An Exploratory Study of Patient Preferences for Closed or Open Weighing Following Discharge from Acute Treatment for Anorexia Nervosa

Within treatment for anorexia nervosa (AN), little is known about patient preferences for open weighing (i.e., weight is disclosed to patients) versus closed weighing (i.e., weight is not disclosed), despite open weighing being encouraged by evidence-based treatments. This exploratory study examined weighing preferences in the post-acute treatment period and their associations with various factors. Ninety cisgender women with AN completed baseline surveys for a randomized controlled trial, wherein they selected open or closed weighing for their baseline visit. Clinical and psychological variables, including eating disorder severity, motivation to recover, weight concerns, anxiety, depression, obsessive-compulsive traits, current treatment, and treatment history were assessed alongside demographic factors. Group differences in these variables based on weighing preference were examined using Mann-Whitney U tests and chi-square tests of independence. Closed and open weighing preferences were evenly split across the sample. Of all factors examined, only number of inpatient treatment stays was significantly associated with weighing preference, with more stays linked to preference for open weighing (p=0.042, r=0.23). Findings suggest that weighing preferences are heterogeneous and not consistently associated with clinical, psychological, or demographic factors, an important finding relevant to treatment planning. Future research should examine weighing preferences in a larger and more diverse sample.