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

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Hi. RAN dxd 3/2015. Initially WR June, then hovered around lower end of WR range, dropping down 4# below bottom of range in Sept. Back in mid to high end of WR range since mid Nov. Restarted periods and stable since last June. Still hypermetabolic and requiring 4500/day minimum. Just wondering what your experiences have been as the HM state finally wears off? Is it a slow fizzle ? Does go up in jumps? Does child's thinking clear as it wears off? Does life get better when it wears off- for child or caregivers?
Your input appreciated!
Mom of d caught in RAN- diagnosis age 14y 3/2015. Inpatient 4/15 CBT, then again 5/15, converted to FBT. WR 6/15- hovered few # in and out. Stable in high WR range since mid Nov. 2015.
My daughter on about same timeline as you - but still hovering around low end of weight range - super easy for her to lose a pound in a week - therapist just mentioned that she is probably still hypermetabolic - she eats a LOT of food.  She did return to her sport, so this may be contributing to her difficulty maintaining her weight, but if she is not at practice, she is usually either lying on the couch watching tv or in her bed on her phone - so not burning a lot of calories otherwise.

So hard for these kids...
worried mom
Preaching to the choir on this one!

My daughter was 10 when at her most ill. She was in the 5th grade. 
She was hospitalized for a month and the dietitians at the hospital were absolutely astounded that she was not gaining in the high 2000s. We took her out AMA (long story) and brought her home where we immediately jumped up to 3500, then 4000, then 4500, then 5000, and ended up at the 6000 calorie a day mark for around 2.5 YEARS. I think we still hold the record here. 

During this time she grew 8 inches in height and went through complete puberty (period, breasts, hips etc.) If we cut back even a tiny bit we would see weight loss. She did not grow "normally"- she would lose or stay the same weight instead of putting on the weight first like my other kids. 

At about 13.5 years old we saw everything level off. She stopped growing in height and her body started to redistribute her weight. Her brain kicked into gear and she started to eat intuitively and independently. We were able to back off on calories as she was able to eat on her own following her own hunger cues. 

It was a process. During those 2.5 years of high calories we saw a lot of the most severe ED behaviors disappear (exercise compulsion, hours at the table, panic attacks etc.) but we fought against lunch ditching and food ditching during that time. We ate lunch with her every day the majority of the end of 5th, and all of 6th and 7th grades. 

Even though your child is 14, her body most likely shut down the growing and puberty changes if she has been restricting. Usually it has been going on longer than we parents want to admit. I'm sure my D was restricting a good year before we really knew what the hell was going on. 

My advice is to close any loopholes, make sure all is going in, weigh regularly (we did weekly), and keep the calories high until you see things level off if that makes any sense. Then it is a gradual reduction. We started by first stopping her daily milkshake. The first time we did that- she lost weight so back in it went. The second time we took it out, she maintained…..because she was eating on her own and appropriately. 

IT DOES GET BETTER! KEEP HOPE ALIVE! My daughter is absolutely thriving now at 15.5 year old in the tenth grade. This am her little brother said he was not hungry and D said "There is a rule in this house. If you do not eat, you do not go to school." I gave her eggs and toast and blueberries for breakfast, She got up and got some jam and salsa for her eggs. She made herself tea and put honey in it. She asked me to make sure and put chocolate covered pretzels in her lunch. 

Keep going…...
Persistent, consistent vigilance!
Thanks for your encouragement. Now time to regroup. 14 y/o D was really pushing me away, preferentially to be w Dad. Have known my husband has not fully gotten the picture, trying to work w our docs to help get us truly on same page. Found out yesterday d has been hiding much of afternoon snack intermittently to keep from going up in WR range any more. She is gown weighed. I know current wt not enough bc thinking not restored. I tell her I don't care about the number, the goal wt is when thinking clears and her mind is free. For now tightening the reigns, again for the long ride ahead.
Mom of d caught in RAN- diagnosis age 14y 3/2015. Inpatient 4/15 CBT, then again 5/15, converted to FBT. WR 6/15- hovered few # in and out. Stable in high WR range since mid Nov. 2015.
I recall our FBT team telling us that they typically see Ed thoughts gone within a full year of refeeding. But as you see from some of the previous posts, that timeline is probably dependent on the age of the child and how much more growing they need to do. As for hypermetoblic rate, it's so hard to remember when it changed for our d because of the growing, we're always adding lots of calories. We've been doing this for 2 years and things are way better behavior wise but not nearly "normal" when it comes to eating. I've learned to accept that this is our new normal. It's not perfect, but our d is healthy and alive. Hope this gives some insight. Stay strong and persevere!
Daughter diagnosed with anorexia at 12 in 2013 without having any image issues/concerns about calories or exercise. Hospitalized - 3 days. FBT at home along with outpatient therapy - 16 weeks. Recovered/weight restored - 4 years. Still gaining and growing but has no hunger signs yet.