Table 5 Examples of forum comments for the theme "What can be done?"

5. What can be done?

I never said that all gym staff must be trained to identify and intervene with clients with eating disorder. What I did say is that staff members should have a general understanding of eating disorders and know who clients can contact if they need help. It could be the [eating disorder patient charity] website, a local GP, a local therapist. The way I see it, it's not intrusive if gym staff ask someone if they have talked to their GP about nutrition. That's what they'd do if a client complained about shoulder pain or something like that, right? Mental health shouldn't be any different.

I'm worried that someone who might already have problems with self-esteem or whatever would just feel worse if a stranger at the gym approached them and commented on their weight. Of course, if you know them you should absolutely say something, but be aware that once you get involved in helping someone with their mental health problems, you must be prepared to stick with them for the long-term if you truly want to be an ally.

I would suggest that you engage older climbers—it could be pro climbers or just someone at the gym who's really talented—as role models for the kids. You should frame it as something that they want to do in order to improve their game, rather than just being about diet rules that don't make any sense to them.

BMI is actually a useful indicator of disordered eating, at least in the lower range. If you're very lean and you worry about wrongfully being called an anorexic, perhaps you should pay attention to your BMI and think about if it's really healthy. Sure, I agree that BMI shouldn't be used on its own to bar someone from competing in climbing… but it can be a good screening tool, obviously. In most cases, I don't think it'll be that difficult to either confirm or discard an anorexia nervosa diagnosis.

As long as organizers keep allowing these "living skeletons" to take as long as they need to climb a route, the race towards lower weights will continue. If they would instead introduce time limits, make sure that routes favor "powerful" moves and that they aren't too lengthy, climbers will simply have to embrace behaviors that keep them strong and healthy.

So you've seen someone out there who seems to be on the wrong track?! Give them a hand–show them what climbing should be all about