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Table 4 Illustrative Participant Quotations for Theme 3: Treatment Team Relationships and Autonomy

From: Blind versus open weighing from an eating disorder patient perspective

Subtheme

 

Illustrative participant quotations

3.1 Treatment autonomy

BW

“I found it [BW] very like punitive in some ways. Like I don’t know I’m an adult and I just felt like I was a child being like weighed backwards and then kind of like in trouble if it wasn’t the outcome that was hoped for or something like that.” (Lack of treatment autonomy, R316)

OW

“You can see how your weight is going up steadily, and your meal plan’s working. Whereas if they were to just increase your meal plan and you’re like, ‘why?’, it kind of answers some of those questions.” (Treatment progress feedback, NW213)

“I feel like knowing the number includes you in the conversation with the treatment team.” (Inclusion in treatment conversations, NW207)

“I can’t see any benefits [to OW] other than feeling a little more autonomous and “normal”.” (Increased treatment autonomy, R304)

“It was good to feel like I had some autonomy and was allowed to see it although I guess I could equally be autonomous choosing not to see the weight right?” (Role of autonomy in treatment, R304)

3.2 Trust in treatment team

BW

“I like that they are in control of my weight and I can’t know it. They just showed you what your [weight trend] was doing and I liked that, if you did it with someone you trusted.” (Importance of trust in treatment, N101)

“In the beginning I hated it … I always used to think like, ‘oh no, they’re lying, they’re lying, they’re lying, they’re lying’ … but I think after coming to [BW facility] now for a year, and I know now that my relationship with [psychiatrist and psychologist], I know that I can trust them, like a 100%. Now it’s kind of nice as well to give the control over to someone else.” (Importance of trust in treatment, N112)

“I think those are the two things you really lose sight off when you’re unwell you, there’s so much control and so little trust and [BW] kind of just turns it on its head.” (Importance of trust, R310)

“I previously had a psychologist that completely lied to me about my weight so it got -- like, a really long time and just, it’s made me petrified. She used to say, ‘No I won’t let you look.’ And I would say, ‘Well, is it below this number?’ And she would say, ‘Yes.’ And then one day I found out that she had been lying all that time.” (Need for honesty, NW209)

3.3 Strategies for Enhancing Autonomy and Trust

u/s

“I wish we had the ability to kind of... Talk to somebody about it [best weighing practice], without being shut down.” (Involvement in treatment decision-making, N108)

“I feel that the way they do it here is quite good with giving you a choice...challenging ‘Hey do you want to try and see your number and have therapy around that while you’re here?” (Choice, NW213)

“During therapy, I knew my weight at some stages and then I didn’t know it at others. It depended in what the therapist thought was best. I sometimes felt like I wasn’t being asked, I wasn’t being treated like a “normal person” who could be trusted and could take responsibility of it. Perhaps it would have been good to have that discussion with me and see if it was a “recovery day” where I felt capable of seeing it or not.” (Involvement in treatment decision-making, R304)

  1. Note. BW: Quotes relating to blind weighing; OW: Quotes relating to open weighing; BW# blind weighed inpatient; OW#, open weighed inpatient; R#, recovered participant