To think that staff should stop this girl using the gym?

[MrBloomsMarrow]

I really don't know if I'm BU or not which is why I'm posting. I joined a gym a few months and go around 2 or 3 times a week. I usually stay for around an hour. There's a girl who's always there whenever I go - she's there when I get there and still there when I leave. She's really young - definitely no older than 20.
She's always on the same treadmill and has the setting to maximum resistance ie it's like going up a really steep hill.
The thing is, she's obviously severely anorexic. I'm a mental health nurse and worked in an eating disorder clinic for 2 years so I do know a bit about it.
A normal BMI is 20-25. 17.5 and below is anorexic, 15 and below is considered dangerously underweight and below 13 is critical - this is the point where sectioning someone would be considered. I'd say that she's definitely in the dangerous category, if not the critical. When I worked in the clinic, there were definitely patients who weren't as underweight as she is. She wears vest tops and you can literally see all her bones jutting out.
I absolutely don't mean that they should stop her going as some sort of "punishment", I have nothing but sympathy as she's desperately ill but I feel that, by allowing her to attend all the time and exercise in the way she does, it's kind of colluding with her thinking that she doesn't have a problem. I know she can go and exercise anywhere but I don't think she could do it in quite such an obsessional way outside of a gym. It's a bit like a landlord refusing to serve someone who's really drunk - of course they can go and get pissed somewhere else but it's still the right thing to do.
Also, I think it's actually dangerous to exercise that much when your body is so fragile and I' always worried that she's just going to collapse.
I've been thinking about having a quiet word to one of the staff or should I just keep my nose out?

Did we coffee - can you find it?

OP - you have no idea what has gone on behind the scenes, who is monitoring her or anything. I think minding your own business is the best option really.

She is safer exercising at one gym, where they know her, than at a variety of places or running on the streets.

I know it's upsetting to see her doing this to her body, but there are people better placed to help her than you are.

The gym absolutely do have a duty of care, why else would you need a basic health check during induction? My money would be on them already being aware of it but I'd definitely have a word with management. Ethically I'm not sure if you have a choice, it'd mske me feel really uncomfortable (am also a nurse). Regarding her being safer in the gym than elsewhere, that's not the point - if she's not safe to be exercising, they shouldn't be letting her. Be interesting to know where they would stand legally if she collapsed and died.

It's not the gym staffs' job to be protecting her from collapsing outdoors! Surely it's their job to prevent her from collapsing in their workplace? They're trainers, not medics!

You absolutely have to say something but then you have to trust they have acted on it or have a management plan in place if you see her again. They are leaving themselves open to liability and negligence if they don't. You can't do any more than that though.

I remember the previous thread, I don't think it's the same OP, but it sounds like it's not an uncommon problem anyway.

I'm torn, she so obviously needs help, but I think she's safer in the gym environment than she is out running alone.

But why woud you want to stop her from exercising in the gym if she is safer there crankbadger?

If she can't be in the gym she is likely to turn to pounding the streets, they nights are drawing in and winter is coming, her health will be far less affected by what she is doing now.

As somebody who suffered with anorexia in the past, I also think that banning this woman from the gym could do more harm than good for the reasons already stated above.

A far better course of action would be to try and befriend her and offer support - if she actually needs it.

But, as an adult she is capable of making her own decisions.
If it makes you feel better then you should raise your concerns with the staff.
Then let them deal with it. There really isn't much more you can do.

This is a tricky one. I mean the gym surely have a duty of care. Some kind of social responsibility but I can see it's surely better at a gym than collapsed somewhere on the street in the dark freezing.

Perhaps the first step would be to find out what the policy actually is. They may already be watching her.

Because she's not safer in the gym. There are just more people there. If her heart stops in her condition it's vanishingly unlikely that it will start again irrespective if it's a witnessed collapse or not. Only a tiny proportion of people survive out of hospital cardiac arrests even with immediate, effective cpr/defibrillation. The point isto notenable her to get to that point in the first place and not to make trainers de facto responsible for a person who sounds extremely unwell.

I think it's sad but absolutely not your place to say anything. At all.

Of course she is safer in the gym. Cardiac arrest is not the only thing that might happen to her, but even if that did happen she would have much more of a chance of surviving it if she was at the gym than running elsewhere. It goes without saying that her not having one is a better option but you can't prevent her exercising, only make it as safe as you can and other than doing it in A&E this is as 'safe' as it gets.

But it's not the gym's responsibility to keep her safe and they can't anyway with the best will in the world, because they are not mental health professionals (or physical health ones for that matter). So it's a misapprehension that she's any safer there; in fact she's less safe because the gym colluding with her reinforces her idea that it's okay to exercise and therefore that she's less ill that she actually is.
Anorexia is an incredibly challenging illness. But it is not for the layperson to manage, or feel they have to. It is for that person's family, GP, mental health team and so on.

I am a MH professional and would definitely express my concerns to the gym staff.
What they did about it would obviously be their business, but I would feel very very uncomfortable saying nothing. If this woman has as low a BMI as you suspect OP, then the gym need to be told that she is at risk of sudden cardiac death.

Ooops didn't finish.
I think there's a really strong ethical argument for allowing anorexic people to undertake supervised exercise, I just don't think it's appropriate outside of a hospital gym or other setting staffed by HCP.

As a mental health worker you will understand no one other than a APM or similar with the mental health act backing them are unable to restrict this woman's liberty to as she pleases and rightfully so. The gym have no lace restricting her use. The could however invest some time with her to do some health prevtipn work bit I'm not sure that would be adequate or even a sensible idea without much information about her.

My gym has a policy has if your BMI falls below the minimum for your hight then you need a doctors note to continue attending (ditto a few other conditions, hypertension, diabetes etc) which I think is pretty sensible. I really don't think it's the gym's place to stage any kind of health preventative work unless they have a good background in eating disorders.

I think you also have to take into account that a severely anorexic person may not actually be competent to make the decision to attend a gym. This is another reason why asking her to provide a doctors note would be helpful.

I am not sure what the gym could do but I do think you should mention something to the manager she may just be there the same 2 3 days you are and working out but.... say something although as you know this girl will just do it somewhere else

Oh my your post has made me cry (sheltered life). :(

I think you should def have a quiet word with the gym staff. You've nothing to lose from doing that. Better than regretting if you dont

Crankbadger - I didn't say it was the gyms responsibility - what I said was it wasn't the OP's to interfere in a situation she knows nothing about.

Of course the woman is safer in a building, with people around, than she would be running the streets - I have no idea how you can even think otherwise.

You have no idea what has been said or done re her GP/family/MHP etc You also have NO idea if there is a HCP there with her or not. You have absolutely no bloody idea if she has brought a note in from her doctor or anything else about the woman.

It is nothing to do with any other gym member. Nothing At All.

As I understand it anorexics would pace their room to burn the required calories so i don't quite see how stopping her using the gym would actually help? At the end of the day she will have filled in the requisite forms. Not sure what the answer is but I suppose you could talk to the gym manager.

I think the analogy of the bar man refusing to serve someone completely pissed is a very valid one. This woman is slowly killing herself in front of people every night. The least the gym can do is ask for a recent letter fom the GP. Contrary to what people are saying on this thread, letting her stay at the gym is not protecting her. It is colluding with her and enabling her to continue to damage herself.

Well, of course I have no idea. Neither do you. I'm just giving my opinion. And my opinion is that the gym should not be allowing her to exercise in what the op describes as her current state without assurance from a HCP that it is safe for her to do so. They are not responsible for her safety. Neither are pub landlords and they at least stop serving people who are not competent to decide if they should drink more or not.
And if you really think she's safer in the gym, why isn't it other members' business, bearing in mind she might collapse next to them, especially if they are a HCP and would be obliged to help?

Unless you know her history, you have to stay out of it.

A girl at my gym is currently critically underweight. Its worrying lots of her friends but until she gets over her fiance dumping her, sympathy and support is all that is sensible.

AND we have long distance runners training at our gym - they are scrawny as anything, but win prizes.

I can see where you're coming from Talk, except in this instance the op is a HCP so might know what she's looking for better than a layperson - but that's conjecture.

Interestingly, I only know about my gym's policy re low BMI as my trainer raised it with me! I'm not anorexic but I am naturally very scrawny slight so I know appearances are deceptive.