Typical-Atypical Interactions: One Patient’s Experience of Weight Bias in an Inpatient Eating Disorder Treatment Setting

Abstract

This article examines one patient’s experiences with weigh bias in an inpatient eating disorder treatment setting with a focus on interactions between the patient and her primary therapist. These therapeutic interactions had multiple unintended consequences, including bolstering feelings of denial, modeling of disordered behaviors, and disrupting the therapeutic alliance. Additional instances of weight bias with other treatment professionals, including an inpatient nutritionist and psychiatrist, are briefly discussed. The article ends with several brief recommendations for how clinicians can more skillfully approach issues of weight and size in the therapeutic alliance in order to resist size-related oppressions rather than reinforce them.

Keywords:

• Atypical anorexia
• higher-weight restrictive eating disorders
• inpatient eating disorder treatment
• refeeding
• therapists’ weight bias
• weight bias

Acknowledgments

This publication was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number TL1 TR002318. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.