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Individuals with eating disorders may pursue overexercising in fitness facilities and exercise classes. The primary aim of this study was to assess registered fitness instructors' capability to recognize an individual with anorexia nervosa and determine what they would do professionally in that situation. A secondary objective was to assess fitness instructors' understanding of potential professional, ethical and legal issues inherent in this situation. Fitness instructors and pediatricians were administered a survey consisting of a descriptive case scenario of an individual with probable anorexia nervosa. Fitness instructors were also surveyed on various related issues. Thirty-two percent of fitness instructors indicated the case scenario subject presented with anorexia nervosa compared with 88% of pediatricians, a statistically significant difference. Sixty percent of fitness instructors recognized that there were some ethical and liability issues inherent in the scenario, and 37% identified these as serious. All fitness instructors suggested guidelines in this area would be helpful. Implications for training and continued education opportunities for both fitness instructors and pediatricians are discussed.

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Objective: A retrospective chart review was conducted to investigate outcomes in children and adolescents who entered family-based treatment (FBT) in a tertiary eating disorders treatment setting that offers treatment across the continuum of care (i.e., outpatient, day treatment, and inpatient services). Method: Chart data were extracted for children and adolescents who received FBT during the study period (2010 -2016). Results: A total of 62 individuals were included in the database, 51 of whom (82.3%) were underweight (i.e., less than 95% median body mass index) at FBT start. The majority of the sample (84.3%) who were underweight at FBT admission achieved at least partial weight restoration. A portion of the sample (21%) was discharged to a more intensive treatment (i.e., day treatment or inpatient care). Weight at FBT start was examined as a potential predictor of outcomes; however, those starting FBT at a lower weight were not more likely to require intensive treatment services. Conclusions: Overall, the study supports the effectiveness of FBT in a tertiary care setting, including for those starting FBT at a very low initial body weight (that is, less than 78% median body mass index). Implications for outpatient clinical care of pediatric eating disorders will be discussed. Implications for Impact StatementFamily-based treatment (FBT) for pediatric eating disorders appears to be effective in real-world settings outside of controlled research trials. Children and adolescents who start FBT at a very low initial body weight are not more likely than those who This article was published Online First February 25, 2019.