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?