Dianna Chillo, LCSW-R
The Good, The Bad... And The Scale
Originally published for Project HEAL as a member of Project HEAL's Healer Circle
We live in a culture today, that has imposed a belief, that we need to be happier, smarter, more successful, more attractive, etcetera, etcetera.
These manufactured beliefs create an underlying theme which says, you will never be good enough.
Our diet culture, which has created a standard of beauty, that normalizes unhealthy weight loss and obsessive fitness, has given way too much power to the scale.
For the average person, weight and body image is a topic and a source of anxiety. For most people, the scale, and that simple number that appears on it, has the power to change one’s perception instantly, and turn a good day into a bad one.
You don’t believe me…? Imagine this… you’re feeling pretty good in your body and your mind, maybe you’ve been eating more balanced and even started working out a little. This balance makes you feel good in your own skin.
You step on the scale...and the number has gone up, suddenly you feel terrible and bigger in your body, so basically… you suck! That number has not only altered your mood, but it also has the power to somehow physically alter your appearance right before your eyes.
This is what happens to most people.
Now, imagine those with eating disorders.
Eating disorder recovery and the scale is a topic that brings up a lot of feelings and opinions. For people in recovery, the scale has a direct impact on one’s mood, thoughts and self-worth.
Stepping on this piece of plastic or metal, which reveals a number that no matter what it is, will often monopolize their daily thoughts.
Whether the number has gone up, down, or stayed the same, a person in recovery, attaches self judgement. They have either failed or aren’t good enough. And even if they lost weight, it may feel like a victory, but only for a moment, because that number will never be low enough. To someone in recovery, this number is everything.
I’ve always loved the way Jenni Schaefer, compared her eating disorder to an abusive partner, and how her recovery relied on her need to divorce it. She describes this dynamic in her book, Life Without Ed.
I think it’s an excellent way to depict this struggle, and the scale represents another toxic extension of that abusive partner.
Breaking Up with Your Scale
As a provider and someone in recovery, I truly believe in getting rid of personal scales. I am aware that in some homes, this might not be possible (due to health issues of other family members that require weight monitoring), or that throwing the scale away completely might be too difficult at certain stages of recovery.
I will challenge my clients to get rid of their scales early on, but also want to meet them where they are at. We start by talking about “breaking up with their scale”, by working on not getting on it and the feelings associated with not doing so. If you’ve ever broken up with anyone, you know it’s usually a difficult and painful experience. I speak from experience and through my work with clients, know that ending their relationship with the scale can be even more challenging and emotional.
I grew up in the 90’s and watching the series Friends was a big part of my history. Fellow fans of the show and perhaps younger generations watching reruns, might remember the on again off again Ross and Rachel relationship saga. There was a famous line by Ross Geller throughout the course of the show, defending his innocence during a night of “perceived” infidelity; “We were on a break!” he would shout.
That phrase was shouted whenever that situation was referred to. Early in my recovery, humor was and always has been something that has helped me along.
So, whenever I thought about getting on the scale, I would say in my head or out loud, “We are on a Break!!” For me, the levity in such a debilitating struggle helped and still helps me, to this day.
I often use this example with my clients who are trying to disengage from their obsessive relationship with their scales. We also discuss their mental recording that plays out before, during and after getting on the scale.
This is the internal dialogue they have with themselves, while anticipating what the number on the scale might be and what it will feel like. Regardless of the outcome, this could determine how the rest of the day will go including their mood and behavior.
For most people in recovery, this mental recording looks similar, and generally doesn’t end well. We also explore options for where their scale can be placed during the early breakup phase. I’ve had some clients have family members hide the scale, or put it in their partner, friend, or family member’s car. I have also seen it given to their therapist or nutritionist.
I’ve held onto several scales for clients throughout the years until they were ready to finally let go in whichever way they chose. Each person is different as is their attachment to the scale. For some, these methods are helpful in easing into complete detachment and letting go, while they work through their emotions in therapy around it.
Through the years, I’ve seen many creative ways clients have chosen to totally break up with their scales, from using it as an artistic expression project to using it for softball practice and wailing it across the field with a bat!
These are some powerful and emotional ways to move through the process associated with this kind of breakup.
When and How the Scale Supports Treatment
Okay, so I’ve spoken about the personal breakup between an individual and their scale, and yet using weight and the scale, while in treatment, is just one of the measures to assess how a person is doing, in addition to exploration of thoughts, feelings and behaviors.
But this becomes such a tricky predicament.
On the one hand, as providers, we’re telling our clients not to focus on the scale and not to focus on the number, but then we tell them they are going to get weighed by us. Early on in treatment, regular weigh-ins are important for the treatment team to get a sense of where a person is in weight restoration. It also helps to establish patterns with symptom use; whether binging, binging and purging, or restricting, regular weigh-ins help to identify these issues.
As an outpatient provider, I work closely with an eating disorder RD and the client to identify the best course of action when it comes to weigh-ins. Often, clients do blind weigh-ins to help assess progress but are not exposed to the number.
This also becomes a delicate scenario and must be treated carefully by providers. A person may not be told the number but a provider’s disposition after a weigh-in can be just as revealing and difficult for a client, and these cues are easily picked up on. Discussing emotions and triggers around the eating disorder and behaviors are extremely important and an integral part of the work, and if perhaps, cues are picked up on and must be discussed.
Each person’s recovery journey is different and what is effective for their treatment may vary.
Some schools of thought believe exposure to the number is helpful to work through the difficult emotions associated with its attachment. While others believe one shouldn’t know the number and learn to be intuitive with their bodies. I guess I fall somewhere in the middle, and again I usually base what’s best on how the therapy unravels with each person.
While a person is learning to re-integrate food and learn their hunger cues, they are working in therapy to make room for their thoughts and feelings and re-learning about themselves as well as their bodies. When a client says, “but if I just knew the number,” we often play their mental recording again in session and discuss what feelings are coming up and why this is important to them.
While a client is in the recovery process and learning to be more intuitive to their hunger and comfortable with their bodies, they are figuring out who they are beyond their eating disorder.
As they make less room for their eating disorder, they can explore their hopes, fears, talents, goals and ambitions.
They can rediscover themselves and who they are to the people around them. These are some of the most important aspects in recovery.
The attributes we posses including our self-worth and value are things that the scale and a number will never reveal.