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First of all, thank you all for your comments on the last post! I decided not to respond on that post because it was really about hearing others’ opinions, and I did not want to impose my own.

I will, however, proceed to do that now. 😉 Thank you for humoring me!

Like a few of you said, I absolutely agree that patients/clients should have input as far as whether or not they know their weight. And, I acknowledge that this can be a challenge, especially with patients who are having trouble separating what is best for them and what is best for the eating disorder. When I had my intake with my current nutritionist, we went to the scale, and she just said something like, “We do blind weight here.” It wasn’t presented as a choice, though obviously if I had protested, we could have discussed it (I know that she lets others see their weight because not knowing triggers them). But, I didn’t protest because I was RELIEVED. I know that she if she had presented seeing my weight as a choice, I would have chosen to see it. My motives in seeing would have been driven by the e.d., as I know that I do better with blind weights. But, at that time, I didn’t have control over the e.d.; I would have looked because that’s what Ed wanted. I needed her to take control over Ed by making the decision to do blind weight, because I was not capable of doing so at the time.

I think that, for patients in the later stages of recovery, the decision about whether or not they see their weight should be made in collaboration with their treatment team. I fail to see how wrestling control and agency away from a patient in this area would be helpful to recovery. So, if a patient wants to know her/his weight, and if the treatment team agrees that it is for recovery-positive reasons, I absolutely think that the patient’s weight should not be kept from her/him.

That said, I also think that a patient should not be forced to see her/his weight. This recently happened to a friend of mine, which is what inspired this post, and it was incredibly detrimental to her, and bolstered her e.d. And I actually think that it’s quite possible to go for a very long period of time without knowing one’s weight. I went for a period of years without knowing, and now, unless I let myself look at a GP appointment, I don’t know what it is. If a patient chooses to continue with blind weights, yes, it will take a bit of a commitment to maintain that outside of the treatment center – they will have to ask to skip being weighed or be weighed backwards at Dr. appointments, they will have to commit to not buying a scale, etc. – but it really is very do-able. And there are other ways to gauge one’s weight that allow a bit more for natural fluctuations in weight – how one’s clothing fits, for example. I think we confront the reality of our weight and/or changing weight everyday, whether or not we label it with a number. And I think that, for someone who continues to choose blind weight, if she/he does encounter a number unexpectedly (on a doctor’s chart, for example), if treatment has been truly effective, she/he will be able to cope productively.

Personally, I’m glad that my team enforced blind weight when i needed them to, and I am glad I’m able to choose to continue with it. AND, I’m glad that for other people, they us different methods – one’s that are more effective. I guess this goes back to my firm belief that, generally speaking, e.d. treatment – including whether or not patients know their weight – needs to be about the individual, rather than about blanket policies.

 

This is something that I’ve been wondering about for a while, and something that has come up in conversation with a few friends in recovery lately. I get the feeling that this is something that people are perhaps hesitant to talk about because we don’t want to be seen as judging others based on body size, etc. I know that’s the case for me anyway.

But, if I’m being totally honest, the body types of my treatment providers DO matter. Obviously they are not the be-all and end-all determinant of whether or not I’ll work with someone. Much more important to me is the level of mutual respect I feel w/ my team members, how easily I am able to trust them, whether or not I connect with them, their views about e.d.’s and treatment, etc. But, at first, their body type IS quite important to me. In therapists, I want someone who is “average,” or even perhaps a little bit above “average.” B/c my set point is a bit on the higher side of normal, I prefer to have a therapist who has experienced what it’s like to move through a thin-obsessed society with a body that is, well, not thin. If I have to go through a weight gain process, I also tend to be less self-conscious doing that with a therapist who is not particularly thin.

Dietitians, however, are another matter. I hate to say it, but, at least when my e.d. is active, it would be a struggle for me to work with a dietitian who was not slender. My first RD was very small (she was clearly just built that way), and that was a bit hard for me because I felt so big in comparison. My current RD is thin, not skinny; she looks like she is a very healthy weight for her frame. Slender, but clearly not disordered. This appeases my e.d. a bit, and it encourages me that one can nourish oneself and not be overweight (something that I absolutely believe in regard to other people, but I have trouble applying to myself). And frustratingly, these kinds of standards, expectations, etc. based on size are in direct opposition to what I believe in my daily life about size, etc. I’m actually a firm believer in HAES (health at every size) and a proponent of body diversity. Yet, when it comes to my treatment team, I have preferences.

What about you? Does the weight/size/body type of your treatment providers matter? If you’re a treatment provider, is this something you’ve considered? Is it something you’ve talked about with clients?

I know this can be a sensitive subject, but in my conversations with others, it seems like it’s something that can be important to people and should be open for discussion. And I’d like to think this blog can be a forum where we can all discuss these matters honestly and without judgment. 🙂