medical professionals. Your personal physician has a role to play, as do nutritionists, personal trainers, and licensed counselors like myself.
In the same way that different types of financial professionals such as accountants, insurance agents, and financial planners all have specialized areas of expertise when it comes to managing your money, each type of health professional has training and skills that help you in your weight loss journey. You wouldn’t ask your banker to file your tax return, or ask your insurance agent to write your will—that wouldn’t make any sense. However, when it comes to drastic weight loss, all too often people do something very similar by treating their personal trainer as their go to for all of these roles of medical professionals in one.
As a licensed therapist one comment that makes me cringe is when I hear a client proudly exclaim that their personal trainer is “practically like a therapist” to them.
A good personal trainer is critical to your success—but there are limits to the help they can provide
Before you start sending me angry emails about how much your personal trainer has helped you during your weight loss journey, I want to make it very clear that I have nothing against personal trainers. Personally, I owe so much of my growth and progress in my own weight loss journey to a handful of incredible trainers that have helped me along the way.
In my counseling practice I refer clients to personal trainers all the time because I think that they play one of the most critical roles in helping people’s journeys. I make a point to collaborate with personal trainers that speak the language of drastic weight loss. Meaning, these trainers are sensitive to the emotional side of a weight loss transformation. They know that for some clients losing weight isn’t purely bliss and liberation. That for many the process is actually terrifying. They also understand that sometimes a lack of eating to the assigned food program is not always an indication of a client’s lack of willpower, or desire to change, but in fact a sign of a deeper seeded emotional relationship with food where food plays the role of a comforter. Sadly, because many trainers haven’t necessarily lived the struggle of being overweight since childhood they simply don’t innately get all this. Not coincidentally the ones that do understand it make a habit out of changing lives because of their sensitivity and compassion that guides their work.
And, yet with all that said, even the most sensitive and empathetic personal trainers are still not therapists.
Personal trainers lack the expertise and training to help you deal with the emotional and psychological aspects of drastic weight loss—just as I lack the training or experience to prescribe an exercise or diet plan for my clients. If I were to do that, it would not only be unethical, it would run the risk of actually causing harm to my clients. When people treat their personal trainers as therapists, it puts them at risk of psychological harm in the same way.
To be clear, I am not accusing personal trainers of deliberately attempting to provide counseling services, and I am also not accusing clients of deliberately putting their personal trainers in awkward situations by asking them for advice about psychological problems. Personal trainers are often the ones on the front lines, so to speak, with clients who are seeking to lose weight (it’s still relatively rare for clients to start with a counselor, MD or nutritionist to pursue weight loss). As a result a very intimate relationship can form over the course of personal training between the client and trainer. This makes plenty of good sense. Weight loss, after all, is a very emotional and life changing process.
Personal trainers might even argue that the degree of intimacy in this relationship correlates to better training success. Afterall, plateaus and stalled progress must be explored, and doing so requires trust and openness between the client and their trainer. However, because each area of our life does not exist in a separate box from all other areas of our life, all too often questions about what is causing a setback in training can lead to confessions of problems in a marriage, work stress, emotional triggers that are causing cliens to over-eat, etc. Because trainers ultimately want what’s best for their clients they’ll attempt to give their clients some advice regarding emotional and psychological struggles that are interfering with their training. Thus, without intending to—and without even realizing it’s happening—the trainer steps into the role of a pseudo therapist.
The consequences for both the trainer and the client are often regrettable. On the trainer’s side, when they start allowing clients to discuss psychological struggles with them, they can quickly find themselves overwhelmed and confused on how to help. Managing a client’s workouts and food plans is enough on it’s own. When trainers feel saddled with also being responsible for pulling client’s out of depressive episodes, or to offer up the right piece of advice in long post-workout talks, the trainer’s capacity for their work soon begins to diminish.
I have heard from countless trainers who share stories of this happening. They feel ill-equipped to handle these situations, but know their client needs help, and as a result they eventually get burnt out on training all together.
For the client in this situation, they put themselves in the dangerous situation of turning their emotional safety over to an untrained individual. This can have serious long-term consequences and drastically reduce their chances of successfully losing weight considering most trainers do not fully understand all of the ways that the psychological aspects of emotional struggles are interacting with their client’s weight loss transformation.
How trainers and therapists can work together
The good news is that when personal trainers understand the psychology of drastic weight loss, it gives them increased capacity for empathy for their clients, yet it also helps draws clear boundaries between where they can help and when they should refer out to a licensed counselor for additional help.
This allows situations like the one I describe above to be easily avoided. Whenever they see the warning signs that their clients might have problems that need to be discussed with a licensed counselor, they can make a referral—just as I would refer a client to a personal trainer to help them with their exercise and nutrition program.
Remember, good trainers acknowledge the psychology begins weight loss and cultivate safety in their relationship with clients so that they feel comfortable opening up, but they are always conscious of where the line is, and are trained to notice warning signs that their client may need more support.
The warning signs personal trainers should look for include:
- Client’s opening up about issues in their marriage, parenting, or work life that is creating stress that interferes with their desire to achieve health related goals.
- History of drastic weight loss, followed by weight regain with very little insight into understanding why this may be occurring.
- Clients who reveal intense feelings of unworthiness, lack of self esteem or self confidence.
- Stalled progress for more than a month in a training program where all other medical conditions have been ruled out.
- Inconsistent workouts: skipping workouts, showing up late, seeming absent minded or in their heads a lot during sessions.
- Reported binge eating/emotional eating/comfort eating.
- A client who shares being “scared” of being thin, and who may begin to sabotage progress as they reach their goal weight.
- Extreme social isolation–in some cases a personal trainer is a client’s only form of social connection. This may indicate a history of depression, anxiety or interpersonal relationship trauma.
- Frequent violations of boundaries–calling or texting frequently in distress or panic.
When trainers see these warning signs, they should refer their client to a therapist. The best way to do this is to normalize it—in other words, let the client know that going through drastic weight loss is a difficult and complicated process, and a normal part of that process is dealing with the psychological aspects of it. Seeing a therapist doesn’t mean that there is anything wrong with them, any more than doing a consultation with a financial planner means that they are incompetent when it comes to managing money. Also, if the trainer has a personal story about how seeing a counselor has helped them, or another one of their clients, sharing that story with their client can be a big help.
Of course, in order to refer clients to a therapist, the personal trainer needs to first find a local therapist that specializes in drastic weight loss and develop a working relationship with that professional. Some of the most incredible transformations I have been apart of have been completed through collaborative work that I have done with other health professionals, including personal trainers. When a client feels they have a team behind them that is working in sync, towards the same goal, it builds confidence and hope. Best of all, it allows all members of the team (trainers, therapists, nutritionists, MD’s, etc.) to stay in their lane and stick to what they are trained to do best.
This sort of collaborative team work is my vision for the future of supporting people through a drastic weight loss transformation.
The Road Map to Weight Loss Program: A Stepping Stone
If you are still unsure about making a referral to therapy for a personal training client The Road Map to Weight Loss Program is an excellent place for a client to start. This program is not therapy, but instead education about what changes to expect during drastic weight loss. It’s also an invitation for clients to begin the necessary self-exploration needed to complete a transformation that will set them up for long-term success. You can read more about how we are helping gyms, weight loss centers and personal trainers grant access to this program for their clients.