Living With Food: The Science Supporting Eating Disorder Treatment

By, Drs Lucene Wisniewski and Mark Warren

One of the most common questions in eating disorder treatment is “What is my goal weight?”. Although the answer is generally “I don’t know”, for many patients goal weight is generally determined by ideal body weight, which comes from the Metropolitan Life Ideal Height and Weight Tables.  In 1943, the Metropolitan Life Insurance Company introduced their standard height-weight tables for men and women. At that time, the weights were billed as "desirable" weights, indicating that persons at those desired weights had the lowest mortality rates. That being said, over time the phrase "ideal weight" became commonly associated with these tables. 

The notion of target weight suggested by these tables, therefore, is simply a starting place. Many other factors influence the recommendation of a goal weight, such as the point at which menstruation resumes, the weight at which thoughts about food and eating decrease, among other things. Nonetheless, at the start of treatment, since it is almost impossible to know exactly where things will end up, this number is what we generally mean when we say goal weight. A confusion that arises for many people recovering from anorexia is the difference between resolving medical complications and reaching goal weight. The two of these are both treated through weight gain but are not by any means the same thing. Issues such as bradycardia, prolonged QTc, loss of menses, oteopenia, and orthostasis, will hopefully be resolved prior to goal weight being reached. In some cases they may persist long after this has happened. In no case, however, does the resolution of these complications necessarily mean that target weight has occurred. Although important, the purpose of reaching goal weight is not simply to reverse medical complications, but also to reach a healthy physical state to prevent relapse and provide basis for high quality life worth living as you move on from treatment into day to day life. The resolution of medical complications is of course highly desired, necessary, and will cause great relief to someone with this illness, but it is not a measure of the end of treatment, the end of weight gain, or the resolution of the eating disorder itself.

For more info on the medical complications of eating disorders please take a look at the following links:

Osteoporosis and Osteopenia 

Cardiac Complications 

Refeeding Syndrome 

Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman