For many adolescents and adults in eating disorder treatment, weight restoration is an important step towards recovery. Weight restoration is the process of returning weight back to an individual’s natural biological blueprint following weight loss or weight suppression due to an eating disorder. This is where understanding Biologically Appropriate Weight (BAW) comes into play.
Regardless of where a person’s weight was before their eating disorder, weight loss through restriction is never healthy. Undernourishment has a significant impact on physical and cognitive functioning. Research shows that complete weight restoration ensures medical and psychological stability and is necessary for full recovery.
what does biologically appropriate weight mean?
The term “biologically appropriate weight” (BAW) was coined to allow for a unique and personalized assessment of weight and weight related goals for recovery.
A BAW is the weight at which the medical complications of the ED have resolved, obsessive thoughts about food and body have decreased, and normalized eating and exercise patterns have been achieved. At their BAW, an individual is not using ED behaviors. For females, their menstrual cycles have been regulated. For adolescents, growth is returned to individual growth curves. When assessing weight gain needs in treatment, an informed ED treatment team is going to take into account the person’s weight before treatment, growth curves across their lifetime, family, and body type.
How do we determine biologically appropriate weight in eating disorder recovery
There are many calculators out there to compute generic “healthy weight” definitions. But these are not helpful because they don’t take into account the wide array of factors that determine an individual body’s size and shape (genetics, individual growth curves, gender, ethnicity, family history).
We know that there is no “one size fits all” and each person has their own healthy weight. Your BAW is determined largely by genetics. Studies support that heritability (genetics) of BMI could explain up to 40-75% of an individual’s body weight (O’Rahilly & Fraooqi, 2008; Schousboe et al., 2004). This explains the set point theory which asserts that our bodies thrive at a certain genetically-determined weight range and will fight to keep us in that range for optimal functioning. We highly recommend watching the Poodle Science video for a great explanation of a size-inclusive definition of health.
how do I know if I'm at my biologically appropriate weight?
Many individuals will notice that when they reach their BAW, they are able to readily access their healthy brain and the ED voice is much quieter. Your body is wise. It is hardwired to protect you from harm, including the harm caused by an eating disorder. When you are no longer focused on shrinking your body and instead can listen to and meet its needs, it knows what to do.
We know that the process of weight gain in treatment is hard and scary. It is the exact thing your eating disorder has been trying to prevent. But we also know that you can do hard things. And in facing this fear, you are choosing healing, your authentic self, and a life of full recovery.
- Nutrition Counseling in the Treatment of Eating Disorders by Marcia Herrin, Ed.D., M.P.H., and Maria Larkin, MEd, RDN, LD
- “Weight Goals in Anorexia Nervosa Treatment” by Dr Jennifer Gaudiani