What is an eating disorder coach


Three years ago, Abigail O’Laughlin sat in the parking lot of a Chick-fil-A in Destin, Fla., Heart pounding. She was meeting with her eating disorder recovery coach and they were planning to eat one of the foods she feared the most.

A chicken sandwich may not seem like a big deal to some, but two of the hallmarks of anorexia are the creation of rigid food rules and restriction of food groups. O’Laughlin had loved the meal as a child, but hadn’t allowed herself to eat it in years, not since being diagnosed with an eating disorder at age 14. Her trainer, Sarah Lee, a warm and upbeat woman with a Texan twang, sympathizes – she had recovered from bulimia more than a decade ago.

As the couple ordered, O’Laughlin’s anxiety increased, but Lee depressed her and they ate together, doing mindfulness exercises between bites. Slowly, O’Laughlin’s panic began to subside and an unfamiliar feeling arose: confidence. She did, eating what she wanted. “It was a big milestone for me,” says O’Laughlin. “The feeling of freedom didn’t come immediately, but it was as if the chains were starting to come off.”


Therapists and dieticians don’t have time to go to a gym or restaurant with their clients. But these are things that are necessary for recovery.

Coaches like Sarah Lee are a new and rapidly growing phenomenon in the treatment of eating disorders. These mental illnesses are notoriously difficult to cure: the underlying psychological issues develop over time and take time to resolve. Denial and secrecy are common, and people who suffer from them cannot just turn their backs on food. (Imagine an alcoholic needing to drink moderately three times a day while recovering.)

Relapse rates, depending on how they’re defined, can range between 9% and 52%, according to a 2017 review of 27 studies published in the Journal of Eating Disorders. These disorders also have some of the highest death rates of any mental illness – a 2011 meta-analysis of 36 studies published in the Archives of General Psychiatry found the rate to be around 5% in people with mental illness. ‘anorexia. “Eating disorders often take a lot of treatments for someone to recover,” says Ilene Fishman, therapist, clinical advisor and board member for the National Eating Disorders Association. “It is expensive and difficult for people to access the care they need, both in quantity and in quality.

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Step into coaching, which aims to bridge the gap between doctors, therapists and dietitians and a client’s friends and family, who may be overworked or unsure of how to help. In May 2017, pioneer in the field, Carolyn Costin, co-author of the flagship book 8 Keys to Recovery From an Eating Disorder and founder of the first residential treatment center, Monte Nido, in Malibu, Calif., Established a rigorous certification. of eating disorders coaching. program. The course, which can last up to a year and a half, trains coaches to work with people with clinical eating disorders. To date, there are 62 certified coaches around the world, from New York to Melbourne, and 49 more currently in training. About 97 percent of the coaches in the program have recovered from their own eating disorders.

When Costin, a therapist, first founded the program, other therapists hesitated, fearing the coaches would interfere with their jobs without proper training and supervision. But Costin emphasizes that coaches don’t replace therapists but work in tandem with them, focusing on developing life skills rather than exploring past issues. “The coaches are in the trenches with the clients,” she says. “Therapists and dietitians don’t have time to go to the gym or to a restaurant with their clients. But these are things that are necessary for recovery. “

Eating disorder coaches, like sober coaches, will often make themselves widely available, answering texts and calls around the clock. O’Laughlin’s trainer, Sarah Lee, helps her customers shop, prepare meals and organize kitchen cabinets, and joins them on family meals and on shopping trips. clothes. She also guides them through the visualizations and has persuaded some of them to take the scales apart and cut out the tape measures that they use to assess their bodies.

Other coaches, such as Thousand Oaks, Calif.-based Lori Lee (no relationship) run virtual and in-person coaching sessions, and will even stay with clients for weeks or months at a time, often afterward. treatment in a hospital setting. “Recovering from an eating disorder is like trying to get out of a dust storm – you don’t know where to turn, and things are confusing, difficult and anxiety-provoking,” says Caryn Raba, a New York-based coach who consults nationally and internationally. “Having someone take your hand, act as a guide, and walk you through it can be really important and invaluable.”

Coaching for eating disorder recovery is so new that no study has examined its effectiveness, but research in other areas has discovered the benefits of peer mentoring. In recovery from drug addiction, for example, it can reduce relapses and readmissions, and increase treatment retention, studies show.

One of Raba’s clients, a Californian therapist and fitness instructor, had suffered from anorexia since she was eight years old and underwent expensive therapy for four decades. “Nothing helped. I had never been at war with myself, ”she said. “I could text Caryn while I was cooking. I could call him when I was eating. I was able to trim my habits inch by inch. It was the nuts and bolts of ‘I’m at the grocery store, help … I just want to buy some lettuce, but I know I shouldn’t.’ “

Having someone take your hand, lead you and guide you can be very important and valuable.

However, some professionals still need to get used to the practice. Fishman is concerned that some coaches may not have recovered enough to help or that the treatment will water down. Others worry about the lack of federal oversight. “Theoretically, anyone could say, ‘Now I’m a coach,’ says Rebecca Eyre, eating disorder therapist and CEO of Project HEAL, a nonprofit that helps people with eating disorders. food to access and pay for care. “It worries me, but the certification program helps define it. “

Still, some clients say they’ve gone through years of expensive treatment and relapse, and nothing worked until they had a trainer who could fill in the gaps in their recovery. Other clients who have only experienced mildly dysfunctional eating habits say working with a trainer prevented a more precipitous descent into a full-blown eating disorder. “Having a trainer was the first time I felt like I wasn’t just another patient,” says Caitlin Crawford, a Los Angeles-based singer-songwriter who is recovering from anorexia and bulimia for over four years. “He’s definitely a game changer.”

This article first appears in the August 2021 issue of ELLE magazine.

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