To weigh or not to weigh

Should our weight be kept in check?

Weighing was at the centre of one of my sessions this morning and so I decided to write some more about it while my memory was still fresh.

Should we or should we not weigh ourselves? That is the question.

As always, the answer isn’t clear cut, in fact would there even need to be a question if it was clear cut? My answer will depend on whether we’re talking weighing someone in general (“normal eaters”) or weighing someone in recovery. I would never suggest that people who are struggling with food are abnormal but they have different needs in my opinion, hence the needs for some differentiation.

On a very basic level, I can see why weighing “in general” might be useful. It’s common practice, for example, to frequently weigh newborn babies to make sure they are eating enough and that they are growing properly. If you are to receive general anaesthetic, the doctors might need an indication of your weight, as the dose needed won’t be the same if you are 7st or 22st. So weighing for functional reasons makes sense.

Should we weigh ourselves to make sure we are healthy?

By the way, have you ever wondered why weighing scales are kept in the bathroom? Isn’t the subtext here that it is to keep our health in check? I think this has something to do with painting the scales as a health tool in the same way as vitamins and medications are. Yet, we know that weight doesn’t equate health. They can sometimes overlap (being underweight can be damaging to your health and carrying an excessive amount of weight can lead to co-morbidities) but most often they are not linked.

ED diagnostic criteria are not based on weight per se but on the amount of weight lost/gained in respect of time, and, mostly, on the importance the person gives to their weight/shape. You can be very unhealthy at a “healthy” weight and you can be totally healthy while clinically under or over weight.

If the scales aren’t a measure of health, why do we keep them in our bathroom?

Because that’s where we take our clothes off? We also do that in our bedroom, don’t we? In fact, wouldn’t that make more sense? Isn’t our checking our weight more about appearance than health? Should it therefore not be where we keep our other appearance relating stuff like our clothes?

Anyway, back to whether we should, or not weigh ourselves.

Do I think people in recovery should be weighed? Yes. Do I weigh myself? No.

Weighing can be useful in recovery

Let me explain. I think weighing is useful and, often, even necessary in recovery but that depends on the person and diagnosis/problem. 

I mostly work online these days, so I don’t weigh people, this is done by their GP/nurse/hospital and the number is then relayed to me. Why is it important? To keep people who are restricting safe. We need to know what is happening to them weight wise, so that we don’t realise months down the line that they have been losing weight and are therefore at risk medically. I also often use the number on scales to show people that the food they are eating and fearing isn’t having the impact they thought it would on their weight and this can greatly help them move forwards in their recovery.

The optic here isn’t: “look, you can eat and not get fat”. It’s more: “see, the way you have linked food to your weight is somehow skewed, as it doesn’t seem to work like this from the evidence that we have. What else might you have heard that is holding you back in your recovery?”

Do I think we should weigh people for fear they don’t gain too much weight? No. What about to check they are losing the correct amount of weight? Well, I don’t work with weight loss clients, so the answer is still no.

Some people might come to see me and want to lose weight, but that is never the focus of my sessions. If they do, they do but I’m interested in their relationship with food, not the number on the scales.

In recovery, it is my opinion that the best way to weigh someone is blind i.e., the person taking the weight sees the number but not the person being weighed. It’s important to keep track of what’s happening but it’s also important for people to reconnect with how they feel as opposed to being a slave to a number. I want them to start as they mean to go on i.e., not using a machine to measure their worth or happiness, and once they’re out of the woods, weight wise, once the person is weight restored, the weighing can stop. 

I’m not scared they are going to gain “too much weight”, I trust their body to do the right thing. If they have gained weight, it’s probably because they needed to; it’s not my role to set an acceptable weight for an individual. It would be wrong and potential harmful because our weight is genetically programmed in the same way as our eye or hair colour are, it’s not for me to arbitrarily decide.

There are brackets but once someone is above a certain threshold (the “healthy” range), I know the next bracket is pretty far away so I’m going to let the body decide where it needs to settle.

The reality is that some people will naturally be at a BMI of 26 and that will be healthy for them, while some will settle around 20; we are all different.

If someone is in the healthy range but that they still don’t have a functioning endocrine system (no period, no sex drive, erectile dysfunction), that’s a pretty sure sign that they are not where they are supposed to be and that they need to carry on.

Ok, so weighing can be functional and it can be to check a person isn’t losing weight or that an underweight person is regaining enough weight for them to reach a biologically appropriate level.

Weighing for reassurance

Some people tell me that they still like to weigh themselves for reassurance but I worry that this still maintains weight at the centre of it all.

Reassurance from what exactly?

Surely you can see whether your clothes fit or not? Do you really need a number to orient you towards your next step in life? Most often it’s not about the weight but about the meaning you attach to the weight. I’m more or less than I used to be/than I expected to be/than I wanted to be/than my friend etc. Weighing is always comparing and isn’t comparing pretty much always despairing? To me, stepping on the scales is still saying: my weight is a measure of my worth.

I also worry about the conclusions people might draw about their ability to trust themselves if they still use weighing for reassurance. Imagine that if you feel good in yourself, that you step on the scales and that the number isn’t what you expected, what will that do to you and what will that mean about you? Are you likely to conclude from that that it is in fact ok to be bigger since you felt good 10 min before, or are you likely to conclude that your feelings can’t be trusted since the number is evidence you are not good? I’d rather let myself feel ok and sometimes not ok and letting the feeling glide on me knowing it will soon dissipate and that I can use other measure for my worth such as my career, the love from my family and friends, my abilities etc.

I was weight obsessed as a teenager, I don’t know where it came from but I had what I call a “magical weight” a weight at which I thought my life would be perfect. Of course I went lower than that because the goal post always moves with anorexia, it’s never enough because you’re chasing a perfect life, which will never happen. I remember refusing to be weighed at the rheumatologist but then seeing the number and being horrified. I remember the shift from being ok before the consultation to wanting to rip my skin off after seeing that number. That was a crucial day for me, that was a spark for anorexia (which clearly was already simmering in the background) to light up and start burning me thin.

As I was reflecting about my personal relationship with weighing something struck me. We didn’t have scales at home, so instead I would go in the attic and weigh myself on an old fashioned pair of scales intended for animals and goods.

Let that sink that: I was using a device used to assess the weight and therefore price of goods to assess my own worth. That makes me so incredibly sad. I wish I could rescue that poor teenager from this dark abyss.

Scales are a clinical tool not an everyday item

Nowadays I have scales but I don’t use them and I’m not tempted to. They live in my office, they are not in the bathroom or bedroom and they are not intended for the family’s use. They sit on the floor next to my desk and I almost don’t see them, they could be a plant pot for all I care, I don’t need to interact with them. They are just an old tool left from when I used to see clients face to face. Given that last time I used them was to weigh my suitcase before going on holiday, I will probably dispose of them – more floor space.

I don’t weigh myself because I don’t need to: I can tell I’m fine weight wise and that my clothes haven’t changed for years. It doesn’t mean I stayed at that weight all those years by the way. I probably have gone up and down by several kilos over the years but not enough to require my attention so why should I care about the number? I also worry that I won’t totally be neutral about it when that number used to mean so much.

Not wanting to weigh myself is about limiting the potential harm it still could do, even if I don’t realistically think seeing the number would induce a relapse. I don’t want to change my body, I don’t think there’s anything wrong with my weight but what if seeing the number could rekindle the fire?

If I was at a higher weight than expected, I know I wouldn’t diet my way down but I also know I’d have a reaction to the number and I’d therefore have to unpack that, work through it temporarily to neutralise it and move on and I’d rather not do that because it’s easier that way.

It feels like being on top of a building, getting slight vertigo and having the desire to jump.

I won’t.

I would never jump but I still have the giddying desire to because I know it’s possible.