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

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Hello, everyone.
My daughter has had AN for 3 years now. She is 17 and recently relapsed while I was away on a work trip. Her BMI has dropped to 14 and we are again starting the refeeding process. A lot different now that she is older and her AN is more 'advanced'.

She struggles most with compulsive movement and eating to her meal plan (2500 cals). She insists to go on 30 power walks every day as its 'unhealthy' to be totally sedentary. She says she cannot eat unless she does this walking. She often references health journals stating the health benefits of exercise and articles that state how detrimental sedentary behaviour is. 
Although we are trying to make her stop exercising and get her to eat more, its almost impossible as I need to work and she is at school.
She says it is so 'wrong' to eat that much and do nothing but sit all day long.

I don't know what to say to her anymore. I just want her to heal and be herself again. She is totally depressed and lost.

Just need some advice or recommendations. Should I keep enforcing the zero movement policy and force feeding, or shall I allow her the walking if it will make eating easier?

What has everyone done previously?

Thanks in advance 🙂  

In that bad state with such a dangerous low BMI she is not allowed to exercise at all and must be on bed rest, so no school. You need to supervise her 24/7. Can you get some time off work? That will be needed...
Exzessive exercising is a symptom of AN and needs to be stopped. She cannot stop it herself any more. She is too sick to lose any more energy at the moment.

Her depression is due to malnutrition and bad state. Make her see a GP asap. Heart and blood must be checked.
2500 calories will probably not be enough for gaining weight at that age.

My d was also 17 when we started refeeding (but here the first time) and it is not easy with a nearly adult but possible. You have only a short time frame before they turn 18 and can refuse treatment and exclude you so get her WR asap before she turns 18 is most important now.

Was she ever WR in the last 3 years? Was she free from AN symptoms before that happened?
Keep feeding. There is light at the end of the tunnel.
Agree with Tina,
i would urge you to act ASAP! your d needs to see a GP
I would stop all exersize
exersize is not healthy when you have AN
You only have a short time frame to your d is considered an “adult” and then it gets very difficult for parents to “have a say” and treatments teams legally can push you out 

Did you d see a specialist or GP in the past?
maybe you could make an phone call or appointment yourself to explain the situation and after you have spoken to doc then bring d in to have the doctor tell her she must stop exersizing and eat what you prepare otherwise hospital may be the next stop
my d would listen to the “professionals” as she thought I knew nothing as I’m only “mum”
i would also recommend continued monitoring by physc or your “team” if you had one
my d dx 17 relapsed big time 18 admitted IP adult hospital now 20YO (and doing well)
now sees her “team” for regular appointments to keep a check  on her
i would prefer that I could do it all but I can’t and now she is moved out of home so this is the only “peace of mind” I get 
just trying to paint a picture on how much harder it gets once they turn 18

the only way I know she keeps up her appts is to pay for them

in effect I’m held hostage by her ED but I can assure you I’d prefer the expense than to have her loose another 2 years of her life through another relapse 

the appts “keep her honest” so to speak

hope this helps 

Thank you ladies for your advice. She is seeing a specialist ed doctor every two weeks. Its so strange as her vitals (heart rate, BP...) always are perfect according to her doctor. That is why she cannot hospitalise her on medical grounds. Anyone would think she should be so tired, however she is always so alert and says she has a lot of energy. 

I will keep trying and hopefully get some time off work to kick start the process. 

Their vitals can be normal until one special point and then they break down. At that moment it is in most cases life threatening. My d had normal vitals on Friday and fought for her life on Monday. Only a weekend in between. They can really die out of nothing so it is important to make her see a GP in addition (not only an ED psychologist) and to check pulse and blood pressure (orthostatic) daily in this bad state.
To monitor her only every 2 weeks is for sure not enough.
Are you sure the ED doctor is not only a therapist and knows something about the medical issues with EDs? I ask that because I had to teach the doctors here in Germany what an orhostatic blood pressure messuring is... sad but true that many doctors are no real ED specialists although they call themselves that often...
Keep feeding. There is light at the end of the tunnel.
My d was the same in regards to how much energy she had 
it was crazy she was working 2 jobs, dancing 5 nights a week, and going to school 
everyone used to comment on how much energy she had
let me tell you it caught up with her she spent 2 years in and out of hospital with 2 lengthy IP stays
looking back it was almost like she had ADHD (although not dx with that) but it was discussed

If you doctor doesn’t know about AN/ED I would urge you to find one who does

i found our GP wasn’t concerned at all, in fact no one seemed to take it seriously until my d was very ill, and it’s much better to get on top  of it before your d gets to a state that she needs hospital 

This illness can trick you and everyone around your d they seem fine till there not

It’s really hard when you don’t get the right advice from the doctors
my d was not allowed to exersize at all once  she went to hospital it was complete bed rest until she could eat a certain amount of food was she allowed a SLOW 10 min walk 
Was this easy for a kid who had been SO active HELL NO! She SH, cried became depressed it was horrible but necessary 

BUT the GP had no problem with her dancing whilst so ill 🙁
on one visit he didn’t even check the scales
I’ll be happy once all the GP’s around the world are up to speed on ED’s
seriously how many lives need to be ruined before they take the time to learn about this illness, if I did my job without knowing what I’m talking about or up skilling myself I’d be sacked or charged with failing my duty of care  

if your d can’t stop the walking it’s exersize compulsion which the ED is driving 

i do hope you can get some time off work to help your d, really your the one who has to she can’t do it herself 
the illness will stop her even after my d got out of hospital I still had to run home like the IP, 3 meals 3 snacks all supervised for a very long time 
I had so much time off work it’s not even funny 
good luck, you know your d best
I hope some of this is helpful