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

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Has anybody had experience of their d being given a pelvic ultrasound scan to determine that they are at the correct weight for them?  My 20 year old d has had anorexia since 14, and this is her second prolonged inpatient stay. 

Our consultant for my d says:  in my experience, from the scientific evidence, and from the experience of experts in the field, the pelvic ultrasound scan (which looks at the size & shape of the womb & ovaries, and the presence of eggs in the ovaries), is the best barometer we have to determine if people have reached an appropriate weight for their body’s needs. People with eating disorder tend to find this very reassuring, plus we know that people who have normal size, shape & functioning of their womb & ovaries are less likely to have further loss of bone density, and are more likely to recover from eating disorder.

My concern is that this scan could show the barest minimum healthy weight that my d needs in order for her ovaries to function properly, but it still might not be the right weight she needs to aim for full recovery.  My d has currently a bmi of 18.5 - and her periods haven't yet returned.  She is clearly not the right weight for her.  And I suspect the scan would probably say she's too light at the moment.  However, she could then be required to gain another 2 or 3 kilos, her periods return, and the scan reveals all is well, when clearly there would be more work to do.

Also can anyone point me to evidence that higher bmi's are usually required for full recovery (evidence other than personal recovery stories). 
Thank you!

There have been a few studies showing that ultrasound can help to predict reproductive maturity and whether or more weight gain is needed for this. As you say the biggest concern is that physiological recovery does not necessarily mean mental recovery. As for the evidence of higher weight needed for full recovery - pretty much none is really available. What studies have shown is that higher discharge weights and body fat from treatment equate to lower readmission and relapse rates. Unfortunately that is not the same as saying you need to be at a higher weight for recovery - many of them show higher weight as being a BMI of 20. 

Carrie Arnold wrote this blog about the ultrasounds  http://ed-bites.blogspot.com/2010/01/determining-target-weights-evidence.html a few years ago, and this study is the one that it is based on  https://eatingdisordersreview.com/using-ultrasound-to-predict-weight-regain-in-anorexia-nervosa/ (I have a pdf of the paper if you message me). 

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.
My daughter is much younger than you and I came to the conclusion that for growing kids there is no such thing as a target weight. So I can't give you advice on  a grown adult but I wanted to say to trust your instincts as a parent. It doesn't seem like what they are doing is a good idea.
Just thinking out loud on this. Although the doctor can site evidence about reproductive maturity and the use of the ultrasound l,does this particular doctor look at other measures of recovery? 
I wonder if the pelvic ultrasound can be used as an adjunct to the “measureables” such as her brain state, labs etc. I would hate to only have one or two parameters of recovery. 
Full recovery is more than just ovarian size as you clearly know.
Some members’ daughters on the forum still had very regular periods even when at their sickest.
Like other illnesses there are many ways to define “cure” rates. 
Also, if no periods yet and you will keep pushing the weight up anyway, is there harm in not doing the ultrasound? There is no loss to wait it out and not do the ultrasound at this point, I would think. It does not change management medically as you still need more weight to get her periods. I am trying to reframe that a bit for your doctor to move the ultrasound to the back burner for now. You can always revisit that if you and your d wish.
As well getting her periods back is the best way to prevent bone loss anyway. So either way more weight on get periods and maybe more weight and recovery.

Hope that made sense. 
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)
I think your fears can be put into three possible outcomes:
1. The ultra scan will show that she is not on a good weight and her body is not ready to let her have periods. That is something you know already as she is having none and they will tell her that she needs more weight. That might help to get her on a healthy BMI.
2. The ultra scan shows that there is something other not ED related difficulty that keeps her from having periods. That would be good to know and they can do something against it in addition then.
3. The ultra scan will say that she is on a "good" weight although she is having no periods and has no good BMI. That is worst case scenario and that I would try to avoid if possible. Can you talk to them about the result BEFORE they talk about it to your d?
Keep feeding. There is light at the end of the tunnel.
Thanks everyone, this is really helpful.  I've got a meeting with our consultant on Friday and all the research stuff is brilliant.