Can you take on clients with a history of eating disorders?

Ensuring the safety and wellbeing of your clients is paramount, and this article is meant to provide you with some guidance on this matter.

Nutrition professionals, including insured graduates of the Advanced Clinical Weight Loss Practitioner certification, CAN take on clients who have a history of eating disorders, as long as you explain:

• what your support includes (e.g., exploring hunger/fullness cues, addressing healthy weight goals, completing client assessments, devising personalised dietary strategies, helping to develop long-term healthy eating behaviours that support weight management, tracking behavioural change and health outcomes like changes in body composition, sleep, etc.)
• what your support does not include (e.g., medical/psychological advice, treatment for eating disorders, which can only be done by qualified healthcare professionals)

Considering the sensitive nature of working with clients who have a history of eating disorders, it's important to approach their weight loss journey with utmost care. Here are some ideas to help you navigate this situation effectively:

Initial Assessment:

When engaging with a client who has a history of eating disorders, it's crucial to conduct a thorough initial assessment. This should include gathering information about their current physical and mental well-being, their support system, and any existing medical or psychological supervision they may have.

You can start by performing a risk assessment about your client’s relationship with food using the Food Relationship Questionnaire.

• If your client ranks on the moderate- to high-risk side, ask if they have had any medical or specialist follow ups on the matter in the past few years, or if they are contemplating specialised support.
• If your client’s risk is low, but during your program with them you spot red flags, such as irrational thinking about food or obsessive thinking about their weight, subtly mention your concerns and ask if they are prepared to contemplate specialist support.

Remember, it’s your duty to refer (i.e., to suggest medical or specialist guidance), but you cannot force any client to actually see a healthcare professional. If at any time you feel out of depth, feel free to step out and highlight that specialist support is needed.

If the client is no longer under regular monitoring by a healthcare professional, it is advisable to encourage them to consult with their GP or medical professional for a general check-up. This will ensure that the client receives comprehensive care and that their weight loss goals align with their overall health needs.

Careful Communication:

During your sessions with the client, it's important to maintain open and honest communication. Create a safe and non-judgmental environment where the client feels comfortable discussing their concerns, triggers, and limitations. Encourage the client to share any discomfort or distress they might experience during the weight loss process, and brainstorm solutions they feel more comfortable with.

It may also help to understand that most eating is disorderly. It’s just part of being human. Disordered eating can be very low (such as food restriction on a Monday after a weekend of indulgence), or it can be extreme (like a diagnosable eating disorder). This useful article helps with the distinction and certain red flags to watch out for.

Tailored Approach:

As you design a personalised weight loss plan that takes into account the client's history of eating disorders, focus on promoting a healthy relationship with food and body image rather than solely emphasising weight loss. Incorporate balanced nutrition with lots of food options to choose from and flexibility, avoid restrictive dietary tracking like calorie counting for each meal, and highlight that promoting fullness and avoiding extreme hunger pangs in central to your program.

Ask your client about their past triggers and overly restrictive behaviours so you can be mindful of them, discuss them openly, and work around them collaboratively.

For example, if a trigger of extreme restriction was seeing their weight number on the scales, ask how they feel about regular weigh-ins, or if they prefer something different, like taking circumference measurements of waist, arms, and legs every so often. Or if they choose using the scales during the program, suggest limiting the weigh-ins to every 2 weeks or once a month, rather than daily. Those conversations can be valuable so you can tailor your approach.

Continuous Monitoring:

Regularly monitor the client's progress and wellbeing throughout their weight loss journey. Pay attention to any signs of relapse or negative psychological impact. If necessary, be prepared to adjust the program or refer them to specialised professionals who can provide additional support.

Referral Options:

In cases where you feel that the client's needs exceed your scope of practice or expertise, it is important to refer them to specialised practitioners or therapists who can offer targeted assistance. This ensures that they receive the best possible care tailored to their unique circumstances.

Updated on: 14/10/2026