A Blurred Line between Health & Fitness

We normally think of health clubs as symbols of wellness. Similarly, we consider the fitness instructors within those walls as being icons of health. Unfortunately, many fitness professionals are afflicted with eating disorders such as anorexia nervosa (AN) and bulimia.

Literally, anorexia means without appetite. AN is the psychiatric condition that encompasses purposeful starvation, as a means for achieving an unhealthy body weight, based on a distorted body image and low self esteem. The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines AN as “a body weight less than 85% of that expected.” Often the eating disorder is combined with excessive exercise.

Bulimia, also an obsession of body weight, is characterized by preventative measures of gaining weight after binging. These behaviors include vomiting, over-exercising, and taking laxatives. Unlike AN, people with bulimia are often at a healthy weight, but tend to have large weight fluctuations. Some of the symptoms of bulimia include edema, diarrhea, and enamel erosion from vomiting, whereas AN leads to dizziness, muscle wasting, and dry skin among many other symptoms.

Although there are many clinical differences between the two disorders, the possible outcome, death, is the same. According to the National Eating Disorders Association (NEDA), 90-95% of people with AN are females. Although about one percent of the general population has this affliction, the numbers are much higher among athletes.

For some fitness instructors, there may be misperception that there exists pressure from employers to be thin. Club owners need to emphasize that the goal of exercise and proper nutrition is to be healthy and that looking good is a bonus. Looking good. Looking healthy. Not looking as thin as possible. Employees with eating disorders not only misrepresent the mission of a club, but also might cloud practical advice for members. Health clubs should establish a policy of how to address suspected eating disorders among not only employees, but also members. This may include brochures on the topic, outside referrals, and one-on-one in-house counseling.

For employees, the policy may also include whether or not to fire an employee who refuses to seek treatment. One of the difficulties is that only medical professionals are qualified to diagnose these conditions.

Consult a therapist in your area who specializes in eating disorders. This person may provide invaluable advice on how to approach an individual and what the club can do to provide support. Keep in mind that you will be confronting a very fragile psyche.

Club owners may even consider legal counsel to determine what policies would be ethical and would limit liability. In other words, decide which actions would least likely spark a lawsuit. The mere mention of lawsuit may make some people choose to ignore an employee’s eating disorder, but that would actually put the club at an even greater risk. As I mentioned earlier, you need to protect your members from receiving poor advice.

Learning about eating disorders and developing a policy may be a good opportunity for health clubs to offer lectures on the topic and a support group for employees and members. Since anonymity is essential, clubs may choose not to advertise the meetings; rather, offer the support by invitation only.

Personally, I have always maintained very healthy eating and exercise habits, and a positive body image, but I have trouble keeping on weight. Every time I mention my weight challenge to someone, I receive the same reply, “I wish I had that problem.” Then, I counter with my usual response, “It’s just as unhealthy to be underweight as it is to be overweight.” Since I am thin (and at a healthy weight), people tell me that they want to be my size. I tell them that they shouldn’t put energy toward looking like me. They need to work toward being as healthy as possible; looking their best will follow.

As health and fitness professionals, we owe it to our customers to set a good example by avoiding extreme nutrition and exercise behaviors. It’s difficult enough for people to adhere to a moderate exercise volume and to impart some caloric restriction. It’s funny to see how relieved people are when they hear that I am not a vegetarian.

This article takes you through the first step of addressing eating disorders: awareness. The next step is to eliminate denial whether it is you or someone you know who has the condition. Take positive steps, now, toward improving your employees’ health and maintaining the integrity of your club’s mission.

For more information on eating disorders, visit NEDA’s website: www.edap.org.

About the Author

Jeanne “Bean“ Murdock, is the owner Beanfit Health and Fitness Services. She is the host/producer of Celiac Radio and the author of “Ask Bean“, an online column and “Successful Dating at Last! A Workbook for Understanding Each Other“ and “The Every Excuse in the Book Book: How to Benefit from Exercising, by Overcoming Your Excuses.“ Contact Jeanne for more information at 805-226-9893 or through her website at www.beanfit.com.

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These resources are for the purpose of personal trainer growth and development through Continuing Education which advances the knowledge of fitness professionals. This article is written for NFPT Certified Personal Trainers to receive Continuing Education Credit (CEC). Please contact NFPT at 800.729.6378 or [email protected] with questions or for more information.