By Linsey Atkins
Weighing a patient in a treatment session and the use of the weight is often a contentious issue; new practitioners sometimes find it daunting; some therapists argue it is counter productive, for others it is fundamental to the treatment; weight itself is so often manipulated as part of the core pathology and can be a constant battle ground between patient and treatment team. There is such an interesting paradox between trying to get someone to be less fixated on weight and at the same time it being so important to treatment. In addition for children and adolescents particularly the calculation of expected body weights, and subsequent setting of goals or targets is a complicated and inexact science.
Evidence based treatments for eating disorders such as FBT and CBT E involve collaborative weighing of the patient. However, it may be argued that the actual ‘weighing in’ and follow up ‘discussion of weight’ in therapy sessions is counterproductive particularly during re-feeding phases of treatment. The efficacy of collaborative weighing will be discussed with reference to recent findings in the neurobiology of eating disorders as well as insights from clinical practice.
Linsey Atkins, DPsych is an experienced Clinical Psychologist and Director of Hope Family Clinic, an Australian based Centre that provides individual and family based treatment for adolescents and adults with eating disorders. Dr Atkins specialises in the delivery of evidence based treatments for eating disorders and has been the Coordinator of the Family Based Treatment (FBT)Eating Disorder Program at the Royal Children’s Hospital in Melbourne, worked as the lead therapist on an randomized controlled trial (RCT) comparing Parent-Focused Treatment (PFT) and FBT for AN, the Team Leader of the Butterfly Day Group Program for adolescents and adults as well as Coordinator of the outpatient eating disorders program at Monash Health. Dr Atkins is an accredited FBT therapist and faculty member with the Institute of Training in Child and Adolescent Eating Disorders and has trained with the Maudsley Hospital, London and other specialised adolescent services in the USA. Linsey has published several articles on adolescent eating disorders and provides clinical supervision and consultation on family based treatment.