Table 6 Illustrative Participant Quotations for Theme 5: Weighing Practice Preferences

5.1 Open Weighing

OW

“I like to see the number … Like I can’t sit comfortably if I don’t know.” (Need for Control, OW201)

“I think it’s a way I can see progress, and it gives a sense of comfort I guess, in terms of just knowing what your body is doing.” (Progress feedback, OW207)

“I’m finding it [OW] more useful because then I can kind of rationalise that you know that you know I gained like 2 or 3 k in a week when that’s not the truth. So, it kind of helps me challenge the eating disorder a bit by knowing that you’re wrong, because I only gained this much. But I always prefer to know.” (Cognitive challenging, OW210)

“Blind weighing was the worst because it gave me that panicky feeling of not knowing.” (Intolerance of weight uncertainty, R309)

5.2 Blind Weighing

BW

“I think not knowing makes treatment, I think it, sort of takes it away from the weight, and it’s just what your body is supposed to be.” (Reduced weight importance, BW106)

“I think it’s just one less thing to worry about... I think that it’s very easy to fixate on individual numbers and figures whereas what I think is most important in here is the overall trend.” (Reduced anxiety and preoccupation with weight, BW107)

“I think it [BW] kind of sets the platform for you to then be able to then take the focus off the weight when you go back into the real world and to be able to go “actually it hasn’t killed me it’s not the worst thing in the world and it’s okay.” (Exposure to weight uncertainty, R315)

“[not seeing my weight] certainly helps me to make progress and be much healthier on a day to day basis” (Progress towards recovery, R311)

5.3 Blind weighing adaptations

BW

“At [BW treatment facility] they had a weight graph … it didn’t have numbers, it just showed you what your weight was doing...and I like that … it’s … a little bit of exposure.” (Weight Graph, BW101)

“BMI banding gave me some safeguards … I would know where I might be sitting … I think it’s kind of exposure [to weight gain] but without exposure to the actual kilo amount. Banding for me gave me leeway of the flexibility of being able to move up and down, so 100 g wouldn’t send me into panic, you know, if I moved from, I don’t know, 40 kg to 40.1 kg then knowing that would send me spiralling into anxiety … but not seeing those really small incremental changes, I think reduced … the emphasis that I had on my weight, but the bands still meant that I didn’t feel like I was out of control.” (BMI Banding, R306)

5.4 Stage of Treatment

BW

“I think during the weight gain process, [blind weighing] definitely makes things a lot easier. Like obviously it’s not completely, stress free... But … if I were continuing to see my weight go up I’d be a lot more stressed out. So... I think it helps a little bit with the motivation to keep following my meal plan, and stuff like that, and comply.” (Acute stage, BW108)

“I would say for girls who have first come in that, perhaps blind weighing is more beneficial … Because the eating disorder voice is so strong, and any upwards movement it doesn’t matter if it’s 200 g or 2 kg, I think that that would completely freak you out and you’d be a mess for that whole day I’d imagine after weighing. And your head would be screaming at you to not follow the program.” (Acute stage, OW207)

OW

“[OW] definitely not early on. Perhaps when you start being on the recovery road you may discuss it with the clinician and together decide what would be best. But even when I thought I was ready later it turned out that I wasn’t so maybe patients wouldn’t have that insight …? Perhaps when fear of weight change is gone you can start seeing the weight …” (Best timing for OW, R304)