Why We Need to Talk About 'Scale Trauma' in Eating Disorder Recovery


Why do we pretend stepping on a scale is harmless?

Aside from a child (who hasn’t been indoctrinated into our weight loss obsessed culture yet), I haven’t met a human who could step on a scale without trepidation or explanation. For many people, the scale directly impacts their mood, what they will allow themselves to eat that day and how hard they need to push (punish) themselves at the gym.

“I lost weight! I feel great!”

“I gained weight. I feel terrible.”

“I felt great because I thought I lost weight. But the scale said I gained weight so now I feel terrible.”

The scale has a tremendous amount of power because of the value and moral purity we often attach to losing weight. For decades, courtesy of diet culture and an eating disorder, I was a true believer. I believed in the ultimate and absolute healing powers of weight loss. I thought losing weight would fix everything: cure my anxiety and depression, cure my eating disorder, heal my often debilitating self and body hatred. I thought when I finally lost the weight I would be smarter, healthier, more beautiful, a better mother and finally feel like I belonged. I believed losing weight was the key to living my best life.

And no matter how hard I tried, I couldn’t maintain a constant state of weight loss (I don’t think anyone can). The scale served as frequent and potent confirmation that my body wasn’t worthy of love, connection or belonging, and neither was I.

When the scale is the ultimate arbitrator of your value and self-worth it is not just harmful, it is trauma. I call it “scale trauma.” And we need to start talking about it. Especially within the context of eating disorder recovery, where patients are experiencing treatment sanctioned scale trauma on a regular basis.

Scale trauma is the eruption of stress and anxiety that occurs before, during and/or after stepping on a scale. The stress and anxiety can be so consuming it overwhelms one’s ability to cope.

For the 30 million individuals in America battling eating disorder thoughts and/or behaviors, stepping on a scale can potentially cause overwhelming physical and mental stress, anxiety and depression. The act of stepping on the scale is the trauma. Knowing the number (number trauma) is a separate trauma akin to pouring kerosene onto an already raging fire of eating disorder thoughts. I distinguish between the two because there seems to be an unspoken fallacy amongst the eating disorder recovery community that “blind weigh-ins,” where the person on the scale doesn’t see the number, are benign.

In eating disorder recovery, stepping on a scale is never benign.

During the many years I struggled with an eating disorder and struggled with recovery, knowing I had to step on the scale when I went to the doctor was intolerably stressful. For days and/or weeks leading up to the appointment, my anxiety would turn into a hurricane of eating disorder thoughts and behaviors as I stressed about what the scale might reveal. To be clear, I almost never knew the actual number because my weigh-ins were “blind.”

But “blind weigh-ins” were rarely blind. Either the number slipped out or the doctor’s mood and behavior indicated what the scale said about me. Most of my primary care physicians let the number slip out in one way or another. The only thing I thought about during and after the visit was my weight gain or weight loss.

The number didn’t usually slip out with my recovery providers, but I always knew if my weight was up (my doctor was so proud of me and super positive) or down (my doctor seemed distant and didn’t trust me). Whatever the number, I knew that number defined me in that moment. Whether it was a therapist or nutritionist, he or she used that number to determine if I was complying or not complying with treatment. The underlying distrust between us was palpable and completely antithetical to recovery. Rather than focus on the feelings and emotions triggering my eating disorder thoughts and behaviors, we were both distracted by my weight.

Scale trauma is real and we cannot afford to ignore its negative impact on eating disorder recovery.

There isn’t a doubt in my mind that one of the reasons I am recovered today is because I wasn’t exposed to scale trauma during my recent recovery. I haven’t stepped on a scale in two and a half years. In fact, my therapist and I never used my physical appearance as a metric to track my progress (this was hard for me but important). The focus was on my thoughts and behaviors. I didn’t feel shame for having eating disorder thoughts and/or behaviors during recovery because I knew having them, confronting them, challenging them and diffusing them was part of recovery. She and I tracked my progress by how my thoughts, language and behavior evolved. Removing scale trauma had a positive impact on my recovery because it opened up space to heal.

This isn’t a call to action to remove all scales from eating disorder recovery (although wouldn’t that be awesome). I recognize the use of scales in eating disorder recovery is deeply ingrained and even well-intentioned. This is a call to action to start talking about scale trauma. To acknowledge and address the negative impact of scale trauma in eating disorder recovery and start talking about other, less traumatic, metrics.

Follow this journey here

If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237.

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Thinkstock photo via Ingram Publishing

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