Establishing a contract with a patient diagnosed with anorexia nervosa to participate in measures designed to produce a specified weekly weight gain can serve several important purposes in the treatment of the disorder. Here are some rationales for implementing such a contract:
Clear Treatment Goals: Anorexia nervosa is a complex and potentially life-threatening eating disorder characterized by an intense fear of gaining weight and a distorted body image. Setting a specific target for weekly weight gain provides the patient and the treatment team with a clear and measurable treatment goal. This helps focus the efforts on overcoming the resistance to weight gain and monitoring progress.
Motivation and Engagement: Patients with anorexia nervosa often struggle with motivation to gain weight due to their fear of weight gain and body dissatisfaction. By involving the patient in the process of setting the target for weekly weight gain, they may feel more invested in the treatment and more motivated to achieve the goal they helped establish.
Collaborative Approach: Establishing a contract fosters a collaborative approach to treatment, where the patient actively participates in decision-making. This can enhance the therapeutic alliance between the patient and the treatment team, leading to better treatment adherence and cooperation throughout the recovery process.
Accountability: A contract creates a sense of accountability for both the patient and the treatment team. It outlines the responsibilities and commitments of each party and helps ensure that the patient's progress is consistently monitored and supported.
Safety and Monitoring: Anorexia nervosa can have severe medical consequences, including malnutrition and electrolyte imbalances. The specified weekly weight gain helps to ensure that the patient is making progress towards a healthier weight range, reducing the risk of medical complications and providing a quantifiable indicator of improvement.
Gradual Progression: Setting a weekly weight gain target allows for a gradual and steady approach to weight restoration. Rapid weight gain can be distressing for individuals with anorexia nervosa and may reinforce negative beliefs about weight gain. A measured and consistent approach is generally more tolerable and sustainable.
Behavioral Reinforcement: Meeting the specified weekly weight gain can be reinforced through positive feedback and rewards, providing additional motivation for the patient to adhere to their treatment plan and work towards recovery.
Education and Empowerment: Involving the patient in the goal-setting process and explaining the rationale behind the weight gain target can help educate them about the importance of weight restoration in recovering from anorexia nervosa. This knowledge empowers the patient to take ownership of their recovery journey.
It's essential to note that the contract should be developed and implemented with sensitivity and in collaboration with the patient's treatment team, including physicians, therapists, dietitians, and other healthcare professionals. Each patient's situation is unique, and treatment plans should be tailored to address individual needs and challenges. The contract should also be flexible enough to accommodate adjustments based on the patient's progress and well-being throughout the treatment process.