I know that the topic of whether or not people in treatment for eating disorders should be told their weight is currently under debate at my own treatment center, as well as a number of others. Blind weight (where the patient does not get to see their weight) is often standard practice in eating disorder treatment, especially for clients who have a strong drive for thinness as a symptom of their e.d. However, some treatment facilities insist that clients in outpatient care or extended care see their weight, as it is something they will have to face at least sometimes in the “real world.” Occasionally treatment providers leave it up to the client to decide, though this of course can be dangerous too if the client is unable to separate what is best for them from what the eating disorders wants. So, I’m wondering . . .
What’s your opinion on the matter? Should whether or not a client knows her/his weight depend on the eating disorder diagnosis? Should it depend on the level of care? Who gets to “weigh in” when it comes to weight? Who decides what is best?
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October 25, 2009 at 4:35 pm
vive42
I’m with the people who think patients need to face reality, rather than be protected from it. Every treatment I’ve done I’ve been on a scale within days (hours if possible) of leaving. Not because I wanted to sabotage my treatment but because I felt that if my recovery was being based on lying to myself it wouldn’t be any good any way.
If people don’t want to know I don’t think they should be forced of course. Even though I know as well as anyone that an anorexic mind is not functioning normally there’s no excuse not to continue to treat people as humans and give them some level of agency. One of the things which I feel undermined my treatment in some instances was being treated as if nothing I saw or felt was valid.
October 25, 2009 at 6:35 pm
aquana
I don’t think your exact weight matters. I do not weigh myself at all, and it’s the best thing I’ve ever done for myself. I’m not sure if that approach would work for anorexics, but it sure works for me!
October 25, 2009 at 8:42 pm
david
I needed blind weights till I was accepting of my weight. It took about three months. Now I don’t care. Before if I maintained I would restrict, after working on it I am ok with maintaining, losing or even gaining a little. I’m ok with the body’s set point.
Getting there was very hard. I had to break the addiction to the scale. I would weigh myself 6-10 times per day. That was not healthy behavior. So while blind weight is ok, so is knowing if the patient can deal with it.
October 26, 2009 at 7:29 pm
Keira
My latest IP admission (last week) I was on daily weigh-ins (stupid, I know) and I was the one who told them what it said (Obviously they would confirm it). It gave me an opportunity to deal with the anxiety of gaining weight and gaining a “normal” body shape for my height/genetics/etc.
I think it was better for me to know my weight rather than gain the several kilos that I did then go home and weigh myself. Watching it gradually (well, in my mind skyrocket… seriously 1kg a day!) go up gave me many chances to reality test… I was 1kg heavier and nothing bad happened. I faced the fear of my weight going up and recognised that my fears were irrational.
But that’s just my experience
October 26, 2009 at 7:52 pm
VoiceinRecovery
Did you read the local study on Anorexia and weight? It was called “Body Dissatisfaction Moderates Wight Curves in Inpatient Treatment of Anorexia Nervosa” I thought it was a really interesting study that brings up these issues a little. There is definitely more research needed on weight curves, especially for those inpatient. I also read an interesting Recovery based Health Research and it also used weight as a partial basis for recovery and I was shocked about that. I think most would agree that weight does not determine health – but it is often a requirement for inpatient care (for obvious health reason) but doesnt necessarily equate mental health. Most criteria for recovery had a weight, mortality, symptom severity, eating attitude and menstrual cycle basis. I find it interesting that this is so different than most personal accounts of what recovery looks like to individuals. Your question is good. If interested the article on struggling with recovery – let me know. Its from Sage and I could email it to you. Sage is having a free membership deal until the end of the month so i am going crazy on reading, saving everything on EDs I can get!
October 27, 2009 at 7:32 am
Keira
VoiceInRecovery (+ anyone else who is interested),
I have access to a lot of psych databases + journals so if you ever find an article you would like a fulltext of, I’m happy to grab it for you. The joys of being at a research intensive university
Keira
October 31, 2009 at 9:57 am
sayhealth
It does sound really interesting! If you wouldn’t mind emailing, that would be great! That way I don’t have to go trudging through databases.
October 28, 2009 at 11:47 am
ihatetoweightandmore
if someone wants to know her weight, that’s her right, even if it’s not considered the best idea by professionals. i think this is true even if its someone under 18. this is her body.
otherwise, i think it’s best to get away from numbers, at least for a while. i’d introduce them later, when hopefully the patient is in a better place. but that’s just me. i don’t know the science.
great questions.
October 29, 2009 at 9:56 am
surfacingaftersilence
I think that sometimes in the beginning of treatment when the patient is really uncomfortable with even the IDEA of gaining weight and may be physically uncomfortable from the weight gain, blind weights might be a good thing.
But at some point, you’re going to come across your weight. Even if you always get on the scale backwards at your doctors, you may see it on your chart. Or you may go to a specialist who doesn’t get the blind weights thing but for medical necessity needs to know your weight.
And what happens when you see that weight and it’s higher than ever before? Even if it’s been your weight for the past months or years? That could be enough to trigger a relapse.
The last year of working with my OP Nutritionist, we worked on me getting on the scale and seeing my weight and not REACTING. i could be upset, but I didn’t have to change my eating or exercise habits. And eventually, I was able to get on the scale and not get upset, because i was able to see that your weight goes through cycles during the month, hell, it goes through cycles during the day!
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