SCALES.
To fish, they are essential for protection.
To reptiles, they are essential for movement, water retention & camouflage.
To someone with an eating disorder (ED), they continue to reinforce a state of heightened anxiety and fear.
Our role is help you feel comfortable with seeing a number on a scale, to not let that number define you and to support you to eventually recognise that your worth is so much more than a figure.
Where the client can make an informed decision regarding whether they believe weighing will facilitate or hinder their recover, as Clinician’s, it is our responsibility to obtain full consent before taking someone’s weight. Before a decision is made, it is important to have a conversation about the risks and benefits associated with weighing.
It is common for our clients to not want to get on the scale at all, however we know that the more something is avoided, the stronger the fear response and the more cemented the ED thoughts become e.g. “I have put on 5kg from the smoothie I drank yesterday”.
Exposure over time, allows you to see that your eating disorder regularly blows thoughts out of proportion. Exposure over time allows for trends and fluctuations [up and down] to be seen as normal.
Whilst we do not recommend avoiding weighing all together, we are certainly not suggesting the latter – frequent weighing. Your eating disorder may ask you to weigh yourself 2,3,4,5+ times a day. The challenge here, is that it is normal for our body to have small fluctuations in weight depending on [but not limited to] the time of day, hormone changes, food/drink consumed, water retained, and bowel/bladder movements.
Your body fluctuates to function.
Weighing this regularly reinforces that what you eat directly influences your body weight and shapes thus, maintaining the eating disorder. Part of recovery is learning to associate food with other aspects of your life – energy, social occasions, concentration, enjoyment.
When weighing as a Non-Negotiable
There are some circumstances where weighing is a non-negotiable element of treatment, such as in the case of Maudsley Family Based Treatment or where weight restoration is essential and medical stability are needed. Your treatment team will set a nutritional rehabilitation goal [a minimum weight], with the expectation that this goal is a moving target. This is because your body is meant to continue to grow and change during and after treatment.
Weekly/Fortnightly or Monthly weight checks may be required. Your treatment team will discuss this with you.
When weighing may not be appropriate
There are times when weighing a client is more harmful than helpful, such as when there has been a lived experience of weight stigma or similar trauma. Regardless of whether you share specific details with your clinician or not, you should always be asked about your experiences, thoughts, feelings of being weighed and given an opportunity to say ‘no’.
A persons weight/BMI is not the most important measure of recovery.
Blind weights
If being weighed is essential for treatment however knowing the figure may be harmful, the Clinician should offer a blind weight. Your treating team has the responsibility to communicate clearly with you about their rationale for needing to know your weight.
A blind weight is where you face backwards on the scale, or the figure is not shared with you as the client. In this circumstance, your Clinician should clearly communicate to you, what the data will be used for, whom it will be communicated to and how it will be communicated.
Being weighed at Myrtle Oak Clinic vs. at home
We recommend to our clients, to let us weigh them in session rather than weighing themselves at home. The main reason for this, is so we can discuss your thoughts and provide a safe space with support, to manage the emotions that may arise during this time. We can work towards setting goals with you [when you are ready] to decrease and eventually cease weighing at home if needed.
Our clinicians at Myrtle Oak are trained specifically in eating disorders, receive regular supervision, and apply evidenced based practice to deliver quality treatment and care. Call us on (02) 4362 3443 or Contact us to see if we are a good fit for you.
