“What will I weigh?”
Her face overcome with tears, my client expresses the intensity of her desire to be in any body but her own. She clings to the hope that reaching a particular number on the scale will provide a sense of belonging, both in her own skin and in the world at large.
As an eating disorder dietitian, these painful conversations are common in my office. It is terrifying for a client to relinquish control over food, especially when a meal plan is implemented to promote weight gain. In order to establish her trust, it follows that I should have a precise answer to this question.
And yet, “I don’t know.”
Experience has not sharpened my ability to calculate a client’s “set point.” Instead, time has shown me the complexity of this question. Through witnessing countless treatment stays, I now understand that the answer she is seeking will not be defined by a number. Freedom from disordered eating is an evolving journey that will shape her in ways that far exceed physical appearance.
Nutritional counseling for eating disorders requires that I take a wholistic approach, viewing my client’s body through both a medical and therapeutic lens.
From the medical perspective, there is value in gathering numeric data outlining the trajectory of her weight history. Weight-for-age growth charts may depict a noticeable change in weight around the onset of her eating disorder, or illustrate abnormal weight fluctuation due to long-standing patterns of disordered eating.
This graph is considered the golden standard by our western medical model for establishing a physical weight range to support a client’s recovery. Yet, a growth chart does not take into account the psyche or emotional body.
An eating disorder not only manipulates physical size, it numbs the powerful current of emotion that lies below the surface. A client must incorporate psychotherapy to process her eating disordered thought loops and re-connect with her body’s innate cues for hunger and fullness. Only through cultivating stillness is she able to hear the wisdom of her intuition and allow the true weight of her inner self to emerge.
I do not have the authority over a client’s body to know exactly what she will weigh when released from the cycle of disordered eating. So, here is my heartfelt response to her question:
“You weigh more than just your skin and bones. You are the weight of your voice, your creativity, and your emotional experience. Hold the space for that weight to emerge along your journey through eating disorder recovery. You are inherently worthy of your presence here, regardless of the number on the scale.”
*This image is of “Paseo de la Princesa,” which translates to “Path of the Princess” in San Juan, Puerto Rico.