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

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giraffe58
My daughter(21) has been ill now for 5 going into 6 years with severe restrictive anorexia. Multiple relapses, hospital stays, IP, Compulsive exercise but turning her life round at a Bmi of 11 last year. She herself with support from us as a family, this forum and feast website has supported her in starting to eat (with all the daily battles and ups and deep downs), reducing her exercise and to now have a Bmi of 16. We are still in the process of daily minute by minute trying to move forward, refeeding the ongoing process and working on numerous issues. The latest (apart from all the other issues) she now wants to join a gym again. I am absolutely against the idea and are trying to remind her of the hell she has been through with the unrelentless urge to exercise before and that all the advice is not to exercise untill patient is well established in weight restoration but she is adamant. Any ideas how we can resolve this matter? Thank you all for your amazing support and please know that my thoughts are with you all in your battles too.
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giraffe58
Dear Tooth fairy, thank you for your kind reply and thoughts. Yes she lives with us and yes it has been very hard but she has done the hardest part by defying this horrible illness daily.

What do you mean by having a contract?

Thanks again.
Giraffe58
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AUSSIEedfamily
Dear giraffe58,

In your situation I would discourage the gym as strongly as possible. We had a very close call with our D who was doing very well although using excersise to manage food intake. She was doing some competetive swimming & was using our local gym trying to build muscle & her younger sister was also doing the same. One evening our D collapsed without warning & was taken by ambulance to hospital the diagnosis was heart arythmia a type of heart attack.

In conversations recently with our now fully recoverd D she described the anxiety & stress of not being able to move at all after eating & felt that some level movement would do some easing of that anxiety & stress. Dr Laura Hill at the Centre For Balanced Living uses very pedestrian type walking after each meal during the 5 day NEW-FED treatment program. & as people recovery introduces levels of movement that are not undoing food.

ED Dad
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giraffe58
Dear Toothfairy and AUSSIEedfamily, many thanks for your replies. Girrafe58
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Kali
Hi Giraffe58

How wonderful that you have helped your d. bring her bmi up from 12 to 16 in a year!
I think you will need to advocate very strongly against the gym. 16 is a big step forward for her but she is only partway there, since she is still underweight. You have made amazing progress and she has worked hard. Keep going!!! 

Are you supporting her financially since she is living at home? If so you have the leverage to compassionately let her know that joining a gym is not in her best interest right now. Are you and she working with a team (therapist, nutritionist, psychiatrist) who can back this up and support her by also letting her know she should not join a gym? Are there other interests you can encourage her to participate in instead?

To give you an idea, after my d. was weight restored, she did no exercise for 11 months. She walked the dog on our block and walked to the train. That was it. Her team and I have just told her she can do light exercise for 20 minutes twice a week IF she adds on the calories she burns with the exercise to her food intake for the day. She can do yoga for example, and we have told her that the gym or distance running is still not a good idea for her.

Kali
Food=Love
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giraffe58
Dear Kali, I agree with your analysis completely.
We are supporting her but she has money of her own. Unfortunately we have no support from elsewhere, but will try and support and totally discourage what I believe is the right thing to do. She had come such along way and I just do not understand this new idea of jeopardising her recovery.
Thanks again
Giraffe58
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giraffe58
Thanks x
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giraffe58
Dear Toothfairy, many thanks again. I was able to download the previous link and had a look at the contract.
Trying hard to regroup and to think of how to resolve this but thank you so much for your kind support and advice.x
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Torie
Hi Giraffe - Congrats on all the good progress you and your d have made so far!  It's hero's work, I know, for both of you.

I wonder if there is something else she would like, besides the gym visits.  A puppy? Photography class? Musical instrument?  Painting lessons?  Maybe there is something else you could offer to provide, letting her know you are proud of all the progress she has made and would like to add something to her life ... just not something that will jeopardize her recovery.

Just a thought.

Keep up the good work. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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giraffe58
Dear Torie, many thanks. It is definitely an idea which will be worth pursuing. The puppy one already materialised 2 years ago but what an added bonus to all our lives! Thank you very much x
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momofboys
Hi Giraffe58,
We also had major issues with exercise with our son. He never stopped exercising completely. A contract is a good idea, however she may not be well enough yet where you can trust that she is being honest. In the earlier stages we laid out for our son what we felt acceptable exercise was. Anorexia had completely hijacked his ability to know what that looked like and of course he always thought what we suggested was "doing nothing" and not exercise. We found it best to be able to actually see him when he was exercising so that we could see what kind of intensity he was putting into it. When it was anorexia driving it he would be very agitated and intense.

If you are going to allow her to exercise it would probably be best to exercise with her so you can monitor her for a while. Going for a walk together is great (anorexia thinks it is doing nothing).

Also replacing calories burned is a really good idea.

Our son would get an idea in his head about something he wanted to do and we would tell him if it fit into our guidelines of reasonable exercise we would be okay with it. Often times the idea would go away in a few days.

You are doing great, you have brought her a long way. You'll get through this too.
Mom of 22 yr. old boy mostly recovered from AN. Dx May 2013, started refeeding June 2013. He is thriving, we continue to be watchful.
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Psycho_Mom


No. Just no.

How about DBT skills class instead? She could learn to recognize and tolerate the anxiety that causes the feeling of need for compulsive, unhealthy exercise.

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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BattyMatty_UK
Back in 2011 we were having serious problems with my 17 year old son's compulsion to exercise, as I wrote in a post here:

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Compulsive exercise which he finds 'really hard' to give up. It stops him being in school for a whole day because he sees this as 'sitting around doing nothing' and he can't sit still. He is at schools mornings only at the moment and even then is tempted to 'go for walks round the grounds' (read 'go for a run / exercise'...). He WANTS to stop, but CAN'T. He does try hard and some weeks manages minimum exercise whereas other weeks, like last week, he does loads...

A few weeks later we introduced what we called a 'contract' to help him contain the exercising (in an ideal world we would have stopped the exercising altogether, but in my son's situation it wasn't going to happen... This is a thread I began about how the contract worked for us (it may not work for you, but it's a thought??) http://www.aroundthedinnertable.org/post/8-weeks-into-our-recovery-contract-things-are-moving-swiftly-forward-5252790
Bev Mattocks, mother of 24-year old male DX with RAN 2009, now recovered. Joined this forum in 2010 - it was a lifesaver.
 
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BattyMatty_UK
PS: Here's what I wrote in my book about the sheer amount of exercise he was doing at the time, which may or may not be of use to you xxx:

 

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Ever since the October heart scare Ben has been banned from doing PE at school. Unfortunately he’s exercising at home to compensate and to ensure he doesn’t “put on massive amounts of weight”. It’s a kind of purge, almost like a sufferer of bulimia might vomit to control their weight.

“Walk me through a typical day’s exercising,” says Linda as she reaches for a pen and paper.

Just when we think he’s listed all the “100 crunches, 100 sit-ups and 100 press-ups” for any one day he interrupts with “I haven’t finished yet!” Not once, but several times. School days differ from home days, weekends from week days. Ben is exercising from morning to night.

By the time he catches the school bus in the morning he’s already done 100 crunches and sit-ups during the 60 minutes we rush to get up, showered, breakfasted and out of the house. Meanwhile at school he deliberately makes himself late for lessons so he can run from classroom to classroom. 

One reason he’s still only at school part-time is because he can’t handle the thought of “sitting around doing nothing” for the afternoon as well as the morning. When he gets home at lunchtime he pushes himself to do more crunches and repeats these throughout the afternoon - and before and after the evening meal. In addition he’s still doing weight sessions most days and going for a couple of runs every week. Meanwhile he can’t sleep because his mind is constantly racing as he tries to balance input and output.

The bland CAMHS consulting room feels like a bizarre confessional as Ben confesses his entire exercise regime and Linda’s piece of paper becomes several pages. Our very urgent task is to find a way of breaking the cycle. It’s a Big Ask. I sigh and look at Linda for an answer.

“What if we draw up some parameters?” she suggests to Ben. “We allow you to do a limited amount of exercise every day and you agree not to exceed this.” It seems such a simple solution to a seemingly unsolvable problem.

Between us we devise a structured regime of exercise over and above which Ben isn’t permitted to go.

“Then, over the next few weeks, we’ll monitor the effect it’s having on your weight to prove that less exercise doesn’t mean you’ll get fat,” Linda adds.

Ben agrees to the trial.

The following week Ben and I walk around a local lake. Watching the wildfowl silhouetted against the setting sun, we talk about exercising and how he’s making a real effort to cut back. Now he has the structured “exercise plan”, as he calls it, he’s finding it much easier to manage. Instead of spiralling out of control he now has parameters and - incredibly - from Day One, he sticks to it. And the more he sticks to it, the easier it gets. And the easier it gets, the less exercise he feels compelled to do. I feel like shaking Linda by the hand.

 

Bev Mattocks, mother of 24-year old male DX with RAN 2009, now recovered. Joined this forum in 2010 - it was a lifesaver.
 
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momofboys
BattyMatty said: Now he has the structured “exercise plan”, as he calls it, he’s finding it much easier to manage. Instead of spiralling out of control he now has parameters and - incredibly - from Day One, he sticks to it. And the more he sticks to it, the easier it gets. And the easier it gets, the less exercise he feels compelled to do.

This is very similar to our situation. Once we set down some parameters, our son felt more secure. We did it more informally, just discussing it, but had the parameters written down so that we would remember.

BattyMatty said:  (in an ideal world we would have stopped the exercising altogether, but in my son's situation it wasn't going to happen...

This is exactly what we felt.

Our son is still recovering, but is in a really good place now. He still exercises but it is in a very reasonable way. He is in control, not anorexia. Occasionally when he is under a lot of stress we will see the intensity return, but it is never prolonged. It is more similar to what someone without anorexia would feel when under a lot of stress.

Something else that he discovered when we put parameters in place was that running is addictive for him. Before getting sick he ran cross country. Just recently he went for a one mile run just to see if he still could. When he got home he said, "Running is gross." Wow, I never thought I would hear that.


Mom of 22 yr. old boy mostly recovered from AN. Dx May 2013, started refeeding June 2013. He is thriving, we continue to be watchful.
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giraffe58
Many thanks to all for sharing your unique experiencs and your kind thoughts.
Each and every reply and suggestion and thought is much appreciated. Giraffe58
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