Blind versus open weighing from an eating disorder patient perspective

Abstract Background Weighing is a key component in the treatment of eating disorders. Most treatment protocols advocate for open weighing, however, many clinicians choose to use blind weighing, especially during the early phase of treatment. Despite considerable debate about this issue in the litera...

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Main Authors: Franzisca V. Froreich, Sarah E. Ratcliffe, Lenny R. Vartanian
Format: Article
Language:English
Published: BMC 2020-08-01
Series:Journal of Eating Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40337-020-00316-1
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author Franzisca V. Froreich
Sarah E. Ratcliffe
Lenny R. Vartanian
author_facet Franzisca V. Froreich
Sarah E. Ratcliffe
Lenny R. Vartanian
author_sort Franzisca V. Froreich
collection DOAJ
description Abstract Background Weighing is a key component in the treatment of eating disorders. Most treatment protocols advocate for open weighing, however, many clinicians choose to use blind weighing, especially during the early phase of treatment. Despite considerable debate about this issue in the literature, there is no empirical evidence supporting the superiority of one weighing approach over the other. In addition, little is known about patients’ perspectives of open and blind weighing and which weighing practice they view as more acceptable and/or beneficial for their treatment. Methods Semi-structured qualitative interviews were conducted with 41 women with a current or past diagnosis of Anorexia or Bulimia Nervosa: 26 were undergoing specialist inpatient treatment (n = 13 being blind weighed; n = 13 being open weighed) and 15 were community members who have recovered from an eating disorder. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics, weighing anxiety and weight concerns were also assessed. Results Qualitative analyses yielded five themes: (1) therapy engagement and progress; (2) Control and tolerance of weight uncertainty; (3) treatment team relationships and autonomy; (4) life outside of treatment; and (5) weighing practice preferences and rationale. Participants stated that blind weighing decreased anxiety and eating disorder psychopathology (e.g., weight preoccupation) and increased treatment responsivity. For many, relinquishing control over their weight facilitated body trust and was a necessary step towards recovery. Participants found that not knowing their exact weight helped challenge their overconcern with weight. Lack of support post-discharge was identified as a major difficulty of blind weighing. Overall, the majority of participants preferred blind weighing, particularly at the early, acute stage of treatment, whereas open weighing was viewed as more suitable at later stages of recovery. Quantitative analyses found current blind-weighed patients felt significantly less anxiety around being weighed and had greater tolerance of weight uncertainty than current open-weighed patients. Conclusions This study provided in-depth patient insights into open versus blind weighing practices. The next step for future research will be to supplement these insights with treatment outcomes gained from randomised controlled trials comparing the two weighing practices.
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spelling doaj.art-5e8ebd0fa9734c24814b920c05a84cae2023-09-02T08:26:52ZengBMCJournal of Eating Disorders2050-29742020-08-018111410.1186/s40337-020-00316-1Blind versus open weighing from an eating disorder patient perspectiveFranzisca V. Froreich0Sarah E. Ratcliffe1Lenny R. Vartanian2School of Psychology, UNSW SydneySchool of Psychology, University of SydneySchool of Psychology, UNSW SydneyAbstract Background Weighing is a key component in the treatment of eating disorders. Most treatment protocols advocate for open weighing, however, many clinicians choose to use blind weighing, especially during the early phase of treatment. Despite considerable debate about this issue in the literature, there is no empirical evidence supporting the superiority of one weighing approach over the other. In addition, little is known about patients’ perspectives of open and blind weighing and which weighing practice they view as more acceptable and/or beneficial for their treatment. Methods Semi-structured qualitative interviews were conducted with 41 women with a current or past diagnosis of Anorexia or Bulimia Nervosa: 26 were undergoing specialist inpatient treatment (n = 13 being blind weighed; n = 13 being open weighed) and 15 were community members who have recovered from an eating disorder. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics, weighing anxiety and weight concerns were also assessed. Results Qualitative analyses yielded five themes: (1) therapy engagement and progress; (2) Control and tolerance of weight uncertainty; (3) treatment team relationships and autonomy; (4) life outside of treatment; and (5) weighing practice preferences and rationale. Participants stated that blind weighing decreased anxiety and eating disorder psychopathology (e.g., weight preoccupation) and increased treatment responsivity. For many, relinquishing control over their weight facilitated body trust and was a necessary step towards recovery. Participants found that not knowing their exact weight helped challenge their overconcern with weight. Lack of support post-discharge was identified as a major difficulty of blind weighing. Overall, the majority of participants preferred blind weighing, particularly at the early, acute stage of treatment, whereas open weighing was viewed as more suitable at later stages of recovery. Quantitative analyses found current blind-weighed patients felt significantly less anxiety around being weighed and had greater tolerance of weight uncertainty than current open-weighed patients. Conclusions This study provided in-depth patient insights into open versus blind weighing practices. The next step for future research will be to supplement these insights with treatment outcomes gained from randomised controlled trials comparing the two weighing practices.http://link.springer.com/article/10.1186/s40337-020-00316-1Eating disordersOpen weighingBlind weighingPatient preferencesQualitative
spellingShingle Franzisca V. Froreich
Sarah E. Ratcliffe
Lenny R. Vartanian
Blind versus open weighing from an eating disorder patient perspective
Journal of Eating Disorders
Eating disorders
Open weighing
Blind weighing
Patient preferences
Qualitative
title Blind versus open weighing from an eating disorder patient perspective
title_full Blind versus open weighing from an eating disorder patient perspective
title_fullStr Blind versus open weighing from an eating disorder patient perspective
title_full_unstemmed Blind versus open weighing from an eating disorder patient perspective
title_short Blind versus open weighing from an eating disorder patient perspective
title_sort blind versus open weighing from an eating disorder patient perspective
topic Eating disorders
Open weighing
Blind weighing
Patient preferences
Qualitative
url http://link.springer.com/article/10.1186/s40337-020-00316-1
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