How is the patient with Eating Disorders weighed? Review of weight approach in treatments

Abstract

Introduction: excessive concern about weight and body shape in Eating Disorders (ED) lead to obsessive checking and/or body avoidance behaviors. There is consensus that weight is a fundamental element in the treatment of eating disorders, however multiple approaches coexist in weighing.
Objectives: to describe how weighing is addressed in the treatment of patients with ED.
Materials and method: the study consists of a descriptive bibliographic review. Scientific publications were included through the updated database search: Scielo, Lilacs and Pubmed, from 2010 to 2020. Search descriptors were: “body weight and eating disorders/eating disorders” and “treatment, eating disorders and body weight”.
Results: out of the bibliographic search, 14 international articles of descriptive design were included. The sample groups of the studies were diverse, including students, athletes, patients, control group and professionals, with a sample size of 2287 participants and 24 institutions specialized in eating disorders. No study identified the professional in charge of weighing the patient. 75% of the articles that described the weighing modality chose blind weighing at the beginning of the treatment and the rest opted for open weighing, using it as exposure therapy. All the professionals modified the weighing modality according to the patient’s anxiety level and the treatment time. Patients preferred blind weighing as beneficial for their treatment. 90% of the studies showed that individuals who self-weighed more frequently initiated binge eating and compensatory behaviors earlier.
Conclusion: evidence-based treatments do not consensually address how the patient is weighed, and the recommendations vary according to therapies and time period. The therapeutic utility of ED weighing is essential to assess risk, alert to changes in food intake, and to reduce anxiety. However, it is necessary to approach it with professionalism and interdiscipline to reduce the impact on behaviors harmful to health and psychopathology. More studies are recommended to help build common criteria and regional consensus guidelines to improve the treatment of ED.