Improving Patient Weigh-ins

All roads in anorexia nervosa seem to lead back to weight, and weigh-ins are an integral part of the treatment process. Yet, as Dr. Tony Jaffa and co-workers at the Cambridgeshire and Peterborough National Health Services Foundation Trust in the UK report, how patients are weighed and what they wear during weigh-ins vary greatly (Eur Eating Disord Rev 2011; 19:368). So, Dr. Jaffa and other researchers designed two anonymous website-based surveys to ask ex-patients and eating disorders professionals what they preferred.

Twenty ex-patients and 98 professionals responded. Both groups were more concerned with accuracy than with privacy. Patients preferred being weighed in underwear as opposed to street clothing. When the professionals explained their policy for what patients wore when being weighed, most were primarily concerned with obtaining an accurate weight and only 9% thought that accuracy was less important. A fourth of professionals sought privacy, dignity, and the patient’s comfort over accuracy.

More than half of the former patients who were weighed in underwear reported feeling comfortable with the way they were weighed versus 26% of those who preferred being weighed in normal clothing. Ninety percent of patients were concerned with accuracy or preventing falsification of weight, while 70% were concerned with privacy and dignity. Of those who voted for weighing in underwear, about a fourth felt that a light garment such as a t-shirt or hospital gown could be worn over the top if more comfortable. No patients recommended weighing in normal clothing. Interestingly, as outpatients, about half were weighed in their underwear.

Between 30% and 57% of patients reported falsifying their weight during treatment. The lowest rate was 30% on the authors’ inpatient unit, 47 % in general practices, 50% on medical pediatric wards, and 57% in outpatient settings.