F.E.A.S.T's Around The Dinner Table forum

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strawdog
Hi
My d suffered with over exercising before her diagnosis earlier this year. The link between food and exercise was very strong. If she ate more than normal she would then have to go the gym. So obviously this instinct isn't going to go away quickly. My question is - now 3 months in to refeeding should we see this compulsion gradually receding along with other ED behaviours? Will it ever go away completely? She really sufferes with eating on days when she hasn't done much movement. For example yesterday she was at school and then got a lift home (normally walks). Then after dinner she normally goes out for a dog walk and it was raining so she didn't go. By the time we got to evening snack time she was really complaining of not being hungry and struggled with the concept of more food as in her mind she hadn't done enough exercise to justify it. This has happened before - another example being she looks at her evening job (waitress) as exercise and when work was cancelled one evening she had ended watching an exercise video in her room. She is allowed to run once a week (has to be fuelled) but still looks as it as burning calories rather than enjoyment. Is there anything we can do or as her brain recovers more perhaps these tendencies will reduce. I really want her to see exercise and movement as something to enjoy and not a means to an end to allow her to eat.
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Ellesmum
I can only tell you my experience, my d was a gymnast and loved to work on tricks for hours, plus trampoline,  I had to ban all this and for a long time she’d complain and beg but I told her she simply wasn’t strong enough. She rarely mentions it now and she was dedicated, I have to still watch out for secret exercise in her room and a lot of her friends socialise at the gym so this is a new challenge but again they go in the same way as they might go to the cinema, now and then so thankfully it’s not a constant issue.   

So yes, for us the compulsion has faded and that happened quite quickly, she’ll still do the odd handstand at random though.  I don’t use the word exercise at home, I use activity and have instructed CAMHs to do the same.   

Thats just us, some kids have deeply entrenched exercise compulsion particularly if they were elite athletes, I don’t think yours was competitive was she?  I’m trying to talk about activity as a fun thing, like swimming as a fun thing to do occasionally or ice skating to join in with friends. 
Ellesmum
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strawdog
Hi Ellesmum
No she never did any organised exercise before - everything she tried she gave up because of her anxieties. She didn't want to be look foolish or be the one that came last or messed up and let people down. Such as shame because with her tenacity and drive she could have been really good at something I'm sure of it. So for her going to the gym was a means to an end - to burn calories. But I'm not so much talking about days when she hasn't done 'proper' exercise it's just days where she has sat around all day and not even been able to get outside for a walk. I guess she knows she's on a diet which is designed to put weight on and considering he still thinks she is at the weight which is fine then for her such days mean she is going to get fat and hence the reluctance to eat her evening snack last night. Thinking about it we all have to some degree a feeling of feeling fat or fulnessl or over indulgence when we've had a big meal - especially when we haven't done much exercise - it's a normal feeling to think - I've eaten too much - I must go for a walk or to the gym right? Not everyone feels this way but lots do. So in a lot of ways what she feels is normal - maybe when she comes off the meal plan eventually then she'll feel differently?
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tina72
It is not normal to think so. It is ED.
Many parents here with kids with exercise compulsion needed to go cold turkey and stop any exercising totally for a long time to break that thinking.
I will search for some articles on that for you.
Maybe it is worth a try to stop that completely for some months.

Recovery from ED is quite similiar to drug withdrawel. I talked about that to a parent that worked in that part before his d got sick. He said that they needed to cut all lines to ED just like with the drug abuse patients at work. No connections to other drug abuse people, no possibility to have drugs, no stay in that milieu. So he also said it is really needed to stop ALL ED behaviour. And exercising to compensate eating IS an ED behaviour.
Keep feeding. There is light at the end of the tunnel.
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tina72
https://tabithafarrar.com/2017/05/exercise-anorexia-case-cold-turkey/
https://tabithafarrar.com/category/exercise-and-eating-disorders/




https://www.kartiniclinic.com/blog/post/exercise-and-the-severely-anorexic-patient/
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
It’s normal to need a walk because we feel sluggish after a big meal, it’s not ‘normal’ being obsessed with calorie burning that meal.   So wearable health tracking devices need to go for instance, all the kids seem to have them so it’s tricky.   

I felt my d needed fresh air and to get out of the house so we’d always do something daily even if it was just a walk to the local shop for milk, it’s depressing just lying around all day.  I am surprised now I think of it how her exercise compulsion faded (to a large extent)  I cringe now but when she first got sick I used to encourage her to trampoline, I thought it would release happy hormones and she loved it so much, I didn’t realise back then the danger of it.
Ellesmum
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tina72
Ellesmum wrote:
  I cringe now but when she first got sick I used to encourage her to trampoline, I thought it would release happy hormones and she loved it so much, I didn’t realise back then the danger of it.


Can you imagine, I was so crazy to send my severely underweight d to the swim hall because she got hungry after swimming before ED moved in and I thought that could get her to eat. I feel so guilty about that now.
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
tina72 wrote:


Can you imagine, I was so crazy to send my severely underweight d to the swimhall because she got hungry after swimming before ED moved in and I thought that could get her to eat. I feel so guilty about that now.


We just don’t know what we don’t know I guess, hindsight is pointless I suppose, things that seem so obvious now seemed like good ideas at the time and we did them with good intentions.   
Ellesmum
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scaredmom
Strawdog,

Just to bring this back to your question. Firstly, three months  is very early and you are doing well.
The only way to curtail the feelings over time is time and decrease or cessation or severe limitation of the exercise. My d was allowed a walk early in re feeding and she at 11 would outpace my h! Then we took away the 15 min walk. Then she stood all the time and only sat to eat and go to bed. 
That was hard and she was quite anxious. 
For us, it did get better with more time and food and less activity.
some have used limited activity to help with anxiety too.
Please note too that if they don’t get real exercise they may do other physical things to burn the calories like run up the stairs many times as they ‘forgot’ something, or jiggle their legs, or hold on their abs or do squats, sit ups, secret exercise even in bed! Or the shower etc... Ed tries to find ways to get his way anyway anywhere. just keep your eyes peeled
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom
I was just thinking, I wonder if I can put this in a little math equation:
Food = exercise, for your D those two go together?
I wonder if substituting exercise for something else may help break the association. I found with my d a little bit of exercise always escalated to too much and we had to stop all exercise and substitute non active things like games, or ping pong for ten minutes at a time only, my d is quite an artist too so drawing was important and I booked her in for guitar lessons, because she had to sit to learn to play. So inadvertently, she would sit more without knowing. I am not sure if her issues would have settled with time but I had to get it under control. It was frightening to say the least to see a kid stand ALL DAY and never sit to watch TV or with the family.  
It is like breaking a habit, some people smoke after dinner or with a coffee so in order to  break the habit you have to break the association.

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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strawdog
Thanks for the replies - she doesn't have extreme exercise compulsion that's the first thing to say - she is happy to lie on her bed all evening watching boxsets and she doesn't stand all the time or race up and down the stairs. She'll be 17 soon so it's hard to find things to do after dinner together at the best of times when they're that age. I'm not entirely sure if the dog walk after dinner is 100% to burn off calories or just that she feels better out in the fresh air and maybe it takes her mind off her stomach being bloated and it just clears her head with all the revising she is doing. It's impractical to go cold turkey on everything she considers exercise - walking to and from school, work, dog walking etc - I think this would be an extreme cause of action and certainly not one I could ever imagine her agreeing to. They have to slowly go back to some sort of life at that age. She still has the Leavers Ball looming in a few weeks and I'm sure that is not helping her state of mind. 
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scaredmom
Well then I think I totally missed the question? You mentioned on the third sentence of the first post on this thread about compulsion and that she was over exercising and she thinks that waitressing is exercise? And she is upset getting a lift home from school? That is quite concerning to me. That is part of ED I think.  My apologies for not responding to your concerns in a meaningful way for you. 
For sure getting back to life is the goal.
so I am not sure what the question is? 
Is it her feeling bad about not being active? 


When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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tina72
If exercising/walking/moving is NEEDED for them to compensate eating and if they feel bad about not doing it and get angry when you give her a lift from school that is concerning.

What you can do after dinner that is not burning calories:
play family games
watch TV together
listen to music
read a book
have friends around
...
you get what I mean. It is not necessary to burn calories to have a good evening.

"She really sufferes with eating on days when she hasn't done much movement."
That is not normal. She might be calory counting and have a list in her head what she needs to burn each day. Does she have a fitness app on her smartphone? Step counter? Fitbit?

"I really want her to see exercise and movement as something to enjoy and not a means to an end to allow her to eat."
I think you can do nothing about that then to help her to break that logical combination. When exercise is cancelled then she learns that she can/must eat without having that "allowance". Going back to exercise then after breaking that circle a few months later can help her to enjoy it.
Keep feeding. There is light at the end of the tunnel.
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mtkmbc4
My d is in a partial program at UCSD. They have a sports participant track that allows reintroduction to movement once they are 85-90% of target weight range and have been medically cleared. It’s all very gradual, very supervised. Movement is normal and prior to the onset of the eating disorder, my d was very active, it’s her natural wiring. She never exercised to burn calories or to lose weight even once ill. For her, exercise brought joy and some anxiety relief.

Under very close supervision by us and her ED team, my d can take a 10 min leisurely walk 3 times per day (1 after each meal that is 100% completed.) She is now additionally cleared for three vigorous 15 minute walks per week after which she must have her refuel snack. 

The kids must fill out a movement diary card that is discussed with their team that addresses things like how movement made them feel and whether it was driven by unhealthy ED thoughts.

Clearly for many kids, obviously when they are still dangerously underweight, exercise must be completely halted. I think that a very thoughtful supervised return to movement and sports is possible for some when it is a “hook” and an incentive to stay compliant with ED recovery and relapse prevention. Our kids already tend to be black and white thinkers in some areas. Absolutely forbidding all movement (again, obviously necessary in the beginning for health reasons) can further play into the all or nothing thinking and not allow for gradual flexibility in approach to life.

My d is still in the very early stages of this program. We will be watching to make sure it is ready right approach for her and shift tactics a bit if necessary.
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Yogi13
My daughter was exercising excessively before my lightbulb went off, and I realized she had an issue.  We are five weeks into treatment (very new), and one of her main concerns has been exercise.  I can see how connected it is to the illness, and so can her Dr.  I have allowed her to take 10 minute walks to clear her head, and lately she has been doing a little upper body weight routine for 10 minutes a few times per week (supervised).  Her Dr. agreed to this as long as all of her food is eaten (and it has been).  However, cardio is not allowed because of the calorie burn.  The one thing I do see is that in the beginning she would freak out about whatever she ate because she couldn't exercise, while now she speaks less about it.  Her language is changing the more she is eating.  I know we have a road to travel, but I am grateful for every meal she eats where she isn't screaming and throwing her food.  So my point is- I know exercise can feed the disorder, but the little she does makes her happy, I see progress and her view of food and exercise seems to be changing . I am by no means going to allow much more than this for a while, but fr now it's working.  If this wasn't the case, I probably would forbid her to partake in physical activity.  
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Jojo2271
for all those confessing to encouraging activity and exercise...i bought my daughter a series of sessions with a personal trainer att christmas . I knew she was not eating enough but thought that the trainer would encourage her to eat more...I also told trainer i would not buy gym equipment so could he devise a programme of exercise she could do at home...so effectively i paid for and facilitated her being able to exercise to high intensity in her room at home ..and this was ( still is ) major part of her ED...i could weep at my naive stupidity
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strawdog
Jojo2271 wrote:
for all those confessing to encouraging activity and exercise...i bought my daughter a series of sessions with a personal trainer att christmas . I knew she was not eating enough but thought that the trainer would encourage her to eat more...I also told trainer i would not buy gym equipment so could he devise a programme of exercise she could do at home...so effectively i paid for and facilitated her being able to exercise to high intensity in her room at home ..and this was ( still is ) major part of her ED...i could weep at my naive stupidity


You can't blame yourself JoJo - we all make decisions we later regret. All you can do is what's best for your daughter now.
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strawdog
Yogi13 wrote:
My daughter was exercising excessively before my lightbulb went off, and I realized she had an issue.  We are five weeks into treatment (very new), and one of her main concerns has been exercise.  I can see how connected it is to the illness, and so can her Dr.  I have allowed her to take 10 minute walks to clear her head, and lately she has been doing a little upper body weight routine for 10 minutes a few times per week (supervised).  Her Dr. agreed to this as long as all of her food is eaten (and it has been).  However, cardio is not allowed because of the calorie burn.  The one thing I do see is that in the beginning she would freak out about whatever she ate because she couldn't exercise, while now she speaks less about it.  Her language is changing the more she is eating.  I know we have a road to travel, but I am grateful for every meal she eats where she isn't screaming and throwing her food.  So my point is- I know exercise can feed the disorder, but the little she does makes her happy, I see progress and her view of food and exercise seems to be changing . I am by no means going to allow much more than this for a while, but fr now it's working.  If this wasn't the case, I probably would forbid her to partake in physical activity.  


This is pretty much exactly the same with my d - was told that if we didn't allow her a little exercise to let off steam then we could be in danger of going backwards. I think it comes down to the fact there is not a one size fits all therapy for kids with EDs especially those linked to exercise compulsion and/or underlying anxiety issues. Some have implied here that you should go 100% cold turkey on exercise so that they don't link eating food to burning it off with exercise straight afterwards. If we adopted this approach right now, today then I think we could have a serious problem on our hands and we may get a serious rebellion on our hands. Some might argue that you may need to have that battle in order to fully move forward to a full recovery. My argument here i that you can't go 100% full turkey anyway - she would just focus on work or her walk to and from school as a point where she can burn calories etc. Better in my mind to do the same as Yogi and keep feeding and allowing moderate exercise and hopefully as her brain fully recovers the link is gradually weakened. 
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Ellesmum
Jojo, try not to dwell on that,  in the early stages here when d was too anxious to go to school and barely eating I used to let her trampoline, I thought it would take her mind off her troubles and raise her happy hormones.  I shudder at the thought now but we don’t know what we don’t know,  I knew we had an issue with food but didn’t have a clue about ED’s.  I also thought it would give her an appetite and help her sleep.  
Ellesmum
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Jojo2271
Oh ellesmum.. In a wierd way your "confession" made me laugh.. Yes me too.. Not a clue
But onwards and onwards is the only way now.. Learning from the mistakes 
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Yogi13

I appreciate all of the feedback and support here.  I don't know if what I am doing is right or wrong-as this is all new to me.  We will be starting week 6 on Tuesday, and I have increased her calories.  She speaks differently from how she spoke in the beginning when she was starving herself and at the beginning of re-feeding.  She is willing to eat things she would normally cringe at, and this am she ate three calorie filled pancakes and went back to bed (her 8th grade dance is today, so i let her stay home from school).  One month ago she would eat a banana and felt the need to "work it off".  In April, I didn't think she would be going to ANY dance, much less graduation, orientation for high school, and Regents Exams (we take them in NY), and she will be able to participate in ALL of the aforementioned activities.  She was so weak that she wasn't able to go to school and concentrate.  I am so very thankful for the progress she has made thus far, and I will not allow ANYTHING to undermine it.  I am treading lightly with the amount of exercise I allow, and she is being closely monitored. 
  
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tina72
"I don't know if what I am doing is right or wrong-as this is all new to me."

Yogi13, read your post again and see all the progress and you have the answer. You are doing great and so you must do something right!!! 🙂
Keep feeding. There is light at the end of the tunnel.
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Yogi13
Thank you, TIna72.  I sure do hope so and that her progress continues.  
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Becs
I bought my D a treadmill for Christmas - literally one week later I had my lightbulb moment and realized it was ED's Christmas present. It has never been used other than when I kick it as I walk past. She is in IP currently and I have just sold it. She doesn't know yet. But when she is well enough we will have a weekend away together and she'll have lots of money to shop. Her exercise compulsion was crazy. Our dog walks would be accompanied by her screaming as we wouldn't let her go 20 metres further. We had to almost rugby tackle her as she ran in laps round the house, or physically block her running up and down stairs. She'd hit or bite us when we did that. It was awful. Any future exercise will be with me or a team sport and it won't be happening for a very long time. I think trying to prevent compulsive exercise was a harder piece in our fight than the eating. Good luck to all who are struggling with it.
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sandie
One of the videos from Feast of knowledge day in NY that someone has recently posted about is about temperance based therapy and there is a nice presentation demonstrating how you need to rewire the brain to break an unhelpful ritual like compulsive exercise. I recommend. It has made me look with fresh eyes also at the need to rewire to break other habits like safe foods etc. And to think about some rewiring of my own brain I need to cope better as i think i am wired to cry a lot at the moment. Xx
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