If a therapist notices the client losing weight should they say something or not mention it?

Question

The client (26 y/o female) has already had an eating disorder in her past (10 years ago).
She has recently become very depressed therefore, seeking treatment.
She has epilepsy which has gotten worse and severely broke her leg forcing her to move home, past and present family issues (so its a hard situation in dealing with bad memories in her moving to her family home-PTSD?).

-She may be coping with these issues by subconsciously and slowly delving back into the old habits.
-Is just depressed making her not feel like eating.
-New seizure meds. causing low appetite.

Could be different reasons...
But should it be mentioned in the session that i noticed her losing weight?
or ignore it in fear that it may make her want to lose more (if its the eating disorder behaviors coming back)

Just looking for input on what others would do in this situation.

Thanks :)

Answer 1

I think she should be told that it is noticeable. At the same time, I would point out that it is not a desirable change as it is not a healthy one. That way, the problem is promptly addressed. I don't see how avoiding or ignoring it can be a good thing. Surely, waiting it out can only cause more complications. In fact, it will probably escalate since the patient may not even be conscious of what she is doing. Therefore, why not highlight it right up front so that both the therapist and the patient can begin to work toward finding a solution?

Answer 2

I think it would only be a good idea if the sessions revolved around the person's eating habits or if they were depressed and mentioned that they had not been eating.

To tell someone they are gaining weight is not accepted so much now a days (health craze). I would leave that topic alone unless it was important to the session.

Answer 3

Pardon me, but where are you that you can't call a professional or your supervisor?

From therapy 101: Research patient records, determine course of treatment and history for her last eating disorder, read the references on eating disorders and their treatment, Determine several ways to raise the issue with the patient and then consult with a professional.

Answer 4

I would certainly mention it and make sure the doctor who writes her scripts knows.

Answer 5

yes. it should be brought up, but subtly or at least nicely