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

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Wantbacktonormal
Hello,

13 year old AN daughter out of hospital (first time) for 6 weeks after a stay of 5 weeks.  Current weight is 92 lb and target weight based on 50% BMI is 110 lb, she has never been on a curve greater than 35% which would be a target weight of 105 lbs.

We are in FBT but she pretty well refuses to talk with any of the team members.  Has gained only 5 lb since coming home.

She has pushed away most friends and is sad pretty well continually, mood swings are extreme (compared against pre AN mood and personality).  She has asked to go back to playing soccer repeatedly and we have discussed there would be more nutrition added as well as increase expectations to accommodate the 3-4 practices a week.

We know what the related recommendations are, nothing till target weight reached and even then maybe months after that.  However we are considering the risk for the hoped for social benefit and reduced sadness, also quite afraid of the impact a meltdown at a practice may cause.

So to ask a question, has anyone had a positive experience with child returning to competitive sports early?

Thank you
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Enn

Hello and welcome! I hope you get the support and information to help you.

please read around the forum and search for topics as well please look at the feast-Ed.org site. So much great info!

As for exercise and soccer 3-4 times per week. mu d did go back only 2 days per week and had to have a snack a good one after soccer. I would suggest though to have the snack prior to activity. My personal thoughts are that 3-4 times per week may be too much to start. How about just once a week for two week and see if her weight is ok and she is compliant with her extra snack, then two times per for two weeks etc.. 

The concern I have is that too much too sooner make it harder to get control and go back later if needed. Clear guidelines and expectations and clear consequences need to be hashed out before any extra, I feel. 

As for her weight target there is recent thread to look at . Also my d was always at 25% bit I suspect that ED was present longer and when my d got above 50% she really improved . 

I know others will be here soon with their thoughts and advice.

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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Barberton
@Wantbacktonormal,

I agree with @Enn that too much too soon is harder to control. There are obviously benefits to having physical activity, and negative consequences to not being allowed to join in sport with your peers. There is no one correct answer. You will have to manage this carefully for your daughter.

My d is similar age and we faced this same question. We started out with very short (slow) walks after lunch. We then added some yoga/pilates in front of the tv. Again, we kept things slow and relaxed and I monitored the whole time. When she first returned to school we did not let her join in PE classes, which was extremely upsetting for her and difficult to manage. But once her weight got to a safer level, we slowly added sport back in AND increased her food intake. By this stage her thinking was more clear and she could accept the idea that if she wanted to play sport, then she needed to compensate lost energy with more food. 
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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CourageForAll
I don't have anything to add to what was said above but my D is also a competitive soccer player.  She was also in hospital for 5 weeks but she's only been home for a few days.  I would be interested to hear how it goes.  My D is anxious to get back to it but she won't be able to get back to it for a while probably.
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feedingcaponsus
My 18 yo AN daughter’s sport is rock climbing. She was in the hospital for 2 weeks and then residential/outpatient for 4 months. Right after she got out of residential and went into php, the doctor let her go back to climbing 20 minutes, once a week with an extra snack taken beforehand. She allowed her to slowly add in duration and frequency over the next year, always with supplemental snack beforehand. I was surprised it worked letting her try so soon; I remember my daughter crying after that first 20 minutes as she had no conditioning left and was double her size (she went from 65 lbs to 120 lbs in residential).  I thought no way would she want to keep going esp with all the extra food, but she did and a year later she was back climbing on her team. Climbing helped a lot with facing through anxiety, so I think it was, for her, a key part of her recovery.  Over the next year, she grew 5 inches and gained another 20 lbs. she has one small dip in weight when she ramped up to 3 weekly practices, but just added in additional calories and gained everything back. 3 years later shes completely recovered. And she still climbs.
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Foodsupport_AUS
You have been given some good advice about going back to sport. I would add one other point. Sometimes the part that is asking to go back to sport is her ED rather than her. Many kids with ED have been competitive in sports in all sorts of areas. Sometimes that competition and perfectionism are all ingrained as part of their ED. There have been quite a few that have even been at elite sports level who once ED was done and dusted chose never to go back to their sport because so much of it was a part of their illness. So try to make sure you are not making ED happy. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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Wantbacktonormal
Thank you to everyone for the responses.  I take away that while it is a risk if we do go forward we need the plan to be clear with expectations and consequences.  As well as it being a gradual ramp up.  I think our plan is aligned with the above and the physical side is covered (coach on board with a gradual reintroduction with attendance at every practice but increasing participation level) but my biggest fear remains that she takes a shot on goal (Or something else) and it is not as strong as it was in the past and then emotions snowball from there (speaks to the perfectionism aspect of one of the comments, unfortunately she has always put a lot of pressure on herself from as far as we can remember). Will look to provide updates.
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Enn

I know you are concerned about her feeling she is not as strong now as she was before. And honestly it is the truth . She can’t be as fit as she was due to her illness. There will unfortunately be  many more  moments like this  with ED .  They will be confronted with their illness on different fronts. It is not a bad thing it is real. She may not understand it right now. 
I hope it goes well.

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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Barberton
@Wantbacktonormal, The worry you feel about your d's possible 'snowball' of emotion is totally understandable. But that is what you are here to help her through. Your voice (and support) has to be louder than the ED's voice.

I guess you have to ask what the ED voice would be saying to your d in those circumstances and talk to her in a way the will counter that voice.
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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Wantbacktonormal
It has been about a month, so thought I would give an update in case similar situation applies to others.

First couple of practices were touch and go and she went off to the sidelines to compose herself, she battled through and for the last couple of weeks they have been a source of some happy anticipation in going and enjoying the practices while there.  Coach did an amazing job of working her back into full participation over a period of around 5 practices and talking to her about “shaking off the rust” being normal. There have been no objections from her to the added nutrition before and afterwards (obviously not happy per say, but recognizes the reason and accepts).  I think the added snacks may have actually helped our efforts to increase some of the nutrition increases on non soccer days as well.

In general, up to this point I think it has been a positive.  I feel she is a long way from being back to herself from a mental perspective and I am on pins and needles every time she gets a bad shot or loses the ball, but I can only hope this helps with all the other areas of day to day challenges with the expectations she places on herself.

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