Registered: 1528754293 Posts: 297
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I think I may have touched on this before, and I've searched the threads, but I can't seem to find a clear-cut guideline on exercise after wr.
My D12 was wr mid-September. Has has two periods. Is gaining and maintaining well. Exercise was a partial component of illness. Before refeeding she did pe class and gymnastics once/week, plus occasional workouts. Once we began refeeding in March she began 10-15 mins intensive exercise/day for two months plus pe class, and quit gymnastics. Then we cut out workouts upon diagnosis in May, along with pe, and allowed a 30-min daily stroll after supper for next three months. Once the intensive workouts were cut out in May her need to be standing kicked in. She was gaining about 2 lbs/week at this time. Cut out her walk mid-August upon learning about leptin levels and periods. Standing compulsion ended then, too. End of August first period in 8 months. Fully wr early/mid-September. I don't know if exercise would have been considered a strong component of her illness. No interest in exercise or walking since mid-August, except she wants the social aspect of pe, of being with her friends and not missing out. She said her friends say they are doing fun things and she wants to go, too. It seems three regular periods would indicate her hormone levels are good again. She is gaining and maintaining. I am considering allowing her to try pe class once in her six-day cycle (instead of twice) next month if she has her third period and no obvious concerns in regards to physical activity and see how it goes. I'm a little on the fence about this. Some say no exercise in the first year, some say pe class or social activities are fine at this point. We don't have an ED team, so no expertise there, really. This seems like a grey area and maybe I need to use my judgement? She has never been what you would call an "athlete." Gymnastics was one hour a week, non-competetive which she had been enrolled in for less than a year. Other than that, never any organised sports outside of pe, and no interest now, other than joining friends for gym class. Would be interested to hear experiences/thoughts of others with similar circumstances and the guidelines given by their team. __________________ Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think. - A. A. Milne
Registered: 1454901521 Posts: 682
Reply with quote #2
I'm glad to hear your d is WR and that her period has returned. Well done! I can tell you what we did. During refeeding my d didn't do any exercises including PE at school. When she started to grow again and was eating food without skipping meals, she was allowed to do PE again (term 4). At that stage she wasn't WR yet and it was also pre-extinction burst. She was WR during the first term of the following school year and was allowed to do PE. Only the following year did I allow her to do sport outside of school once a week (team sports) and she only did it because her friends were doing it. __________________ 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 months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.
Registered: 1530817002 Posts: 68
Reply with quote #3
We just reintroduced PE and normal activity slowly. Once weight restored she was allowed one session of PE a week, after a few week we introduced her second session as she continued to maintain/gain weight and so on until back to normal. I think you would just need to monitor the situation carefully and make sure she eats well on the days where she has PE so she doesn’t slip into a negative energy deficit! Xx
Registered: 1496061527 Posts: 1,855
Reply with quote #4
We allowed PE once a week after WR and it worked well. But my d was not overexercising in her dark days.
I talked about it with the PE teacher first and she had an eye on her the rest of her school time (1,5 years) and did not allow her to do exhausting stuff. So for example when they were running in the country there were 3 groups and my d was always in the walking group. Tina72 __________________
d off to University now 22 months after diagnose, still doing FBT and relapse prevention
Registered: 1284535839 Posts: 3,905
Reply with quote #5
mimi321 I think your plan sounds really sensible. It mixes the social aspect of sport, and helps make sure there is no compulsive component to her exercise. You can try that for a few months and make sure the periods keep on coming. You are doing really well.
My own D did not go back to PE at school - diagnosed year 8. I chose not to get her to go back to PE because it continued to be such a battle to gain and maintain weight in my D's case and she had compulsive exercise as part of her illness. __________________ D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
Registered: 1396016102 Posts: 5,360
Reply with quote #6
Hi mimi - I wonder if you could use this as a bargaining chip? Any fear foods or ED behaviors the need to be extinguished? If yes, maybe you could work out a plan to allow gym provided that she does x,y,z. If no, she is probably ready to ease back into gym.
Kudos for all the progress!! You rock!! xx -Torie __________________ " We are angels of hope, of healing, and of light. Darkness flees from us." -YP ♡
Registered: 1528754293 Posts: 297
Reply with quote #7
Thanks, everyone. Yes, we've come a long way for sure!
We are still working on fear foods every day at snack-time, usually a small piece of something the first day, which I repeat throughout the week. This seems to bring about temporary stress (crankiness, taking a long time to finish and sometimes arguing/bargaining or trying to tuck/hide a piece here and there which is fairly new). I don't see these behaviours at any other meal or time, luckily. I'd rather deal with that on it's own rather than make it a condition of going to pe as we're going to do it whether pe or no pe probably for quite awhile. And as for her reactions, well that is important feedback to me as to where her head is at, and if I tie it to going to gym I think she would try to hide those reactions/thoughts and then I would worry it might manifest somewhere else. It seems to put pressure on her as well when I try to tie it into something else that doesn't really help in our experience. Other than the above, I can't think of any behaviours that need to be addressed. Obviously I would like to see the above dissipate a little more, but we still have some time to figure it out. It doesn't really amount to a whole lot really I don't think, the amount of exercise she would get in one gym class every week or two. If she wanted to walk to the park with friends or play tag, etc, I think that would be pretty comparable and I would be okay with that at this point. So maybe next month we will give it a try providing we're still on track overall and then we'll see how it goes. Thanks, everyone! __________________ Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think. - A. A. Milne
Registered: 1396016102 Posts: 5,360
Reply with quote #8
Originally Posted by
mimi321 It doesn't really amount to a whole lot really I don't think, the amount of exercise she would get in one gym class every week or two. Most days, kids in my district don't burn all that many calories in gym, what with the time it takes to change clothes twice and get lined up or whatever. And a lot of the activities are pretty low key. So I would agree with you. xx -Torie __________________ " We are angels of hope, of healing, and of light. Darkness flees from us." -YP ♡
Registered: 1455722103 Posts: 42
Reply with quote #9
In our case we let d get back to regular sport (school and outside) as soon as wr even though still Ill, with green light from pediatrician. For her it was 60% fun & social, 30% pressure release from AN and 10% AN driven to loose weight... so overall it helped, also because we used it as bargaining chip; then when AN thoughts diminished it helped her eat actually a lot before training session to not feel down during. She did and enjoyed a lot of sport pre AN __________________ tdm13 ___________________________. parents of d who started to restrict food at 11yrs in Aug2015, diagnosed as AN. Hospital resident mid-Dec to mid-Apr2016 under traditional treatment (isolation+weight contract). Total failure made us switched successfully to FBT at home. WR in Aug 2016. No more symptoms since Jan 2018, follwoing growth & bmi percentile
Registered: 1528754293 Posts: 297
Reply with quote #10
Just thought I'd share this response I got from Dr. Gaudiani to a question I submitted (at Helping Hands Summit) asking about her general recommendation about returning to exercise after wr.
To paraphrase, Dr. Gaudiani said she used to advise no exercise during wr because that would be burning calories but her perspective has since changed. She believes that mindful, joyful movement can actually be very helpful for recovery and likes to introduce it as early as possible actually. The basic requirements should be physical safety and emotional safety to engage in exercise or movement. Start with gentle walks, process after : how did it feel? Were you able to be in your body or were you focused on ED thoughts and calorie burning? So processing the experience upon returning to exercise can be very important. She said that when patient are told they cant exercise because it burns calories, they are unwittingly reinforcing the ED relationship to exercise, which is that it is for burning calories. She likes the message, that mindful movement, with accountability to self and to the team, that movement is about returning to joy in the body. She doesn't feel there is 1 particular weight restoration range. but there does need to be adequate fuel/eating, and not-purging with safe labs, and if the person is acting and feeling safe emotionally, she then asks "what would be joyful for you?" and start slow. * I have to say this makes sense with our experience. We often had a stroll after supper with our D in the evenings during the wr phase. These strolls were often the best part of our day, most often a chance to leave ED within the walls at home in a sense if only for a brief period, and to get out in nature. It was during these strolls my D often made most of her progress mentally, voluntarily coming around to try a new food a few times, or getting away from being socially isolated as we would walk in our neighbourhood or in the park, or telling me she thinks maybe she would like to return to school again one day after all. We always kept it slow. Sometimes we walked in silence if that is what was needed, but more times than not she came to life and chatted up a storm mostly about all things unrelated to ED, with me nodding and taking it all in. About trips she would like to take one day, what she will name her kids when she grows up, or about the lives of the characters in the book she was reading. It all came out. I think it was a chance for her to open up her world a little and to let a little light in during a very dark and isolating time. So in our experience I think this would have counted as joyful movement which was very helpful in her recovery. __________________ Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think. - A. A. Milne
Registered: 1533511641 Posts: 26
Reply with quote #11
That's really interesting, Mimi321. Thanks for sharing it and I hadn't thought about it in terms of bringing joy to the body but it makes sense to try anything that helps our kids regain that sense of trust of and enjoyment in their body. I suppose we just need to be mindful of the potential pitfalls of exercise for each of our individual children and reading some accounts here from other parents it seems exercise is not always helpful on the way to recovery.
For us, allowing our d to take part in rugby has been so helpful to her. Being part of a team, learning new skills and I think using her body productively is all a positive. But, exercise was not part of her ED and she is WR (though she is still not well.) __________________ Smileymum