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goodenoughmum

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Reply with quote  #1 
Hi everyone,

I am confused and wanted to see what other people's experience have been.

We started refeeding using the Maudsley approach following extensive research while we patiently wait for our first FBT session (15/01 - YAY!)  My d has weekly 'blind' weighs through an ED clinic at the local public hospital.  Since Nov, we have avoided an imminent hospital admission and she has gained 3kg (6kg to go).

Her psychiatrist tells d the weight gain which makes ED rear its ugly head for a few days as she feels horrible.  For example, she was told yesterday she gained 700 grams; whilst I'm doing the Silent Happy dance (thanks iHateED [smile]) my d is awash with shame and guilt with severe ED thoughts making the next few meals VERY rough on both of us.

Is this normal practice, if so why?  What are the benefits of telling d her weight gain?
mnmomUSA

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Reply with quote  #2 
The theory goes that exposure to "the number" makes "the number" less of a factor over time.  My D was also told her weight from the very beginning.  So, at least for some practitioners, this is "normal."  However, YOU are the parent and you know your kid best. There are parents here who preferred to blind weigh until their child's emotional state was less fragile.  
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D, age 16, first diagnosed March 20, 2013, RAN, at age 13 Hospitalized 3 weeks for medical stability. FBT at home since.  UCSD Multi-family Intensive June 2015.  I see light at the end of the tunnel!
Sotired

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Reply with quote  #3 
Our d was always told her weight during therapy which made our lives a living hell as it meant no eating the day before weigh in and often the day after.so my advice for what it's worth is that your d doesn't need to know.they will tell you that they HAVE to know but I don't see why.it certainly doesn't make it any better.if you have the option for blind weighing I would do that.but this is just my opinion.
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Sotired42
IrishUp

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Reply with quote  #4 
One of the things that many people with ED need to recover from, is the fixation on wt, finding weight numbers triggering, and having (way too low) wt goals. Manualized FBT therefore has open weighing as part of the protocol; the idea is that "hiding" the wt can act to reinforce the irrational fixations, whereas open weighing is a form of exposure therapy.

There isn't one right ... erm ... way to go on this. Some families find that it is an unnecessary trigger when it's taking all you can do to get meals completed. Other families find that "ripping off the bandaid" and just doing everything on Day 1 that you will be doing on Day 90 (or, tbh day 185, 365 ......) works for them.

FBTs vary a lot in how flexible they are or are willing to become on this part of the protocol, as far as I can tell.

Our experience is that it was hell either way: There is only so much hell that "trigger control" can avoid, as the specifics of what ED would fixate on would simply shift to something else whenever we decided to try to manage something by avoiding exposure. But in her very earliest days when her wt was critically low, we opted for "get food in", and minimized the number of extra stressors as we could.

An old thread with some more discussion:

http://www.aroundthedinnertable.org/post/blind-weigths-vs-open-weights-6326777#gsc.tab=0

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IrishUp
30BT

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Reply with quote  #5 
My daughter has always known her weight, we have done FBT through children's hospital in Sydney and they tell weight! When a IP they weigh 2x per week, as an OP they weigh 1x per week.
It has caused lots of problems every time we get to another whole number but I think overall it hasn't been bad.
14mths and 10kg later she is WR and still growing ( 5 1/2 cm) since hitting 50kg 12mths ago!
They also set WR at different levels for different girls depending on a bone scan and bloods/ puberty status, they don't really use BMI that much and give a round about figure not an actual Number- obviously we have chased the weight up because of the growth!

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Mum to 14yr old girl with AN, WR and trying to get her life back.
EB

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Reply with quote  #6 
Just echoing Irish here - our experience was it didn't matter whether weighing was blind or otherwise, weighing caused ed to obsess one way or the other, as ed is inclined to do when it is prodded. 

A number could set off all kinds of calculations and extrapolations, but the lack of a number didn't stop that from happening either - it just changed the basis of the calculation to one of speculation - often quite colourful speculation demonstrating a "spiraling out of control" entirely beyond argument or logic.

Our problems in caring often lie in our trying to appease what the eating disorder is railing against instead of recognising it for what it is - a symptom of the illness.  My advice, (and, full disclosure, I am speaking as one who found the weighing fall out one of the most stressful and anxiety triggering events that I have ever been through as an adult human being), is to do your best to avoid being frightened of what the eating disorder is frightened of.  Keeping our thoughts and actions based in what is sane can help us make better decisions for the longer term.  Compassion for the person exhibiting symptoms of an eating disorder doesn't have to extend to joining in with eating disorder logic and bowing to the perceived needs of that logic - if we do that we also risk working in the service of the ed.


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Boysmum

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Reply with quote  #7 
We found that knowing his weight made it much more difficult for our son to eat both before and after weighing appointments. It was our choice to instigate blind weighing as we knew his obsessive over thinking was torturing him. If we hadn't had said blind weighing I think the clinicians would have felt comfortable to keep informing him of his weight but it just didn't work for him. My SIL who is a recovered anorexic encouraged us to insist on blind weighing as she said she had also found it helpful.
You know him best, so if you think blind weighing to be what he needs, instigate it x

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13 yr old son diagnosed April 2015 with Anorexia.
goodenoughmum

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Reply with quote  #8 

Hi,

Boysmum, Sotired, EB, 30BT, IrishUp and mnmomUSA thank you so much for your thoughtful replies.

Her weigh in was Monday with a significant weight gain, I believe caused the resulting ED behaviours worsening - I have walked in on her exercising last night (hasn't been a problem since Nov),  resistive, insults, crying, complaining of stomach pain, attempt to negotiate, silent treatment etc.  [eek]

Even though I understand and support the theory behind this approach, I find with my d that it is counter productive at this stage to advice her of her weight gain, it is causing unnecessary pain and shame to my d making refeeding nearly impossible - which is the point!!!!

I will suggest to new FBT therapist that we blind weigh her until she is stronger, I think.

Thank you so much for sharing your experiences!  This is certainly a ride of ones life.....[frown]
Torie

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Reply with quote  #9 
My d's t prescribed blind weighing - drove D absolutely nuts. She couldn't stop obsessing about what her weight was. Things were much easier when we switched to open weights. But then, when she got within 10 pounds of where I knew she needed to be (she was higher than some of the professionals recommended at that point), she got scary emphatic that she was NOT going to gain any more. I guess that's one of the disadvantages of telling them their weight - it lets Ed know when to dig in and refuse.

xx

-Torie

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

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Reply with quote  #10 
We did blind weighing for the first several years for my D. She was only 10,11,12 at that time. She didn't want to see the number. Then one day I just said " ok let's get a weight" and she got on and saw the number and asked " is that good?" I said " it's just a number. You let me deal with where that should be." I remained totally calm and links it was no big deal. It's different for everyone. You have to follow your gut with what is right for your situation. I once got into an altercation with a psychiatrist who was talking about things in front of my very ill kid. I told her I didn't like it and she said all snotty " well in true Maudsley the child is always included in the discussion" . I said " well we are doing my last name method". Not recommending you get in a shouting match with your team ( lol), but it's ok to assert yourself.
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