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Available online: 28 Feb 2008Individuals 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.