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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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EarthyGirl
My daughter has been in and out of recovery for the past 2 yrs. She had gained to her pre ed weight,(Bmi 20.5) we did this while on about 3500 calories, yet she was deceptively exercising, and moving compulsively. We decided to get a new dietitian in March, and she was put on a shockingly low meal plan to maintain her weight. She instantly lost about 5 lbs from that initial BMI of 20.5. She is still on this fairly restrictive meal plan, and just the other day decided that she would quit her constant compulsive movement (lots of walking, pacing, and standing). While her weight is classified as healthy, and close to her pre ed weight, she still has awful digestive issues and no period. I am not sure whether I should increase her calories to 3500 or more, focus on weight gain again, or what. I am also wondering what the effects of her gaining weight while compulsively moving may have been. Should we focus on resting and refeeding (this is confusing because she is at a healthy weight, but gained while exercising/moving a lot, and has been 'WR' for about a year now). Please help! I feel like I have no idea where she is at in recovery, whether or not she's at the end, or starting all over!
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Foodsupport_AUS
.Welcome to the forum. You don't mention how old your daughter is but there are a number of red flags in your post.

It is not normal for most young people to get to a certain weight and maintain - normal teens and young adults continue to gain in weight and BMI till their early 20's. 
It is never normal for someone to continue without their period, if a weight is appropriate and there is sufficient energy intake then periods should resume - this is essential for bone health and mental health as well. 

You mention that you saw a dietitian who recommended reducing her intake to "maintain weight" when she had been maintaining already - my best advice is to RUN and consider reporting the dietitian for malpractice - this is incredibly dangerous advice to someone with an ED. They should not be treating ED's. 

She needs to continue to gain weight along with stopping the exercise - she sounds like she has never truly been "in recovery". Recovery would have meant regular normal periods, normal eating patterns etc.. There is still quite a way to go. You never go back to the start, but it is clear from your post that there is plenty of work to be done. Please feed her more, probably more than the 3500 per day. 

What other supports do you have on the ground?
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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EarthyGirl
My daughter is 15 years old, 5 foot 7 inches. We are currently working with a dietitian and therapist. She gained all her weight in 'semi-recovery' while eating approximately 3500 calories, and speedwalking/moving/sneaking in exercise compulsively. I don't think I made it clear that she started to maintain her weight after reducing her calories to around 2500 to 3000, without her period having returned yet, at a BMI of 20.5, around her pre ed weight. When we saw this new dietitian, her calories were lowered even more (I am assuming to around 1800 or less, because my daughter is on an exchange plan). 
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Foodsupport_AUS
Thanks for the further info. I suspect her weight is too low, it needs to increase as per normal growth charts into her 20's, weight maintenance/ slowing of intake should never occur when periods have not returned. Given that she is only the weight she was pre-ed - again another sign things need to go up. Although height  increase does stop usually a few years after periods start weight increases in to the 20's - a combination of bone, muscle and fats. All essential for wellbeing. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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Torie
EarthyGirl wrote:
While her weight is classified as healthy...

Oh dear, there is really no way to "classify her weight as healthy" like this.  As an example, my d's weight was NEVER "classified as unhealthy" according to the charts and yet, she was diagnosed as having AN by one of the top AN experts in the world.  And, oh boy, was she ill.

Like your girl, my d is tall, which renders the BMI charts even more defective than normal.  (That's just how the math works for the BMI equation: At the same BMI, a tall girl appears thin, a medium-height girl appears medium, and a short girl appears relatively stout.  You can google that if interested.)

I'm with FoodSupport - it sounds like you and your d are among the many who have been let down by the "professionals."  Truly sounds like your d needs more calories and more weight. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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teecee
My then 15/16year old at 5’6 was extremely ill at that bmi. She needed to be around bmi 24 to be getting better. More food is always the answer if ED is still resident in your home
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Enn
Hello and welcome.
It does sound as if your d was never WR or in recovery. I am so sorry the team is really not helping you. Your d needs a lot more weight and how do you feel about going it alone or getting a new team? I agree with everyone who has posted above and thought this might be helpful.
https://www.aroundthedinnertable.org/post/determining-target-weights-10407532?pid=1310567431

How is the exercise going ? You mentioned that she decided not to exercise so much just recently. Do you need help with that piece?
Will your d now allow you to increase her food intake again to at least 3500? We had to get
to 4000 to 4500 for good weight gain. My d stood all the time and it was unnerving.

please let us know how we can help.

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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EarthyGirl
Update: We have increased her calories to 3500, and she has been very compliant. We are also continuing to monitor her movement (daily slow walks with family members), and making sure she is sitting throughout the day. There has been no pushback so far (It's only been a day, but it usually when we would increase, she would immediately have a fit). She seems determined to follow through with eating lots and resting, and ultimately gaining to her body's healthy weight and recovering fully, which is very encouraging and has NEVER happened before. I know it has only been a short period of time, but we are feeling very optimistic. I will continue asking questions, and whatnot as we trek on the road to full, real recovery. Thank you all for your help!
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PurpleRain
great update, keep going!
13 yo d started to eat "healthy" September 2018, she had a growth spurt a bit later, followed by tummy bug. She started restricting breakfast and school lunch in January 2019 (that we know). We succesfully refed at home.
I have found inner strenght, patience and compassion that I did not know I had.
Never retreat, never surrender
keep feeding
 
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