Setting Target Weights: Are We Aiming High Enough?

Weight restoration is an essential component of eating disorder recovery. However, there is no consensus on how to set recovery weights. Research has often relied on reaching a BMI of at least 18.5 or using median 50% BMI. Given that many people with life-threatening and life-impairing eating disorders never reach BMIs this low, this makes little sense. There is a robust literature on the harms of weight suppression in clients with eating disorders, and the benefits of reversing this suppression in supporting recovery. BMI can be falsely elevated in young people with linear height stunting du...Read moree to their eating disorder, and is not correlated with the psychiatric severity of their symptoms and cognitions; the American Medical Association has publicly noted the limitations of BMI as a health index as of 2023. Weight stigma in providers and clients often produces trepidation in setting goal weights that are truly consistent with someone’s pre-eating disorder historical weight trajectory, even when it is clear that they were healthier in a larger body than they are after weight loss. Finally, children, adolescents, and young adults are meant to grow and develop until their late 20’s , adding height and body mass in appropriate physiologic ways throughout these years; setting a ‘maintenance’ weight is not appropriate for any individual below the age of 28 as a result, and each year their goal weight should be moving up to some degree. Using methods that keep our clients weight suppressed, fail to reverse hormonal shutdown or stunted linear height when possible, or do not allow enough weight for cognitive recovery may keep people entering eating disorder treatment in a state of chronic illness and/or vulnerable to relapse. It is imperative to consider goal weights consistent with a true recovery, even when they need to be higher to achieve this. This discussion will review the research and lived experience evidence supporting the need for higher recovery weights for many patients. We will review how to challenge weight stigma in patients, families, and other providers when restoring clients to higher weights. Less...

Learning Objectives

• Identify limitations of commonly used methods of target weight goal setting in the treatment of eating disorders.
• Describe the importance of weight restoration in reversing weight suppression, facilitating catch up linear growth and supporting cognitive recovery in patients with eating disorders.
• Challenge common fears and misconceptions about higher goal weights.

Wednesday, August 21, 2024

12:00 PM EDT - 01:00 PM EDT