I have a new client that I just signed. She was referred to me via email and we agreed to meet face to face for the fitness assessment and the health history. She is very nice but she is 5’1 and weights 80 pounds. She is very thin and frail looking. She wants to do a lot of cardio and I do not feel that is the best way to go. I am open to any advise please. This is my first run in with this type of client and I still want to meet her needs but monitor her health safely.
This is a very difficult situation. Did she indicate anorexia on her health history? I do not question your assessment, because the combination of the frailty and the desire for lots of cardio certainly meets the profile, but it is always important not to step out of scope of practice. Also, if she admits to it the conversation you can have with her can be framed a bit differently. The problem, of course, is that if she has an eating disorder she may be likely not to open to you about it, and may prefer to seek a trainer who will not question her. I know you want to “meet her needs”, but for an anorexic the needs and the desires are at odds. Sometimes deadly odds.
When you go over her health history with her you might ask her about her current weight and goals. Ask why she wants to do so much cardio. If you are going to work with her it would be in your best interests to ask for a form from her doctor asking for guidance in training her, in addition to a health history and waiver. You can frame it that for clients who are more than a certain percentage outside of a certain bmi or weight range in either direction your policy is to get a note from the physician, just to make sure you are not doing any harm, and are serving her in the best manner possible, and you want to see, among other things, if she has had a bone scan, as bone density can be lower in women who are very slim, and you do not want to give her high impact work, or anything that might affect her bones.
The fact is, if she is anorexic she might decide not to train with you if you insist on this, but do you want to risk her collapsing while you are training her? Not just the bad karma for your business, and the legal liability, but is it in her best interests to feed her compulsion to exercise?
you are dealing with an extremely difficult situation here and should not train with her without a physician’s consent. There are so many layers to this often deadly disease, and I would strongly suggest that you only train her as part of a health care continuum.
On the assumption that she has acknowledged to you that she has been anorexic, she may consider herself cured, yet her stated desire that she wants to do a lot of cardio makes me suspicious that she has only shifted her body distortion from one form of anorexia to another. As Ariadne says, you are also very likely to deal with somebody who has osteoporosis no matter what her age may be.
I know you want to help but do not forget that you are dealing with a mental illness which has the highest death rate of any mental illness. I am sure you have already done some research, and here is another article for you to study http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-bo…. You would be taking on an enormous responsibility if you tried to deal with this by yourself.
Hi Kimberly, The above have all gave you very good information. Eating disorders are often the side effects from other psychological factors in a persons life. As a trainer, you will not be able to help this fact. Therefore, your success rate in assisting with her with her fit goals may not be what you expect. Your empathy for this woman is admirable. I have dealt with this same issue a few times in my career. Prepare yourself for the outcome. In my case it was not very nice. There a number of ways mentioned above to avoid training her. Or, you may think you can help her. This is your decision. But, just know that either way the outcome may not be promising for her. I just thought you should prepare yourself. This issue may come up again in your career. Good Luck. Brian Rozzi.