Weighing clients during COVID without the ability to visit with them in person can be a major challenge.
In my practice as a nutritionist, I treat severe eating disorders and have long struggled with the issue of weighing my clients and even more so, weighing my clients during COVID times.
Weighing my patients in a safe and supportive environment is vital to treatment.
Patients are advised never to weigh themselves at home and so looking at numbers on a scale can be triggering. For those suffering from anorexia, bulimia and other eating disorders, looking at the numbers on a scale may be traumatic. The same is true for cancer patients who might spiral into a particularly deadly type of eating disorder called anorexia-cachexia. Of course patients experiencing triggering or are otherwise severely impacted can turn to eating disorder helplines but to manage treatment over time, a consistently safe process and recovery focused approach is best.
In normal times, it has always been vital to weigh patients in my office, where it can be done safely and under the supervision of a trained clinician. I see the number. The patient does not. It’s the right way to treat patients, but it’s always bothered me that weigh-ins take precious time during our sessions – time that could have been spent discussing emotional issues and time spent creating a plan to tackle stressful holidays like Christmas and Thanksgiving. The weigh-ins ultimately take time from my working with clients to devise a supportive eating strategy.
With a pandemic raging, weighing clients during COVID in a safe non-triggering manner has been an even greater challenge. So no longer are the challenges the time a weigh-in takes form the actual time spent treating the disorder but instead a greater challenges arises that prevents clinicians such as myself to do the actual weigh-ins – that is, to get any measurement at all from clients.
Unexpectedly, this has opened up more time in my sessions to tackle the big issues. But it has also created a gap in treatment. Regular weigh-ins done in a supportive environment are the gold standard for measuring the direction of treatment. Are we going uphill or down? Should we increase the level of care? Are we spiraling towards crisis or climbing to health?
Remote video sessions through Zoom or Teams are helpful and allow for face-to-face interactions – another important facet to treatment – but but those methods for communicating answers none of those questions. Only measuring clients’ weight progress will answer those questions.
Solving the problem of weighing clients during COVID
This problem of weighing clients during COVID troubled me for months. So, I teamed up with a group of hardware engineers, software designers and compliance experts to solve it. This month we started a pilot program using our newest numberless scale that transmits my patients’ weights directly to me via a secure online dashboard.
My patients cannot see the numbers on the face of the custom designed scale so that they cannot obsess over numbers. As the clinician, I get the weight data I need to direct care and we’re not taking time from our sessions to gather data. And most importantly, clients are not being triggered by numbers.
We’re at the starting line, but I hope eating disorders can soon enter the world of remote patient monitoring and telemedicine in the way that other areas like diabetes and heart disease have already done. By weighing clients during COVID using modern telemedicine solutions, we are taking big first step in making it a part of our standard practice as nutritionists and clinicians treating eating disorders.
If you are a nutritionist or are involved as a clinician treating eating disorders, see more about how a numberless scale can keep your clients feeling safe during COVID.

Marisa Sherry, Founder & CEO
Marisa Sherry is the founder and CEO of ExtensionMD, a remote patient monitoring provider for clinicians and patients of eating disorders. As a dietician, she has spent two decades helping HIV patients with wasting syndrome, children with deadly food allergies and for the last 10 years severe eating disorders. She has a master's in Clinical Nutrition from NYU.