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doris

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Reply with quote  #1 
Hi, My daughter has just been diagnosed with anorexia after getting her to the GP last week. We have an appointment with CAMHS (we're in the UK) on Tuesday but she is restricting her food intake to just 200ish calories a day. Everything I've read points to "refeeding" to try and put weight on but at this intake she is only going to get worse. She insists on only fruit and veg - she did have some chicken (about 20g) yesterday evening but she is constantly working out how many calories she's having... I feel lost and confused as to how to progress with this, I can't "hide" calories in plain fruit or veg. Any help or advice would be very much appreciated x
melstevUK

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Reply with quote  #2 
Hi Doris,

Welcome.  So sorry you have had to find us but at least you have landed on the best website in the world for getting help and support from people who really understand these illnesses.

Right now your concern is to ensure she is getting enough fluids in between now and Tuesday - if she refuses to drink anything, you will need to insist on taking her to A and E to check that she is not dehydrated, which will be a medical emergency.  

I don't know what her weight is or her bmi - but at this intake level she will need hospitalised pretty quickly I imagine.  However, if you can get her started eating more at home and get the weight reversal going, then it can be avoided.  It partly depends on the strength and commitment of your team.  At least your GP has got her fast-tracked through the system, by the sound of it.

What you can do is tell your d that she has a life threatening illness, that you will not stand by and watch her die, that she will need to learn to start eating again and putting on weight - and which you will know will be absolutely terrifying for her, but that you will help her fight this illness.  Ensure that she understands that you know this is an illness, and that she is not 'choosing' to be ill - whatever her behaviours and whatever she says.  Think of her brain having been 'hijacked'.  In a nutshell she has a biological and genetic susceptibility of going down this path after too much weight loss, which 'triggers' the switch in the brain.

There is lots of information which you can find on the website, when you have time to explore in more detail.

In the meantime, can you create a table for a weekly meal plan, with six boxes for each day of the week - and it is your job to help her fill it.  If you can get her to sit down with you, at a time when she is not eating - and tell her that she needs to eat more than fruit and vegetables.  Offer half a glass of milk and a rich tea biscuit for a start.  Don't deviate - just give her these two choices and ensure you get tomorrow filled with something like a banana (whole one) for breakfast, half a glass of milk for a snack, a large plate of vegetables she is currently eating (could you persuade her to eat them as a soup, if you boiled them up with stock? - she will see the stock as calories but try and stand your ground, because this at least resembles a 'normal' meal), another half glass of milk for a snack, fruit with zero Greek yoghurt for tea and then another half glass of milk for supper.  If you can get that agreed and down her - you will have at least started the reversal and challenged successfully the resistance which you will meet.  Don't be surprised if she screams and shouts - sit there calmly and expect her to come back to the table.  Also, she should be drinking freely - even tea or coffee without milk, or low calorie juice will be ok in terms of fluids.  

Other people will tell you to push for more but right at this moment if you can get double the calories and even some milk and biscuits in tomorrow - that will be a start.  

I would ask for an immediate hospitalisation at the moment - they might even consider it themselves, but specialist places are desperately in short supply - so you can't guarantee what their response will be.  However, this is a pretty desperate situation if her intake has become so low so I hope they will offer it.

It's going to be a long and tough journey, with a lot of heartache - but many others have walked this journey and come out the other side.

Hugs.  Others will be along soon.

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Theodore Roosevelt.
Sotired

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Reply with quote  #3 
Hi Doris
You can try 'life stops until you eat' perhaps.this means that everything she loves disappears until after she has eaten-no phone,no computer,no tv.in our house we also tried no going anywhere until food was eaten. Once the food is eaten she can have her phone back-but make sure you block any pro ana sites and calorie counting apps.
Depending on how much weight she has already lost I would be going back to your gp tomorrow to have your daughters obs checked.make sure your gp has done an orthostatic heart rate.first the doc takes the heart rate lying down.then standing up.this gives a much clearer indication of how hard the heart is having to work.if things don't look good then your daughter may have to go to hospital to be checked out there.my daughter was first admitted for dehydration for example.
Many here have success with plating up the food themselves.so you prep and serve all the food your d used to eat and then sit there with her until it is done.
We required a higher level of care in our case so my d was refed via NG tube in hospital and then we tried fbt both at the hospital and at home.fbt is family based therapy and it's based on the theory that the family is best placed to re feed their child.they get fed six times a day-3 meals,3snacks.you choose all the food.
If you notice your daughter looking pale,shaky,very cold hands and feet or she faints-go straight to a&e and get her checked out.this illness can be deadly so always better safe than sorry.
Others will chime in soon, I just wanted to give you a few things to know about and try.
Good luck

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Sotired42
Foodsupport_AUS

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Reply with quote  #4 
Welcome to the forum so sorry that you have had to find your way here. A new diagnosis of AN is very frightening and the age old problem of how to get someone with anorexia to eat is something that all of us with children with AN have had to deal with at some time. There are some great Hall of Fame posts about how to get started at re-feeding. It is normal for your D to resist your efforts, but it is also important for you to insist that she does eat more food. You can make a plan of adding in extras over and above what she is currently eating every day. Stop all activity. 
As others have said if you are really concerned she may need assessment in A&E. If she is not able to eat and unable to get out of her current dire situation with your help she will need to be admitted to hospital. Using this as a threat is unlikely to be helpful, rather the goal for you is to make it so that she feels she has no choice but to eat. 

Please ask lots of questions. 

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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.
Mamaroo

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Reply with quote  #5 
Hi Doris, sorry to hear about your d. Min d also restricted to the point that she was only having around 1000 kJ per day. My d had nothing left to live for, constantly crying. She ended up I in IP for 2 weeks to stabilise her and we refed her at home. First slowly, as Melstev said. Start with her safe food and add to it.

Are you familiar with the Minnesota semi starvation project? I'm just going to quote from Wikipedia:
"The investigation was designed to determine the physiological and psychological effects of severe and prolonged dietary restriction and the effectiveness of dietary rehabilitation strategies. The study was divided into three phases: A twelve-week control phase, where physiological and psychological observations were collected to establish a baseline for each subject; a 24-week starvation phase, during which the caloric intake of each subject was drastically reduced—causing each participant to lose an average of 25% of their pre-starvation body weight; and finally a recovery phase, in which various rehabilitative diets were tried to re-nourish the volunteers. Two subjects were dismissed for failing to maintain the dietary restrictions imposed during the starvation phase of the experiment, and the data for two others were not used in the analysis of the results.

Among the conclusions from the study was the confirmation that prolonged semi-starvation produces significant increases in depression, hysteria and hypochondriasis as measured using the Minnesota Multiphasic Personality Inventory. Indeed, most of the subjects experienced periods of severe emotional distress and depression.There were extreme reactions to the psychological effects during the experiment including self-mutilation (one subject amputated three fingers of his hand with an axe, though the subject was unsure if he had done so intentionally or accidentally). Participants exhibited a preoccupation with food, both during the starvation period and the rehabilitation phase. Sexual interest was drastically reduced, and the volunteers showed signs of social withdrawal and isolation.

One of the crucial observations of the Minnesota Starvation Experiment discussed by a number of researchers in the nutritional sciences—including Ancel Keys—is that the physical effects of the induced semi-starvation during the study closely approximate the conditions experienced by people with a range of eating disorders such as anorexia nervosa and bulimia nervosa. As a result of the study it has been postulated that many of the profound social and psychological effects of these disorders may result from undernutrition, and recovery depends on physical re-nourishment as well as psychological treatment."

Here are more information about the experiment: https://archive.org/details/MenAndHunger

My d didn't want to eat with the rest of the family, so she ate in her room with me distracting her by playing candy crush. Remember that if you don't see her eat, the food is not going in. They are very clever hiding food in their clothes or even in their mouth and later spitting it out. Speaking of which, she should go to the bathroom before every meal and not go after a meal unsupervised due to the possibility of purging.

My d became very distressed during refeeding and started to cut herself. We had to hide the knives, scissors, needles etc. It was just the ED, it passed as the weight got on, although with initial weight gain, her anxiety increased. Today she is at a healthy weight and we are tackling the last ED symptoms. You'll get there as well 😁.

Sending you lots of hugs 🤗🤗🤗🤗

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D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.
tina72

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Reply with quote  #6 
Hi Doris,
we had a similar problem in january before our d went IP. She took only 500 cal per day and didn´t drink any more so she got dehydrated. Thats an emergeny case. Try to get her to ER if she doesn´t drink more. Try to make her drink smoothies. That looks like fruit/vegetable and you can hide some canola oil in it. Don´t let her see when you prepare it. Make her drink a little shot and the a little glas. Try to increase that up to 500 ml a day. Tell her she has to go to the ER if the doesn´t drink and will get a tube then. If that doesn´t work, there is no other way than ER. Sorry to say this but that is life threatening.
Tina72
daisy1779

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Reply with quote  #7 
Hi I have recently been in a similar position to you, my daughter 13 gradually restricted more and more and 5 weeks ago was probably eating 200 calories per day at most. We were already under camhs (uk) due to an overdose in April and were awaiting an appointment with the eating disorder team. I ended up taking my daughter to a&e and she has been In hospital since. I wasn't sure what they would say when I took her and was so worried that they would send us away but thankfully they took us very seriously and she was admitted within an hour as her blood pressure/pulse/blood sugars & temp were all dangerously low. I'm still very new to this but would say trust your instincts. I asked every professional we had seen if/when I should take her to a&e and no one really gave me an answer, in the end it was my partner that pushed me to take her and I am so glad he did. She's still restricting at times in hospital and it's looking like she will need tier 4 but she's safe and they will tube feed if necessary (she has been close to having it done)
Holroyd957

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Reply with quote  #8 
Hi if your D has only been eating 200kcals/day she is at high risk of refeeding syndrome and should initially be refed on a hospital ward where her electrlolyes and cardiac function can be closely monitored. I would suggest taking her to a&e and taking with you a copy of MARSIPAN guidelines.
seaglass

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Reply with quote  #9 
First of all kudos to your GP for getting you a CAHMS appointment so quickly. Some people face an agonising wait.

200 cals a day is worrying. Did the GP check blood pressure (sitting then standing) and do an ECG? Did she/he check bloods? All that will be done at CAHMS but you might want to insist checks are done tomorrow just to be sure?

At this initial point any increase in food is a step in the right direction. If she really will only eat fruit and veg go for avocados and bananas etc... try a smoothie (add rapeseed oil and maybe almond milk if she will drink it). Are there any recent foods she would eat before restricting? If so get her to eat them (e.g. Dry cereal/crackers etc).

It's so scary and worrying when you've just got a diagnosis. At least you've not got a long wait to start treatment and get support and advice.

Will she drink milk? Hot choc? ..

Over the next few weeks you'll learn more about starting refeeding. Hang in there and ask qs here. It's an amazing forum.

toothfairy

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Reply with quote  #10 
Hi there,
Did your D eat & drink today?
If not or if only 200 cals, please take her to A &. E tonight as she could be at serious risk.
Please let us know how you are doing.
Best of luck

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BattyMatty_UK

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Reply with quote  #11 
Hi Doris, How are things going? I notice that it's a few days since you posted.

Lots of good advice above. I know that often it can be a case of 'easier said than done' with this kind of thing, but the leverage ideas mentioned above sound like plans. And as MelStev says, make it clear that you're not going to give up on her.

Quote:
What you can do is tell your d that she has a life threatening illness, that you will not stand by and watch her die, that she will need to learn to start eating again and putting on weight - and which you will know will be absolutely terrifying for her, but that you will help her fight this illness.  Ensure that she understands that you know this is an illness, and that she is not 'choosing' to be ill - whatever her behaviours and whatever she says.  Think of her brain having been 'hijacked'.  In a nutshell she has a biological and genetic susceptibility of going down this path after too much weight loss, which 'triggers' the switch in the brain.

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Bev Mattocks, mother of 24-year old male DX with RAN 2009, now recovered. Joined this forum in 2010 - it was a lifesaver.
 
doris

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Reply with quote  #12 
So I have tried to reply to all you lovely people who reached out to me a few times but it really is an emotional rollercoaster isn't it?
Since our initial Camhs appointment we have been meeting them fairly regularly and in regards to intake DD is doing much better. She is drinking plenty of water and three meals a day. We are working on increasing to 3 snacks as well. She is still massively resistant to anything other than fruit veg plain meat. Sometimes she will eat eggs and the tiniest amount of cheese she has milk in porridge for breakfast and another glass of milk as a snack before bed. Yesterday she eat a few nuts. In many ways I feel we are heading in the right direction, she probably averages around 1500-1800 calories a day. Butt, she has now gone back to school, her packed lunch is just an avocado and a mango. She has lost 2lbs this week so now weighs less than on our first camhs appointment. I get that she's not going to suddenly, magically get better but my god I didn't realise it was going to be this all consuming to care for her. And, she only has around 10lb to gain to be in her healthy weight range.

A real positive is my husband came to the camhs meeting yesterday for the first time and he is now beginning to realise the depths of the illness. He has gone from being an ostrich to a kangaroo!!

Once again thank you to those that replied to my initial plea for help. Your messages of support and advice were / are hugely appreciated. I'm sorry it's just only now I feel able to update you. X
Foodsupport_AUS

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Reply with quote  #13 
Oh dear, it sounds like although you have made some huge changes in the last six weeks you are still really struggling. From the date of your first post I gather you have been trying re-feeding for six weeks and so far despite having increased her intake have only slowed the loss rather than gained anything. I am sure that you are trying your best, ED is one tricky beast. 

One suggestion would be to take her out of school. Given there is no reliability that she will eat anything at school, unless you have arranged to supervise her, perhaps she would be better eating at home. However depending on how she is going mentally you may be able to use school as a leverage to get her to eat more, if you can arrange the supervision for lunches and morning tea. Some kids are keen to continue to socialise and go to school so you can take that opportunity to for example insist on a large breakfast before leaving for school, insist on supervision at school for meals etc. 

I am sorry to tell you, but it is also likely that your D will need to gain more than the 10lbs to get her "to her healthy weight range". Many here have found goal weights have been underestimated in many cases, especially when suggested at the start of an illness.

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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.
doris

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Reply with quote  #14 
So 5 months has passed since my last post. I have checked in here from time to time and learnt alot from reading the posts of others. I think it's fair to say that at the beginning (and probably even now) I really didn't know how much I didn't know. 

Since September..she lost another stone in weight and fainted twice (breaking her nose on one occasion), I removed her from school at the end of October as she was just too exhausted and too obsessed with school work. She was finally admitted to a paediatric ward for two weeks at the end of November.  In hospital she was put on a refeeding plan that involved ensures if she didn't eat and the threat of an NG tube if she didn't have the ensure. It wasn't till she went into hospital that she finally acknowledged that she was ill and I realised how much I had been bending to EDs rules. When she came home we stuck to the meal plan and she has gradually put on weight so that despite growing a couple of cm she is now just within her target weight range. We have been on a family holiday, she has eaten out in restaurants, she has been shopping with friends, a lot of her very fixed routines are now softening and she is seeing more and more reasons to get better.

Don't get me wrong I know we have a looong way to go yet. I still have to prepare and sit with her, very often holding her hand through every single meal and snack. ED explodes in a rage of hitting, kicking, hateful, swearing, plate throwing anger from time to time but so far I have managed to talk her through and she has, in the end, eaten everything I have put in front of her since she came out of hospital. We still stick to a fairly "healthy" diet but last week we had pizza and a burger..tonight sausages are on the menu (fingers crossed) these are all foods that ED said would never be eaten ever again. 

She's just told me that the last couple of nights she has dreamt of beating anorexia..not in the way she used to by dreaming of binges but in a way where she is out enjoying herself with her friends and being a "normal" 16 year old. 

So so much to be positive about and yet I am utterly exhausted, completely over emotional and terrified for her (and our family's future). My marriage is suffering, my son is worried, my husband and I run our own business and my brain is incapable of dealing with anything but the very basics and I spend so much time feeding there are just not enough hours in the day. My husband has thrown himself into work and whilst he does have an understanding of what D is going through he is more than capable of sabotaging meals and provoking ED by being thoughtless (but then maybe we need to poke ED from time to time to then win a battle?????)

I often read on here that I need to get her back on or above her previous weight curve..she was overweight this time last year and started at Easter eating healthily..do I really need to get her back to being overweight??

Thank you for providing this forum, and thank you for helping me realise I am not on my own..the battle continues..... x
tina72

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Reply with quote  #15 
Hi doris,
no, you are not on your own and I hear you, I know what you are talking about so well.
I see the number of your posts and I would suggest you come here more often? I still use this forum for information and asking, but for social contact, too, and you seem to need some and a place to vent. This is the right place for that. We know what you are talking about.
First: Congratulations for what you have achieved up to now! You are doing a very good job refeeding her and fighting fear food! I read that she is coming back and that she nearly lives a normal life again. That is great! Is she back in school?

It is totally normal that you are so exhausted at the moment. You needed to work 24/7 for such a long time and now as your d is getting slowly better your own body and mind cries for help. I felt the same, since my d was WR and everything went better I had some "breakdowns" with crying all the day without any cause and I am tired all the day (I try to have a nap every day after lunch if possible) and I sometimes have the "manager disease" with my eyes, I do not see clearly for some minutes then because of stress. I do try to take care of myself and do something nice with hubby every week, but as you say, our marriage has taken some scars. Thank god my d has no siblings.
It will take some time to get into "normal" life again. That is part of phase 3 and it is a problem for the whole family. ED changed everything. We will stay anxious for some time. We will see food and our kids with other eyes. Life will not be the same than before. I was very sad about that. But then some wise woman here said to me: you will not get that life back. So what? That doesn´t mean you will not get a nice life back. We just need to conquer a new life. With the rest of ED. With the scars. But we fought for something very precious and it is o.k. to have those scars.

Weight: As long as your d is growing, she will need to gain weight. Most young adults gain weight until their mid twenties. That does not mean she has to be overweight again. But it is difficult to say which weigh xy is the right for your d. Most dietitians and GPs set the target weight too low. I like the "state, not weight" thought very much. You say she is now just within her target weight range. If this is a percentile that was normal for her before ED, try to keep her there and see if something in her behaviour changes. If not, put her slowly a bit higher. We needed to add only 1 kg to target weight to see some difference in behaviour, others needed to put on more weight for some time. Remember that she is still growing and her body is not fully developed. What might look overweight now can be a nice female figure in some years.

Tina72
Torie

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Reply with quote  #16 
Hi Doris - It sounds like you have been making great progress - yay!

Quote:
Originally Posted by doris
I often read on here that I need to get her back on or above her previous weight curve..she was overweight this time last year and started at Easter eating healthily..do I really need to get her back to being overweight??


That's a good question.  I wonder how you decided she was overweight before AN.  If we are tall, the BMI charts tell us that we are overweight even when we are the same shape as a "proper" weight shorter person. (The math is screwed up for the BMI calculation.) 

Also, there have been some huge research studies showing reduced morbidity and mortality for people in the "overweight" range as compared to people in the "normal" range.

Honestly, though, I don't know the answer to your question.  The only thing I know to do is keep feeding until you see improvements in state.  If the improvements continue even when the weight stays the same, it is probably enough weight for now.  (They do need to gain a little each year through the  young adult years - 20's - as this is normal for everyone.)

Some people do need to be "overweight" to be healthy.  Compared to suffering with AN, that is a small thing. xx

-Torie

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Torie

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Reply with quote  #17 
Here are a few articles that discuss the failings of the BMI calculation:

https://www.medicalnewstoday.com/articles/265215.php

https://www.huffingtonpost.com/david-belk/body-mass-index_b_7693450.html

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
doris

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Reply with quote  #18 
Tina72 and Torie, thank you both. Sausages eaten YAY!!!

She was set a target range that equated to a BMI range of 19-20.7, Torie your articles on the failure of BMI calculation are interesting, especially since all our family are tall and D is still growing. I've got so used to the mindset of bossing ED and ensuring D is gaining weight that now we are just about WR I'm trying to second guess what comes next. I think she feels I am just going to keep pushing for ever more when all along she has been terrified of ending up back where she was (though I would give anything to be back there!). Whilst state is improving, it is far from "right". There is an element of negotiation going on and I'm unsure whether it is D or ED doing the negotiation.. so I just keep feeding. Torie, your suggestion to see if the improvements continue when the weight remains the same makes sense to me.

Tina72 I understand what you're saying.. I will try and post more often! Ds school is a Grammar school - very grade orientated and she was due to sit her GCSE exams this summer. The pressure put on her by the school and herself/ED was just too great so I have not let her go back. (6 days before hospital admission the headmistress was demanding to visit us at home or speak on the phone to D, she wanted to "knock sense" into her. Needless to say I did not let her speak to D). We have now been referred to a medical need tutoring service run by the local authority where she has lessons with a couple of other girls, at the moment just for maths but other subjects will be introduced. It is a really low stress environment and so far seems a better option. If she doesn't sit exams this summer she can stay with them to sit them next year. I have said all along that in the scheme of things the exams don't matter, getting better does. It is hard because she was VERY sociable and she is missing out on a lot with her friends but we do encourage her to try and meet up with them each week. She has also recently started back dancing once a week which she loves (dance teacher fully aware of illness) She has managed to see the dance as a social fun activity and another reason to get better, the deal is she has to have an extra snack on dance day and if she starts losing she can't dance.
Foodsupport_AUS

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Reply with quote  #19 
Wow, you have done an amazing job over the last six months. Great job for helping your D through and slowly but surely helping her back to health. It is testament to your persistence that she is getting better and slowly but surely moving towards being a normal 16 year old. 

Having had a look at that BMI recommendation from your team, it is notable that firstly the target range is at or below the 50th percentile. That means they have suggested that she be at a lower weight than half her peers. Given you are a tall family it is likely that she would need to be above the 50th percentile of height for weight. As Torie has said the taller you are the higher your BMI will be to be at a healthy weight. If she was overweight in the past it is likely that her biology is going to be continuing to try to drive her weight higher, there are numerous studies on obesity and dieting which show that the hormonal changes of weight loss are present even 2 years later. Biologically she is likely to be going to need to be well above that 50th percentile of weight for height to be healthy. Have you plotted things out on mygrowthcharts.com?

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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.
Torie

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Reply with quote  #20 
Quote:
Originally Posted by doris
Tina72 and Torie, thank you both. Sausages eaten YAY!!!


Woohoo!  That's awesome!

Quote:
Originally Posted by doris
She was set a target range that equated to a BMI range of 19-20.7, Torie your articles on the failure of BMI calculation are interesting, especially since all our family are tall and D is still growing.


Well, did she ever LOOK overweight?  (To you.)  This is such a tricky topic because the downside of remaining underweight (FOR HER - never mind what the charts say or what any person says) is so extreme for an AN sufferer that you really want to be SURE she is well and truly weight restored.  Much better, IMO, to err on the side of too much rather than too little.  It sounds like the safest bet would be to make sure she gets at LEAST to the borderline between "normal" and "overweight," especially if she is tall.  My girl is tall, too, which is probably part of the reason she was very ill, despite never being in the "underweight" range.  I don't know if the charts say she is overweight now or not, and frankly, I don't care.  She looks great, and, much more importantly, she is living a full and normal life off at university.

Quote:
Originally Posted by doris
There is an element of negotiation going on and I'm unsure whether it is D or ED doing the negotiation.


Negotiation?  I would discourage that.  Your d has only been out of the hospital for a couple of months, and it sounds like ED is still strong.  The most I would suggest at this stage is, "I understand.  I'll take that into consideration."  Really, even that is probably too "soft."  (I always have trouble being too much of a softie.)  

Quote:
Originally Posted by doris
Tina72 I understand what you're saying.. I will try and post more often! 


Great!  We'd love to see more of you here!

Quote:
Originally Posted by doris
She has also recently started back dancing once a week which she loves (dance teacher fully aware of illness) She has managed to see the dance as a social fun activity and another reason to get better, the deal is she has to have an extra snack on dance day and if she starts losing she can't dance.


Dance? Oh gosh, that's one of ED's favorites.  I would strongly encourage you to keep this as limited as possible.  And to make sure the snack is caloric enough to make up for the calories lost to dance.  Any chance you could divert her interest to music or art or photography or anything at all that doesn't burn calories?

I hope this post isn't discouraging.  It's so exhausting and soul-depleting to refeed, and you're doing SO WELL shepherding your d back to health.  Please know we are with you in spirit. xx

-Torie

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EC_Mom

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Reply with quote  #21 
Congrats on all the progress you have made! Let me say, BMI is mostly meaningless. BUT most of the parents on here with recovered kids have BMIs that are quite a bit higher than the doctors recommended.

It's great that you are close to a medically healthy weight, but I would NOT set yourself or your d to believe that 'target' is a number at which everything stops. Target is a range, and target is much more determined by her STATE than anything a doctor says. 

Our first (fired) pediatrician set our target at 103, which was d's weight before we realized she was sick (she had been sick longer, it turned out). At 115 our next, very good pediatrician said we could slow down. At 130 my d started behaving and thinking more normally. She looks gorgeous, like Marilyn Monroe. She is about 138 now and likes herself. 

So take any target that is based on weight alone with a pile of salt. See where her state is. Then let her body find its target.
tina72

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Reply with quote  #22 
I would suggest that you try to do blind weighing if you do not at the moment. My d refused that for a very long time and then suddenly allowed us to do (4 months after WR) and it is WAY less stress now and I can more easily keep her in a range that I think is healthy for her and not ED.
Saussages!!![thumb] Go for it!
Try to work out a plan to fight fear food with her team. Do not fear something ED is afraid of. The more variety in eating the better the outcome. She should eat at least everything she ate before ED, including fast food, pizza and "unhealthy" food.
We did it that way:
We made a list with 3 categories:
1. I can eat that without problems.
2. I will try to eat that in the next time, but have problems with that.
3. I cannot imagine to eat that at the moment.
There had to be at least 10 things in categorie 1 and 2. That was base of our meal plan. We added one thing from categorie 2 every week. Sunday is fear food day. Today my d mostly chooses which we take, but at the beginning I decided that. When she ate that, we put that meal to categorie 1 and replaced the empty place on categorie 2 with one from categorie 3. I hope you can understand what I mean.
Categorie 1 is getting larger with this from week to week. You need to serve all again and again to get her used to it again. We now have only a few left on categorie 3 but we still work on that.
Without a plan you keep her within 80% recovery and there is no aim to achieve 100%. But that is possible.

Dancing: my d is doing that, too, and I know I have to keep an eye on it. It it single ballet dancing or couple standard dancing? My d is doing standard dancing and we did allow that because it was her only social contact at that time. She never lost weight by doing that and it is only once a week and without any competition. But she knows that this will be cut out first if she looses weight.
Periods: My d got them at 45,5 kg which is very early and then lost it again at 48 kg. So this is no good sign to see proper WR.
A young women needs some more weight to develop a female figure and breasts. My d is very sad today that she missed that and has still the figure of a 13 year old. We hope to have some chance to develop that in the next 1 or two years but it is probably not happening. So please use that time to get more weight on her, you cannot get that back.
Tina72
doris

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Reply with quote  #23 
Quote:
but I would NOT set yourself or your d to believe that 'target' is a number at which everything stops. Target is a range, and target is much more determined by her STATE than anything a doctor says.


How I wish I had understood this fully back in those early days. D and husband are fully convinced that now she is "in range" she will be back to normal within a matter of weeks. Husband even says.."she looks great now don't make her put any more weight on" [frown]  Our therapist has set her up to believe that she will bob along quite happily in the target weight range set.. and in my 
naivety I have gone along with this idea. I'm anticipating heading towards major battles to get above this target if/when it becomes apparent that she needs to do so. Thank you all for your support..it is a huge help. X
tina72

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Reply with quote  #24 
"Husband even says.."she looks great now don't make her put any more weight on""

Doesn´t he see that she is still stuck in ED behaviour?
Doesn´t he know how much ED is tormenting her?

At some point of recovery you have to ask yourself a question:
If I stand on the edge of two roads, and one would lead to thin figure and keeping ED alive and the other would lead to a more heavy figure and living a normal life, which one would I chose for my d?
I always knew if it means that she would have to be overweight to be happy again, I would chose that. Better slighly overweight than dead.
Everybody has his/her own genetic weight. You cannot get under that and stay healthy.
Try to get hubby and therapist into the boat. She cannot recover 100% if you still feed ED.
Tina72
doris

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Reply with quote  #25 
Tina I hear you, I agree with you..far better "overweight" than stuck with ED..just got to pull everyone else along to my way of thinking. Torie's comment is great motivation for me to do this 

 
Quote:
I don't know if the charts say she is overweight now or not, and frankly, I don't care.  She looks great, and, much more importantly, she is living a full and normal life off at university.
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