During her career she was known as first as "Ima Waddler", then as "Baby Ruth", the name she kept for the rest of her life. While working with Ringling, Ruth met and married Joe Pontico, a 135-pound man who sold balloons with with the circus. People who worked with her said she was among the kindest, most generous people in the show, and she faced the hardships brought on by her size with cheerful resignation. Once, while visting her sister, she fell through the floor and had to be removed with a crane (the Ponticos' own home in Tampa had reinforced floors). Another time, she was unable to enter her sleeping quarters on the circus train until mechanics cut away part of the doorway.
She stayed with Ringling until 1934, when she fell gravely ill with typhus, a disease carried by rat fleas that causes a dangerously high fever. With a temperature of 104 degrees F, Ruth was considered unlikely to survive. She was hospitalized for two weeks in Springfield, Missouri, where she lost over 100 pounds on her doctor-prescribed liquid diet. Astonishingly, she recovered.
Ruth joined Royal American shows after her typhus scare and continued performing until 1941, when she underwent surgery in Tampa to remove a benign tumor. Although the surgery initially appeared to be successful, Ruth did not regain consciousness and passed away on November 29, 1941. She weighed 815 pounds at the time of her death.