Patient wishes overruled established treatment guidelines.
A recent study sought to uncover reasons that clinicians regularly fail to weigh patients appropriately during cognitive-behavioral therapy (CBT) for eating disorders. Drs. A. Daglish and G. Waller of Sheffield University, Sheffield, UK [see also article on abbreviated CBT elsewhere in this issue] evaluated patient- and clinician-based reasons this occurs (Int J Eat Disord.2019. June 7. doi:101002/eat.23096 [epub ahead of print]).
After surveying 74 clinicians who practice CBT, using case vignettes that varied in patient diagnosis and distress levels, the two researchers found that clinicians were more likely to weigh patients with anorexia nervosa than to weigh patients with bulimia nervosa, but less likely to weigh those who were distressed at the idea of being weighed.
Clinicians who thought weighing was helpful were more likely to do so. The authors note that their recruitment strategy may have tended to attract participants already predisposed to weighing. Moreover, it seems possible that such a survey might bias reporting toward what is perceived to be best (rather than actual) practice. In each case, actual rates of weighing could be lower than described. The authors suggest these findings call for enhanced training and supervision around the benefits of open weighing of people in eating disorders treatment.