The Wedding Deadline
Renee, 29, is six weeks into training. Her stated goal is to lose 12 lb before a wedding in five weeks. Partway through a session she mentions, almost casually, that she has been eating 'about 900 calories a day' and using laxatives 'a couple times a week' to speed things up. She asks you to keep it between the two of you, to add three extra cardio sessions, and whether you can recommend 'a fat burner' to get her across the line. She has no diagnosed condition, sees no doctor, and is otherwise healthy and cheerful in sessions. She is not a minor.
1. What do you say in the next five minutes, and what do you deliberately not say?
Read the worked answer
Say
- Address the secrecy request first, because everything else depends on it: 'I keep your information private as a rule. I'm not able to promise to keep this particular thing to myself if I think your health is at risk.' Do not accept the confidence and then break it later.
- Separate the person from the behavior, without lecturing: 'Thank you for telling me. That took something. What you're describing worries me, and not because of the wedding.'
- Ask, don't interrogate: how long has this been going on, whether she has talked to anyone, whether she has a doctor or therapist she trusts.
- State your boundary clearly and without drama: you will not program for rapid weight loss, you will not recommend a fat burner, and you are not the right professional to manage what she just described.
- Make the referral concrete: a physician and, given the eating behavior, a clinician who works with disordered eating. Offer to help her find one.
Do not
- Diagnose her. You are not qualified to label an eating disorder, and applying a label you can't support is both outside your scope and likely to end the conversation.
- Recommend any supplement, especially a stimulant 'fat burner' - a thermogenic stacked on laxative use and severe restriction is a genuine risk, and supplement recommendation is outside your scope regardless.
- Agree to the 12 lb in five weeks, or to the extra cardio. Do not negotiate the goal as though the problem were the timeline.
- Moralize, express disgust, or bargain ('if you just eat 1,200...'). You are not her dietitian and this is not a calorie problem.
2. What do you document, and who do you involve?
Read the worked answer
Document, in her file, the same day
- Her words as close to verbatim as you can get them, in quotation marks - not your interpretation of them.
- The date, the context, and what you said in response, including the confidentiality limit you stated.
- The referral(s) you gave and whether she accepted them.
- Your decision about training going forward and the reasoning.
- Not a diagnosis, and not speculation about her mental health.
Who to involve
- Her, first. The default is that she is the person who decides what happens next, and you should tell her what you are going to write and who, if anyone, you will speak with.
- A physician, because of the laxative use and the level of restriction - both have medical consequences you are not trained to assess.
- A mental health professional with eating-disorder experience, ideally through her physician.
- Nobody else without her consent. Confidentiality has limits, but 'I was worried' is not itself a legal exception; the professional move is to be transparent with her about what you will do rather than to go around her.
If she declines all referrals: you can still say what you will and won't do as her trainer. You are not obligated to keep training someone whose health you believe is at risk while they refuse any evaluation, and stepping back is a legitimate, defensible choice - documented, respectfully delivered, with the door left open.
3. If she stays in training for now, how does the program change?
Read the worked answer
Change the frame first. Exercise stops being a calorie-burning instrument. If sessions become the punishment for eating, you are reinforcing the mechanism, not training a client.
Programming
- Keep the strength work - it is the most defensible thing you can offer her, it is performance-framed, and it is not a weight-loss lever. Emphasize what she can do: reps, load, control.
- Reduce high-intensity conditioning volume and remove 'extra cardio' entirely as a response to food intake. Calorie-burn readouts, if her equipment shows them, get covered.
- Stop weighing her, stop body-composition testing, and stop any discussion of the 12 lb target. If she raises it, redirect to performance or to the clinician.
- Watch the session itself: dizziness, unusual fatigue, poor coordination, or a sharp drop in work capacity can reflect under-fueling. If you see them, stop and address them as a health issue, not a training issue.
Boundaries
- You are not her dietitian; do not build her a meal plan to 'fix' the restriction.
- Set a review point. If she has not engaged with a referral in a defined window, revisit whether continuing is appropriate.
Reasoning: the training program is the smallest part of this problem. The leverage you have is the relationship and the referral, and the program's job is to not make things worse.