Recently, I found myself explaining to someone’s mother how encouraging her daughter to weigh herself was exacerbating her eating disorder
symptoms (binge eating, in this case). As I did so, it occurred to me that
there are four pathways to this relationship. They might seem intuitive, but it helped to spell out the matrix of consequences for this family.
If someone (let’s call her Veronica) steps on the scale and sees a
number that’s higher than she anticipated, she might experience distress. For
many who struggle with binge eating disorder, food is the most convenient and
effective coping mechanism. So, the urge to binge can increase.
If she weighs herself and sees a number that’s higher than
predicted, she could also have an urge to restrict her intake in an attempt to suppress her weight. As it typically does, restricted intake will likely result
in future binge episodes.
Now, if Veronica steps on the scale and sees a number that “passes
the test,” or one that is lower than expected, she could similarly restrict her
intake as a way to continue this weight-loss trend. Again, binge eating is a
likely consequence.
And if she weighs herself and sees a number that’s equally
satisfying, it’s possible she might choose to celebrate by overeating or might
feel that she is entitled to eat past fullness as a reward for her success.
Many will endorse one or more of these possibilities as potential
outcomes of weighing themselves in early recovery. While some professionals
believe that access to weight information in eating disorder treatment is always
contraindicated, I think that there are certain benefits to learning this
information.
Often, those who struggle with binge eating eat sporadically and
infrequently – and avoid certain foods – setting themselves up for future
binges. When encouraged to eat more intuitively, they might have fears about
excessive weight gain. Witnessing weight trends can provide evidence that a
more regular meal plan, which reduces the frequency of binge episodes over
time, will not result in significant weight gain. Here, weight information
serves as an evidence-based cognitive challenge. But, patients in early recovery
might still be triggered by weight information, and it’s important to determine
where individuals are in their recovery and to provide space to process and
learn from concerns that arise as the result of weight information.
You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com.