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krausekl

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Reply with quote  #1 
Hello to everyone!  Just finally checking back in to feast after spending the last 3 weeks driving back and forth to the clinic my son is using for his ED.  He was hospitalized first for his low heart rate (33- 37 bpm resting),weight loss, and psychological response to the ED.  After 15 days as a patient, he was discharged and signed up for the clinic.  So far so good, he has gained weight back from about 88 lbs (he's only 5' tall and age 14) to 99.  He's been very good about eating all that is put in front of him, but they are requiring that he eat 4000 calories per day.  I had no idea how much food that was until I started trying to make his meals for him!  I was confused as to why they wanted so much, since most data online indicates that adolescents taller and heavier than him don't eat near that much unless they are exercising heavily on a daily basis, but they explained how these children become hyper-metabolic, thus burning more calories than normal children their age would.  So, I get this, but WHEN do they decide he's not hyper-metabolic anymore?  When he starts to gain further weight?  How long will he have to take in all of these calories?  He does have trigger foods, and he will eat them, but they take longer.  It takes him about a little over an hour to eat a 1000 calorie meal.  The clinic sets the timer for 45 minutes.  He feels like all he does all day is eat.  He is not allowed to exercise at all, other than walking around to his appointments and in the house (he was a cross country runner and addicted to exercise).  He's not attending school, we are working with the teacher at the clinic and his teachers at school.    I would love any suggestions you all have regarding ways to provide so many calories without the volume.  I am using smoothies as I can, nuts, oils and butters, and avocado.  I try to give him at least 2 or three trigger foods a day ( for him they are sweets and fried foods - also fast food and ice cream), but I don't want to overdo the trigger foods even though they give me the largest calorie count, because I'm afraid he will begin to provide even more resistance than he has already.  I've never had to sit longer than a few hours with a trigger food (for him), and with that one situation, I saved the food and required that he eat it as part of his meal the next day, and he did.  Thanks so much for the support and tips!
scaredmom

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Reply with quote  #2 
Hi krausekl
You are doing a great job. It is hard to get the calories in but you seem to know what to do. I added oil to sauces and whipping cream to yogurt and milk to bump up the cals. I "fry" meat and add cheese. Pasta with lots of oil in the sauce or pesto with cheese is great too. I add oil to the smoothies. There is a thread on high calorie foods too. You are doing trigger foods to which is wonderful. You are moving fast and furiously which will get him better fast!! He is only 14 and needs to grow a lot so don't decrease calories just keep them up. My d is WR and we are still at 3500 to 4000 cal per day. Don't look at what "normal" kids should have
You have to give him what HE needs to beat ED and grow.
Keep feeding +++
You are doing so well.
krausekl

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Reply with quote  #3 
What is WR?  Sorry, still kind of a newbie here - AND to ED.  Thanks for the tips!  So glad your d is doing well!  Wow - I thought he was being given MORE calories than the girls there - so girls also take in as many as 4000 calories?
scaredmom

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Reply with quote  #4 
WE is weight restored. Yes some girls need even more than 4000. When we were really pushing up the weight she was up to 5000! Some have had to push their kids, boys and girls past 6000!! Keep going! Push as much as you can and by "hiding" it he won't see it. Less volume more cal!! Way to go mom!!
scaredmom

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Reply with quote  #5 
Sorry WR is weight restored -typo
eternalhope

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Reply with quote  #6 
Krausekl, you are doing an amazing job! What you have done is amazing. Keep it up. Don’t let up. You’ve gotten him this far, fear foods and all. It just takes time. Higher calorie foods/lower volume on the plate. Hang in there. You’re doing great.
melstevUK

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Reply with quote  #7 
krausekl,

Glad your s has started on his recovery journey.

Did your s put on 11 pounds in three weeks?  That is really good going, or did it take longer?

While it makes sense to push the weight up as quickly as possible - not all children become hyper-metabolic.  My d never did - so I would not assume that this is the case with your s unless his weight only increases very slowly with this amount of calories.

I am all for pushing eating large amounts - but he may do well on less so I would be checking the weekly weight gain.  Everyone else will tell you the opposite - but if he is not hyper-metabolic then eating so much more than he needs might cause its own complications.  That would be my only reservation.

Certainly high fat foods and fear foods are the way to go - I would just want to know that I had the quantities right. The main thing is that he is not allowed to exercise during recovery.

Well done you - you are doing all the right things.

__________________
Believe you can and you're halfway there.
Theodore Roosevelt.
mjkz

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Reply with quote  #8 
Quote:
So, I get this, but WHEN do they decide he's not hyper-metabolic anymore?


My daughter required 5000-6000 calories to gain and for months and months. When your son hits his target weight (usually higher than pre eating disorder), it will take up to 6-8 months before he can back down on the calories to maintain that weight.  He might not need 6000 a day say but he most likely will need 3500-4000 to maintain.  He might need that much for a lifetime but don't back off on his calories for 6-8 months after he reaches a good weight.
deenl

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Reply with quote  #9 
Hi as the mom of 3 boys, honestly, my advice would be to just keep feeding.

My 16 year old ate like a horse and grew like a weed. He could eat 4 slices of bread and half hour later his dinner. He is skinny and all that food was going to growth, muscle development and organ development.

My 15 year old is 2 years into treatment for a restricting eating disorder. My rule is to feed as much as I can get into him including enhancing his nutrition with extra portions of protein and additional lipids like oil and butter. He is growing at a faster rate than average as his body strives to make up for lost time and reach it's genetically programmed height. Any shortfall in nutrition at any time but especially during periods of growth will increase the chance of relapse. https://uncexchanges.org/2014/12/01/negative-energy-balance-a-biological-trap-for-people-prone-to-anorexia-nervosa/

My youngest son, now 11, is growing fast but does not have the instinctive increase in appetite my eldest son had so I have to consciously ensure he gets enough nutrients to fuel his growth and maintain his health. He has some signs that mean I am very careful to keep his nutrition up. Better a few kilo's too heavy that risk a second kid with ED.

Warm wishes
D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
EC_Mom

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Posts: 305
Reply with quote  #10 
I well remember those days when all we did was feed and eat, feed and eat, for hours and hours. It gets better, truly. Keep going.

We were advised to set the timer, etc. For some people that works. I had to throw that out because d would just outwait the timer and I needed to show ED that I would do whatever it takes--including spoonfeeding her dinner until 1am, in her bed, against her resistance, climbing back and forth over her with the spoon while she rolled back and forth. But each time I showed ED that I was going to win, it got a teeny weeny bit better. 

So read up on high-calorie cooking, keep feeding, and know that you are doing what needs to be done to bring your child back to health.
deenl

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Posts: 891
Reply with quote  #11 
One other thing, the weight target is constantly changing. This is the nature of the teenage years even for kids without an ED. They grow, broaden and mature internally and their weight increases. A constant weight over time is the equivalent of weight loss and would keep your child ill or cause a relapse. You can track this at the free website mygrowthcharts.com

Keep up the good work
D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
Torie

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Posts: 4,593
Reply with quote  #12 
One of the many cruel aspects of this vile illness is that pretty much the only people on earth who WANT to eat less than is normal, have to eat so much more.  My d never had extreme caloric needs, but the extra that she did need, she needed for a l-o-o-o-n-g time.  She has been WR for 3 1/2 years, and I think she still has to eat more than her sisters to maintain her weight.

Keep feeding.  xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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