Meanings of Weighing Female Patients and Their Clinical Implications

By Chan, Zenobia C. Y. | Journal of International Women's Studies, May 2008 | Go to article overview

Meanings of Weighing Female Patients and Their Clinical Implications


Chan, Zenobia C. Y., Journal of International Women's Studies


Abstract

Severe weight loss is the chief characteristic of anorexia nervosa. Weight is also one of the important indicators for evaluating a client's recovery. I weighed all clients at their pre-treatment interview, the beginning of every family session, and at the termination session, and kept records based on follow-up telephone calls after family treatment ended. I found the process of weighing to be noteworthy not only as an instrumental task, but also as a reciprocal learning experience between the clients and myself. Also, my role as the "weigher" of the clients had unexpected effects on my peers, my family and myself. Implications for clinical practice were suggested: an apparently simple task like weighing should be understood in a larger context, including the client's individual circumstances and psychological responses, and the possible reciprocal effects on the professional and their families.

Keywords: Weighing, anorexia nervosa, implications, & Hong Kong

Introduction

Severe weight loss is the chief characteristic of anorexia nervosa. Weight is also one of the important indicators for evaluating a client's recovery. I weighed all our clients at their pre-treatment interview, the beginning of every family session, and at the termination session, and kept records based on follow-up telephone calls after family treatment ended. Over the past three years, I found the process of weighing to be noteworthy not only as an instrumental task, but also as a reciprocal learning experience between the clients and myself. A client should never be made to feel that her worthiness is related to her body weight. Weight restoration should be a means of evaluating a client's recovery only. Also, my role as the "weigher" of the clients had unexpected effects on my peers, my family and myself.

A brief overview of anorexia nervosa

Anorexia nervosa has been defined as a mental disorder. Characteristics of anorexia nervosa include weight loss that brings the weight to less than 85% of ideal, intense fear of weight gain, self-evaluation highly influenced by perceived weight and shape, and absence of at least three consecutive menstrual cycles (American Psychiatric Association, 1994).

Diagnostic-oriented approach

The above criteria can assist in classifying the mental disorder of patients who are suffering from anorexia nervosa with these manifestations. Standardization of diagnostic criteria can help identify susceptible patients quickly, and categorizing this eating disorder helps inform subsequent treatment. This symptom-focused approach allows for a straightforward cure. However, this approach has some limitations, as outlined below. The above criteria provide no means for understanding the individual in her family and social context. Rather, they add up to a medical label that sees the cause of the illness as the patient's over-concern with body image, and as an extreme attempt to be thin for reasons of vanity. When weight is the central pivot around which assessment and treatment are oriented, the patient's mental state becomes secondary to her physical body, and her relationships with her family and her roles in society are not examined.

Despite the limitations of these diagnostic criteria, the biological effects of the disease should be noted. Kotler and Walsh (2000) pointed out that anorexia nervosa affects mainly adolescents and can result in serious medical and psychiatric issues. To take a closer look at the possible manifestations of this illness, three aspects will be discussed: physical, psychological and behavioral.

Physical symptoms

A variety of physical symptoms may develop, such as loss of hair, growth of fine body hair, amenorrhea, absence of ovulation, constipation, tooth damage due to over exposure to stomach acid from frequent vomiting, intolerance of cold temperatures, low pulse rate, easy bruising due to a lack of vitamin C, shrinkage of the internal organs, and various dysfunctions, including of the cardiac system, endocrine system and gastrointestinal tract (American Psychological Association, 2000; World Health Organization, 1992). …

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