User’s Guide | Rules | Contact a Moderator | Registration or Login Problems? | Eating Disorders Learning Center | F.E.A.S.T.



Custom Search of F.E.A.S.T. and Forum Content:
Register Latest Topics
 
 
 


Reply
  Author   Comment  
Mamaroo

Caregiver
Registered:
Posts: 156
Reply with quote  #1 
I'm starting this post to write down some of my thoughts about what weight restoration (WR) is. I'm hoping that long time members of this forum would contribute as well.

So often, WR is presented as a number, a certain weight, however, since children grow and gain weight until they are adults, it means the target weight is also increasing. WR (in my opinion) is not getting back to the pre-ED weight. If WR takes a year an additional 10-12kg should be added, depending on age. For a long time, my d was always 10kg underweight, because she would gain, but checking her weight against her weight chart, she only gained what she was suppose to without ED. Eventually we had to increase her intake to get her to her correct weight curve. I'm including her weight and height chart as an example.

It is also important to note that each child has their own correct curve and to aim for the 50% curve is not always the best. In the attached chart, my d was 50% when she was admitted to IP, because her heart was being compromised. Many GPs who saw her before insisted that she was fine, because her weight was still above 50%.

Weight restoration (for me) means to be back at the historical weight curve. She got back to this curve when she turned 11 and has since continued to gain weight and is staying on this curve.
 

Attached Images
Click image for larger version - Name: weight height for age.JPG, Views: 87, Size: 198.96 KB 

__________________
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. Challenging fear foods and behaviours now.

toothfairy

Avatar / Picture

Caregiver
Registered:
Posts: 1,566
Reply with quote  #2 
Hi there,
For me, I believe in what Dr Peebles says in her video here. It is an hour long but an hour well spent IMHO!

WR is a state, not a weight.Often kids have to go well above their original growth curve to reach recovery.

If I had gone along with our GP and anorexia specialist dietitian , my Son would never have got into recovery...
To be honest , I dread to think what state my Son  would be in by now if I hadnt got rid of her. Its frightening.

He is about 20lbs higher than his ridiculous low " target " weight, and he is doing just great. He is fully functional and happy out!

Of course he will need to be gaining each year up to his 20's.

My Son got ill at 13, he still needs about 4000 cals a day in good recovery.

If you check out mamambears posts, her D had to be fed with about 6000 cals a day through her teens to keep her in recovery.....





__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
noo72

Caregiver
Registered:
Posts: 21
Reply with quote  #3 
I am really struggling with this issue myself right now:
A month ago my dd slipped into the underweight category and we were asked to do a Weight Restoration diet of 2500 calories. She put on just over 5 pounds in two weeks and they told her congratulations, you're now on the weight maintenance plan as you are now in the healthy weight range.  they told her this when i was not in the room. they also told her she could now skip dessert. They seem to be ignoring the fact that she is on the 27th percentile when historically she was always around 75th. i feel like these people are not treating my dd as an individual. she is the same weight now as she was 3 and a half years ago. they announced the change in meal plan  right at the end of the session, with no time for discussion. 

i am at my wits end (see my thread!)
evamusby_UK

Avatar / Picture

Registered:
Posts: 809
Reply with quote  #4 
Mamaroo, I think what you wrote is spot on, and your chart is a perfect example of how a 50th percentile weight is not OK for all. It should be inserted in all training materials!

Laura Collins Lyster-Mensch did the best ever interview of Dr Rebecka Peebles on these weight matters and on how much food to feed. The title is "State not weight". If I remember, Dr P gave pretty much the same example as yours.
http://www.circummensam.com/episode-21-state-not-weight-with-dr-rebecka-peebles.html




__________________
Eva Musby, mother, author, produces lots of resources for parents at http://anorexiafamily.com and on YouTube https://www.youtube.com/user/EvaMusby/playlists
[comp]
Holroyd957

Health Professional
Registered:
Posts: 11
Reply with quote  #5 
The 50th centile means that 50% of the population will be expected to be at a lower weight and 50% above it. If everyone is expected to be on the 50th centile it ceases to be the 50th Centile!! A fact that seems to escape some professionals!
eternalhope

Caregiver
Registered:
Posts: 87
Reply with quote  #6 
Such great information everyone. My d is WR according to growth charts for over 6 weeks, but the ED behaviors are still there. She's compliant with meals, but argumentative and still has ed thoughts and behaviors, such as tearing and smearing of food. She constantly threatens not to eat but in the end, does. It feels like chaos all the time. Does anyone have any insight when intuitive eating will return and she won't be so angry and defiant?
eternalhope

Caregiver
Registered:
Posts: 87
Reply with quote  #7 
Noo72- so sorry to hear your providers don't understand this illness. Everyone has to be aligned. She has an ED, she's not capable of rational thinking. No changes should have been made with the meal plan, and it should not have been discussed with her, without talking to you first and making sure everyone was in agreement. Mamaroo, Toothfairy and Eva
Are all right. State not weight.
Mamaroo

Caregiver
Registered:
Posts: 156
Reply with quote  #8 
Thanks for everyone adding their comments to this post. It is so important not to focus on numbers, but rather on state. I'm including my D's BMI chart as well. This one is interesting, because she didn't return to her previous curve, which was just below the 85% curve. She overshot and is now halfway between 85% and 90%, but I can honestly tell you all that she is now much better. This weekend we had to leave a class mate's birthday party early and she begged me to stay later to eat the cake [biggrin]. Off course we stayed!

Attached Images
Click image for larger version - Name: BMI.JPG, Views: 24, Size: 150.68 KB 

__________________
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. Challenging fear foods and behaviours now.

Holroyd957

Health Professional
Registered:
Posts: 11
Reply with quote  #9 
Mamaroo, huge congratulations on refeeding your D! I agree state not weight all the time. You may though, want to check your D's height charts to make sure she has continued to stay on her expected height centile and if not continue to feed and feed until she does and then some more until puberty is well established. Although state is the most important her BMI may look falsely higher than reality if she has not attained her expected height for her age. If that makes sense! If you are looking at charts it pays to look at weight and height ones as well as BMI to get the full picture. BMI on its own can be misleading. Sorry if I'm telling grandma how to suck eggs!
Kali

Avatar / Picture

Moderator
Registered:
Posts: 659
Reply with quote  #10 
Mamaroo, your daughter's growth chart is a beautiful thing!!!!! Wow, you have done an amazing job!

Kali

__________________
Food=Love
aloha

Caregiver
Registered:
Posts: 52
Reply with quote  #11 
hi
we got the same centile style charts brought out regulary and told we were not making head way, i protested and said i felt that D's diet was too low in calories and genetically from a small family gene pool.
each week ongoing the focus is on weight and no mention of "state of mind".
historically this is going on since Christmas 2015 when signs of disordered thoughts re food started, so as far as i am concerned weight is so important but all areas need to be addressed as the focus on food continually is very distressing for my daughter,
we have made some progress as in school /socially etc but weight very slow to creep up (10th percentile!!) and the "rules" surrounding times of eating etc are very strong so much so cripples all our family life.
when we get to the 50th percentile i will do Riverdance up and down the road.
EDAction

Caregiver
Registered:
Posts: 372
Reply with quote  #12 
As I understand it, the "state not weight" concept is applied as a person with ED gets close to WR and you are trying to determine the right weight for that particular person.  In the beginning, when a person is objectively below his/her historical weight curve the focus is weight, weight, weight.  "State" won't come along until "weight" is close to WR.  Then the focus moves more toward "state".  And the person's state is the best indication of when the person is at the right weight.


mamabear

Registered:
Posts: 5,585
Reply with quote  #13 
I would like to chime in on this.

I represent those who did NOT have a historical growth curve.
My h is a doctor and I’m s nurse and we took our kids for shots etc but didn’t do yearly physicals etc.
We didn’t have anything to go on... so we went on state.

It took a LOT of food and a ton of fats for many years ( diagnosed at 10.5). And we battled massive growth ( nearly 9 inches) and full puberty, and an over doubling of body weight.

Those first 3 years we felt like we were running up a sand hill. We could’ve just keep up at 6000 calories a day... but we could never get “ extra” as her body was just using up every calorie. Then when the growth stopped etc at around 14 we were able to finally get that extra 10-15 pounds on her. And at first I was freaked out bc her face got round and she was putting weight on in her butt and thighs etc . (Because we are all so absurdly scared at some point if “ making them overweight”. )

My husband was like “ we are going to get her weight where it needs to be based on her behaviors. Her body is going to morph and redistribute weight. We are finally not chasing height growth anymore. Stay the course.

He was right. A million percent right.

Once we got her to a strong BMI of 22-23 plus she began to eat independently and intuitively. We were able to cut way back on calories. She started to have food outside of the regimented schedule. She truly began true recovery and she has never looked back.

My daughter is now close to five feet 4 inches tall ( and I do think she would have been taller without ED) and around 145 pounds. She is healthy and happy. She is very open about her past strughles. She will be in college next year. I am savoring every day with her.

__________________
Persistent, consistent vigilance!
Torie

Avatar / Picture

Caregiver
Registered:
Posts: 4,478
Reply with quote  #14 
Quote:
Originally Posted by aloha
the focus on food continually is very distressing for my daughter


That's kind of what AN is all about.  It sucks, but until she is at a proper weight, this vile illness will consume her mind and make her think about food/size/weight/calories constantly.  The only thing that can change that is being weight restored.

Keep swimming. xx

-Torie

__________________
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Previous Topic | Next Topic
Print
Reply

Quick Navigation:

Easily create a Forum Website with Website Toolbox.

F.E.A.S.T. Families Empowered and Supporting Treatment of Eating Disorders
is a 501(c)3 charitable organization committed to maintaining the Around the Dinner Table forum as a FREE service for any caregiver of a loved-one with an eating disorder.

P.O. Box 1281 | Warrenton, VA 20188 USA

US +1 855-50-FEAST | Canada +1 647-247-1339 | Australia +61 731886675 | UK +443308280031 

This forum is sponsored by F.E.A.S.T., an organization of parents serving parents and caregivers of patients of all ages with anorexia, bulimia, and other eating disorders. Information and advice given on this forum does not necessarily represent the policy or opinion of F.E.A.S.T. or its volunteers and is meant to support, not replace, professional consultation.

F.E.A.S.T. is registered as a nonprofit organization under section 501(c)(3) of the United States Internal Revenue Code.

Terms of Use | Privacy Policy | Community Rules | Forum Rules | F.E.A.S.T. Principles | YMadmin | WTadmin
Custom Search of F.E.A.S.T. and Forum Content: