Viewpoint—Fitness centres need to start addressing eating disorder issues

By Dominique Price

A woman is wasting away on the treadmill. She runs on that machine every day for an hour and a half. Her eyes are sunken and every muscle on her emaciated body is exposed.

This woman achieved “fit” and “lean” a long time ago. I suspect that she is over-exercising and under-eating. But I am afraid to approach her, in case I am wrong or in case it isn’t my place to do so.

During the three years I worked as a fitness trainer, anorexia was a taboo subject. Little has changed. A recent survey of several gyms in Centretown showed few measures are in place for dealing with eating disorders amongst members. Only one location surveyed claims to have an explicit, written policy on the issue; none has a definitive stance on approaching visibly anorexic women; and none keep any resources or information on hand, for staff or members.

Several gyms promote Canada’s Food Guide to Healthy Eating, while others offer more personalized dietary advice. But when it comes to eating disorders, employees at these gyms say that the medical issue is simply outside their sphere of expertise. All of the employees interviewed said that they were unaware of any visibly anorexic women or over-exercisers in their gym.

“Maybe it’s a common occurrence, I don’t know. I’ve never come across it,” one manager said.

Let’s be honest. Anyone who spends enough time in the fitness industry knows eating disorders are all too common. I can remember countless discussions with co-workers and friends from the gym, women in recovery from anorexia who were willing to share their experiences. They would describe to me the deliberate ritual of self-starvation: the fixation on attaining an ideal weight; the initial compliments, and then concerns, of family members; the sheer exhaustion; the calorie-counting; the marathon cardio workouts; the systematic use of caffeine, laxatives, diet pills; the secrecy, loneliness and fear.

So, while I can understand why owners and managers are reluctant to admit the presence of eating disorders in their gyms, I also know that the fitness environment, for all its emphasis on health, can be a breeding ground for unrealistic expectations and distorted body image. The gym is a place where people go to lose weight, and as such, it holds a certain appeal for those who are obsessed with doing so.

There may be even more to it. A recent study by the New York State Psychiatric Institute suggests that hormones released by the body in a state of starvation may actually intensify an individual’s compulsion to exercise.

In other words, if you starve a mouse and put a wheel in its cage, not only will it take up jogging, it will eat even less.

According to Statistics Canada, at least two per cent of women between the ages of 15 and 25 suffer from anorexia. In 2006, more than 1,500 people contacted Ottawa’s Hopewell Eating Disorder Support Center for help. Of all these women who are starving, literally dying to be thin, surely some must frequent the gym.

Still, there is no legal obligation for gym employees to approach a member who they suspect is under-eating or over-exercising. Fitness centers usually require that each member fill out a liability waiver and health questionnaire. But women who suffer from anorexia are not likely to divulge that information on a form. And it can be difficult to tell whether a member is underweight or just thin.

It’s a guessing game, and no one knows the rules.

“That’s entirely up to the member,” said a trainer from another gym. “If they want to keep it their best kept secret, that’s their option. What can you do about it?”

Well, something needs to be done about it because lives are at stake.

Since 1987, hospitalization for eating disorders has increased by 29 per cent among 15- to 24-year-olds, the Public Health Agency of Canada says. The recovery rates aren’t good either. Anorexia claims the highest mortality rate of all mental illnesses, with 10 to 20 per cent eventually dying from complications.

Exercise facilities are responsible for monitoring the health and safety of their clients. Maybe gyms need to get in contact with their local eating disorder support centers and put up posters, offer pamphlets or hire on-site counsellors. Maybe they need to implement sensitivity and awareness training for their employees. Whatever the solution, if women are starving and exercising themselves to death, we have to stop pretending that we don’t see it.