March 23, 2023
I committed the cardinal sin on social media this week.
I shared a piece of content, an article, without reading it first.
It was an article from the Guardian entitled: “Unregulated ‘eating disorder coaches’ putting people at risk, say experts.”
I saw that Priya Tew had shared it on Instagram and thought “yes! I agree with this title! We want properly qualified people working in this field!” And hit share to my Instagram stories.
What followed was a slew of messages from clients. All extremely perturbed by the article and its contents, saying that reading it was making them question their way of working and made them feel shame about their business set up.
Absolutely not what I wanted to hear.
So I read the article. And what was inside was not 100% helpful.
Let me explain.
But before I do, a couple of things:
I normally am a big Guardian fan. I listen to their daily news podcast and trust them and their standards of journalism. They break some big stories, really do their research and lead the way on some major global stories that are crucial to break and bring to the public’s attention.
They previously published this long-form article www.theguardian.com/ife-coaching-brooke-castillo-unregulated-industry about the dangers of the life coaching industry, highlighting in particular the work of Brooke Castillo at The Life Coach School which I thought was a fantastic piece of journalism. Therefore, I didn’t for one minute think this piece would be a problem.
Secondly, I am 100% in support of the general premise of the piece, which is that people working in the eating disorder space, or to be quite honest any space in the wellness industry, should be properly qualified.
When it comes to people’s health which can literally be life and death (and particularly with something as serious as eating disorders), practitioners need to stay within their ‘scope of practice’.
This is something I can see is drummed into everyone who is properly trained and qualifies out of reputable establishments. It’s taught to them for literally years – stick to what you are qualified in. Stay. In. That. Scope. Those with the right qualifications are usually terrified to leave it.
However, I want to get into the three major issues with the piece and why I am extremely concerned that what it will do is mean there are less brilliantly qualified practitioners helping people with eating disorders, not more.
Let’s take the major premise of the piece first: the insinuation that “so called eating disorder coaches” do not have the “necessary qualifications” to help people.
I think we are all agreed it’s not a cheap or free course you found online and did over a weekend.
But you can study eating disorders for literally a lifetime. There are courses, diplomas, degrees, masters and PhDs you can get in this area. As with any area of health.
When is the point when you are allowed to help people? Who dictates this?
The point of the article of course is that this area is currently unregulated, so technically no-one oversees the answer to that, as it stands.
Like anything with health and science, eating disorders are a constantly evolving field. Things are changing, things are being learned, new practices and ways of helping people are introduced.
Some people believe in X route, others believe Y is the answer. Many practitioners I see blend different skills, modalities and tools together to help their clients achieve results.
My issue here really is that people that are qualified, that have done the years, that do have the training, and that care deeply about how well they are trained, do their CPD, get supervision and strive endlessly to help their clients change their life, will read this article and believe this is a sign they need to go back to school. That they already had that little imposter syndrome voice in the back of their mind and this just makes it shout more loudly. I’ve seen this in my inbox already. So I know it’s happening.
This article will make these brilliant practitioners want to train more. To learn more. To study more. And to stop helping people. Because they are somehow ‘not enough.’ Not enough in someone else’s eyes. Someone out there believes they are not qualified.
I see this time and time again in this industry. That there is a fine line between having the ‘necessary qualifications’ and literally never helping a single soul because all you think and believe is that you need to keep doing more study, so you stay in academia your entire life.
I wrote this blog post on why-no-one-cares-what-qualifications-you-have if you want to read.
There will always be people who are charlatans and imposters. That literally don’t care a single jot whether they get their clients results or have ‘necessary qualifications’ if they can see there’s a bandwagon to jump on and money to be made.
But I will not stand by and let people who are genuinely capable of helping people with the training and knowledge they have, be derailed by an article that makes them feel inferior and like they should pack up shop.
A small note before I move on about the specific dig about qualifications: the article states that “so-called eating disorder coaches… tend to be personal trainers or dietitians recovering from the illness themselves.”
Personal trainers who have had absolutely no training in nutrition and dietetics should not be promising to heal people with eating disorders.
There is a long-standing argument (which I am not getting into here!) that PTs should never be giving out meal plans and food/eating advice because they are not qualified in this area. However some Personal Trainers actually are qualified to add this to their skill-set and have done the study. They’ve combined qualifications and done the work. Again though, who determines what is ‘enough’ or ‘necessary’ is subjective currently in the unregulated market.
The dietitians inclusion is slightly more perplexing. It takes 4-8 years to become a dietitian and you need at least an undergraduate degree to use the title, and you’re regulated by the Health & Care Professions Council (HCPC). Is that not enough?
I appreciate not all of that study would be eating disorder focused. But how much more training is one required to do before you can help someone…? My worry is it will just put well qualified dietitians in a spin and send them back to school rather than helping people in the here and now.
And then there’s the “recovering from the illness themselves” part. Many, many health and wellness practitioners do their work because they had a personal journey with the condition they help their clients with themselves. They then went to study it so they could help others and be the support they wish they had. That doesn’t make them bad people. That means often that they really ‘get’ their clients and the struggles they have and can help in a better way.
Anyway. Onwards to the next major issue with this article:
The article states:
“So-called eating disorder coaches…are charging as much as £1,000 a month for sessions…”
Money is a massive topic. Pricing is a massive topic. But this statement, and a later one in the article that states “the cost for help can range from hundreds to thousands of pounds” is a huge judgement.
Let’s get honest here. It costs to access services like this to help with eating disorders.
And yes, the NHS (as this is a UK article) is under ridiculous pressure right now. The piece is framed very much in that landscape that the public health system cannot support the people that need help right now, therefore that’s why these unregulated coaches have popped up. The system is completely broken, I think we can all see that.
But if you don’t like the price, you don’t have to pay.
None of my clients force anyone to hand over money. I don’t advocate slimy pushy practices or taking credit cards on the phone or forcing people into contracts they can’t back out of (which is entirely illegal of course).
There are plenty of options out there at different price points. If you think the only way to get help with your eating disorder (or anything with your health) is to pay “£1,000 a month for sessions” then keep looking. There will be someone else out there for you.
But please, please, don’t let’s shame the practitioners who work hard to excel at their work and do offer amazing transformational services, that charge their worth. And yes, that is allowed to be £1,000 a month, or more, if that’s what they deem is the required investment.
In order to reach those prices I literally sit with practitioners and work out how many hours of work they pour into each client and a price point that is going to suit them and reflect what goes in.
It’s not just ‘a session’, ever. It’s the calls in between, the support on email or voice notes or messages, the letter writing to GPs and schools and workplaces, the meal diaries they check and feedback on, the resources they create, the test result they analyse, the preparation and note taking they do for them. All aside from their continuing professional development. It’s a lot.
I have huge issue with anyone putting shade on well qualified practitioners charging their damn worth so that they can create a sustainable business and life for themselves. I work so. freaking. hard to help these amazing people see their value and put a price tag on their work that represents the change they can create and will earn them a decent living.
Most people I work with, largely women or those brought up as female, tell me they want to be ‘self-sufficient.’ To earn and pay their way themselves. To not rely on partners and husbands. They’ve got themselves qualified and now they want to give back and earn back.
That’s simply impossible if they try and take on hundreds of clients and only charge them £40-50 a time. They will be left broken. Their clients will not get the best from them. And then no-one will benefit from their amazing wisdom.
In addition, please let’s also not shame those that willingly and happily will invest in their health and in the case of ED their recovery, to the tune of hundreds or thousands. If that is what they want to do with their money, if they believe and trust in the practitioner, then they are free to do that. It’s how capitalism works.
My final issue is closely tied to the topic of price and that is that the article states “…many clients [are] expected to sign up for a minimum two-month period.”
Yes. Yes they are expected to sign up for a minimum time.
We should not be making this an issue.
If we are talking about eating disorders, do you really think it can be fixed in less than two months? I don’t think even the layman on the street who had absolutely no knowledge of eating disorders would say there was a magic fix that would ‘cure’ someone in less than 60 days.
To be quite frank I’ve worked with enough health practitioners over the last few years to know that any area of health and wellbeing requires ongoing, sustained support. That in setting minimum terms we are quite deliberately trying to stop people believing there is a ‘quick fix’ to their problem. That getting the proper help and advice they need to get to the root of the symptom, ailment or issue, involves working with a professional over weeks, months and yes (particularly with ED) years to get results.
It’s effectively saying “the best way I can help with your ED [or insert any other health problem in here e.g. fertility, thyroid, sore back, weak pelvic floor etc etc] is if we work together over X amount of time and see each other X times, we can’t fix this overnight.”
Asking clients to sign up for a minimum period is sending out the signals that this will take time and requires a commitment from both parties to get the desired outcome.
That if there is an issue but the practitioner just says “book back in whenever you think” that the client has absolutely no idea when they should come again or what will help.
So what do they do? They’ll go for the cheapest and easiest option. They won’t come again or they’ll leave it weeks or months. And guess what? Nothing changes.
Someone wanting to solve their health problem is waiting for the practitioner to tell them what they need. And if the practitioner genuinely believes the way to help them is to work with them over e.g. 6 months and have a session with them every week, because they’ve got years of experience that say that’s what works, then that’s what they should be recommending. Because we are in the business of getting people results. Not taking money off people for sessions whenever they fancy that won’t get the change they want.
It creates recurring revenue and it gives them a stable set of clients they work with in a deeper and more meaningful way. Rather than worrying and wondering if and when the client will show up again and how they’re getting on.
This shouldn’t be something we cast shame over. It’s the way that health practitioners can reach a point where they feel genuinely fulfilled and well compensated for their work. Rather than wondering where the next client is coming from, whether they’re getting any results and chasing people up for money. Leaving them exhausted and resentful and likely to drop out of the profession completely.
Again, I always advocate this is done legally and transparently with a good contract and an honest and clear discovery call conversation first before starting on a longer-term programme with anyone. But in order for everyone to benefit, the client looking for help and the practitioner living and working in a way that feels rewarding, asking clients to “sign up for a minimum period” is something we should be advocating, not complaining about.
I’ve ranted on for long enough now. I am so passionate about this and do not want this article to de-rail a single amazing wellness practitioner, in the Eating Disorder field or any other, from showing up, working with clients, charging their worth and creating programmes that truly serve the people they help.
I want well qualified professionals to thrive and do their work. Not feel ashamed or embarrassed about the study they’ve done, the prices they charge and the frameworks in which they help their clients.
I would love to know what you think.