Everywhere we go, we are prescribed an “ideal body weight”: From our elementary school weigh-ins at the nurse’s office, to our yearly physicals as adults, to recommendations from health “gurus,” we are given a number we “should” be at. This number never takes into consideration our unique biology or environmental factors. It’s based on height, and sometimes, on gender. But standardized ideal body weights don’t exist, because everyone is different, and every body has different needs.
Yet, many eating disorder patients are still given a number that is their ideal body weight, and meal plans are tailored to that number. This causes many problems for everyone suffering from an eating disorder, including continued restriction to remain at the “right” weight, which may not be right for them at all.
Many treatment providers are starting to adopt another theory about the weight eating disorder patients should be at: set point theory.
In this article, we’ll discuss:
- Why treatment centers set target weights for patients
- How setting a specific number negatively impacts the recovery process
- What set point theory is
- How set point theory is changing the recovery process
- How intuitive eating is related to recovery
- How to know if you are at your set point
Why is weight such a big focus when eating disorders are mental illnesses?
Eating disorders are, unfortunately, tied up with physical symptoms, despite being mental illnesses. Society, medical practitioners, even the DSM, the manual that lists diagnostic criteria for mental disorders, focuses on weight and BMI as a defining feature of an eating disorder.
Because weight has been painted as an indicator of the severity of an eating disorder, many practitioners (and insurance companies) base a person’s wellbeing on their weight. Concrete numbers are an easier way for treatment providers to determine health, so naturally weight is seen as a way to gauge someone’s sickness and recovery.
The Problem with Focusing on Concrete Numbers
If you are a person battling an eating disorder, and are at a higher weight/BMI, then you may feel invalidated in your own mind, by those around you, even by medical professionals. You might not believe you are worthy of help, or that you have a problem at all, until you get to a certain weight/BMI.
Research has shown that early intervention gives eating disorder sufferers a much higher chance of making a full recovery, yet many feel compelled to “wait” until they reach a certain number.
In many treatment settings, a patient’s “target weight” becomes the goal, rather than allowing a person in recovery to work on building a healthy relationship with food, and letting the body do what it needs to do during the recovery process.
When so much focus is put on numbers during/after treatment:
- You may feel invalidated by being at a “normal” weight or above while in treatment.
- You may still restrict food to maintain your “ideal body weight.”
- You may adopt new disordered behaviors (compulsive exercise, purging behaviors, etc.) to make sure you maintain a specific weight.
- You worry about going over that number, even if your body is signaling that it needs more food.
- You can’t release control over food out of fear that you’ll go over your “ideal body weight.”
- You may be prescribed an insufficient meal plan because you are already at a “normal weight” when starting treatment. Even if you have severely restricted and damaged your body before entering treatment, you are not viewed as someone “underweight” or “malnourished.”
- The focus of treatment (especially if you suffer from binge eating disorder) may be on dieting and weight loss, rather than recovering from your eating disorder.
- Insurance companies usually stop covering higher levels of care once you reach a target weight, even when it’s obvious that you still need more support.
Note: No treatment program should ever be centered around dieting or weight loss. If you are researching treatment options for your eating disorder, steer clear of any programs that promote dieting as a treatment focus.
Related: Click here to learn more about the effect of weight stigma on eating disorder treatment and recovery.
What is set point theory?
Many professionals in the field of eating disorders now recognize that the “ideal body weight” may not be an accurate number. In fact, many are voicing their concerns that recovery weights are being set too low, leaving many sufferers somewhere in between being not “sick enough” to have full access to treatment resources and “still too sick” to be considered recovered.
There is significant evidence for set point theory, which says that a person’s optimal weight is not based on any one factor, but on many unique, individual ones. The “ideal body weight” can not be a standardized number. A target weight cannot be given to someone without knowing anything about them but how tall they are.
Set Point Theory and Eating Disorder Recovery
Set point theory tells us that the “ideal” body weight is the weight at which your body and mind are functioning properly. If you are at or above an “ideal body weight,” but have been restricting to reach or maintain your current weight, then you are not at a healthy weight for your own body.
Your body’s set point is the weight where you are not engaging in any eating disorders and can experience real food freedom. This is the point where you are totally eating intuitively, listening to your hunger cues, and not restricting in any way.
With set point theory, you can:
- Trust that your body is doing what it needs to in order to recover.
- Know that if you have engaged in eating disorder behaviors to reach or maintain your weight, then your body needs more food to repair itself, no matter what your weight is.
- Remember that extreme hunger is your body telling you that it needs more food, even if you are at or above a target weight.
- If you “overshoot” your target weight, it might just be where you need to be. Your body may never “settle” to a lower weight, and that’s okay.
- Know that you and your struggles are valid, no matter your weight.
How do you know if you’re at your body’s set point weight?
You are not at your body’s set point if you:
- Restrict your food intake to maintain your current weight
- Compensate for your food intake in any way (excessive exercise, purging, etc.)
- Still experience extreme hunger
- Do not have/do not listen to your body’s hunger cues
- Constantly think about and obsess over food
- Have not reached the ultimate goal of recovery, which is intuitive eating
Related: Not sure how intuitive eating works? Click here to read more about intuitive eating and eating disorder recovery.
If you take away anything from this article, let it be the fact that anyone, at any weight, can suffer from an eating disorder. Eating disorders are mental illnesses. They are severe and life-threatening, no matter how much you weigh.
If you or someone you love is suffering from an eating disorder, take the first step today and talk to talk to someone about recovery, or simply learn more about the eating disorder recovery programs we offer.
