Coach HubScope of practice: knowing where to refer
A lifestyle physique coach's scope is real and meaningful: nutrition, training, movement and recovery, weekly check-ins, and support around adherence. But it has edges. Outside them sit medical, psychological, pharmacological and competition work, and those belong to other professionals.
Knowing where to refer is part of the craft. Doctors refer to specialists. Lawyers refer to other firms. A coach who spots an out-of-scope situation, refers without ego and stays in their lane on everything else is a far better coach than one who tries to do it all. Amateur attempts at endocrinology, psychology or contest prep hurt clients, and they put you at real risk too.
Outside your scope
| Situation | Refer to | What you can still do |
|---|---|---|
| Performance-enhancing drugs (steroids, peptides, SARMs, hormones) | A doctor or specialist clinic | Keep coaching training and nutrition. Don't advise on dosing, timing, compounds or cycles, and don't program around their use. |
| Contest prep (peak weeks, water and sodium manipulation, posing, federations) | A competition coach | Lifestyle coaching alongside, if appropriate. You don't run the prep. |
| Signs of disordered eating | A GP first, then a dietitian or psychologist with eating disorder experience | Notice it, name it gently, stay warm and supportive. Don't try to treat it. |
| Medical conditions (diabetes, thyroid disorders, PCOS, heart conditions, IBS, any active or chronic illness) | Their GP or medical team | Coach alongside their medical care, within their team's advice. Never as a substitute. |
| Pregnancy and postpartum | A GP or obstetrician for clearance | No structured deficit without medical clearance |
| Injuries or pain that may need a professional | A physio or doctor | Program around it once cleared |
| Mental health concerns (persistent low mood, severe anxiety, not coping) | A GP or mental health professional | Ease the plan and stay supportive. Don't counsel. |
| Legal, financial, relationship or career advice | Politely decline | Refocus on fitness coaching |
Signs of disordered eating to watch for
This is the most important boundary on the list. Watch for:
- Skipping meals to "save calories," or restricting well beyond the plan
- Compulsive cardio, or punishing training after eating, often far beyond what you prescribed
- Rigid food rules: fear of certain foods, "good" and "bad" food language, panic at any deviation
- Weighing themselves many times a day, or anxiety about the scale beyond normal monitoring
- Constant body checking: pinching skin, repeated mirror checks, "do I look fatter than yesterday?"
- Severe preoccupation with weight or body shape, beyond normal physique focus
- Bingeing (often disclosed late, with shame), purging, or laxative use
- Avoiding meals out or family meals, eating alone, sudden secrecy around food or weight
Remember the rebound client from Module 1, who was skipping meals outside the plan. If you see these patterns, don't pretend you didn't.
Blood tests and health signs: recognise, don't diagnose
Clients will sometimes share blood results, or describe clusters of symptoms: persistent bloating or irregular bowels that don't track food changes, feeling cold all the time, hair thinning, brain fog, fatigue that doesn't match their training. Don't interpret results or name a cause in a check-in. Name the pattern and refer:
"This looks like something worth your GP taking a proper look at. Can you book in and bring these results with you?"
For women, a missing or irregular period during a diet is the biggest red flag: raise calories to maintenance and refer (Module 3.10).
If there's any risk to their safety
If a client says anything suggesting they may harm themselves or aren't safe, don't wait for the next check-in. Respond that day, encourage them to contact emergency services or a crisis line straight away (in Australia, Lifeline on 13 11 14), and urge them to see their GP.
No one to escalate to?
In a team, you'd pass these straight to a senior coach. If you're on your own, the standard is the same: refer to the right professional, ease the plan, stay supportive, and write down what happened. When in doubt, refer. There's never a case where handling a scope-edge situation alone was the right call.
Some lines are always yours to hold
Even when a client asks, you don't:
- Push a deficit faster than is safe for them
- Stack cardio past the ceiling (Module 4)
- Push through weeks of symptoms like poor sleep, low mood, falling performance or crumbling adherence (Module 6)
Those are the moments a coach earns their fee by saying no.