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

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My D is 14. We have weight restored her with Maudsley approach. D was relatively compliant. Now she is continuously finding ways to restrict food. Wiping spreads off toast, refusing smoothie, never completing a meal. She has lost 1kg in last week placing her under her maintenance weight. In addition to this there has been some concerns with behaviourz. D wont change ber clothes. She wears a cardigan 24/7 to cover up. Her phycologist said i need to select her clothes daily however she wont wear them. Ive bought her new clothes too. Its to the point where we are in a summer heatwave and D is wearing the same winter clothes day in and day out. She is also wearing high wedge heels to make herself taller. Is this normal for an ED and does it resolve. Feeling defeated.
It does get old, doesn't it?

Sorry to say, it sounds like your d needs more weight. By that, I mean, she needs to regain the lost kg of course, but then needs to add at least a few more kg. Also, again sorry to say, your post makes me wonder if your d is tricking the weight (water loading, hiding weights, etc.).

It's pretty common for them to insist on wearing the same thing day after day ... not a sign of good health, but not really a surprise, that. I think it's a plus that she likes the idea of being taller - some here report their kids want to stay small so at least you don't have that complication.

I wonder if the cardigan is to keep her warm. (They feel cold when sufficiently underweight.)

What many / most here do is get them to what is thought to be a healthy weight, keep feeding to maintain that weight, and watch to see if there are any improvements in state in the next few months. If not, add a few more kilos, lather, rinse, repeat.

But always remember, it really does get better. Just takes an obscenely long time and crazy-much effort.

Hang in there and keep feeding.



"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
This is why i will always say, that being wr does not mean being cured or recovered. As a matter of fact, being wr just means, that she physical in a better state and therefore able to work on her mindset. This will take time.
I think there was just hope that the hardest part was done, however being new to the ED world im now discovering that there's a long way to go. I just wish i had gone with my gut feeling a ling time ago when i knew something was wrong instead of listening to everyone else. Its hard watching D suffer.
Sorry if i was a bit to blunt? What you have reached is great! You saved your d, physically. This is important! I said: "Weight is no healer", meaning: not alone! There is no way recovery would be possible without feeding and without a healthy weight. Its just basic things. But no ED happens "just for fun". Most of the sufferers do have a lot of fears and ED is a cope mechanism. If this is taken away from them, fears come back or rise. Its important to take these fears serious (even if they sound ridiculous). For the sufferers they are so real and so threatening! The way your d has still to go, is hard, challenging and long. But recovery is possible!
We had a similar experience of anger and resistance when our dd was weight restored. Someone on here said they thought it was extinction burst and I looked it up.  I think it was this, we just kept on the case, consequences for not finishing meals etc and this resolved within a few weeks, good luck.
17 years old, well into recovery and taking full control of food herself and gaining weight, she's loving life at the minute, it does get better!!
Hi strengthfaith,

First of all, a big ol' WOOOOT!!!! for getting your d to a healthy weight!!!  Well done, you!

Secondly, I think a lot if not most of the parents here have had a similar experience: w/r doesn't usually bring immediate improvement.  In fact, there is evidence that w/r correlates to the HIGHEST level of anxiety and head noise experienced by ED sufferers.  So when you see that most sufferers are discharged from treatment as soon as they achieve a 'healthy' weight, you begin to understand why 85% of them relapse...!  It takes a looooong time at full w/r and normalized nutrition before brain healing happens.

EDs are biological brain disorders.  Malnutrition causes a lot of the emotions and behaviors that are so common amongst sufferers--and tbh, among people who are malnourished for any reason (see the Minnesota Starvation Study or any area of famine).  The brain is an organ of the body, and since it has such a high energy demand, it suffers most when energy is scarce.  Many studies show that the brain is impacted in both form and function during malnutrition:
FORM:  the brain literally shrinks and the gap fills with cerebral fluid.  The mass of the brain is regained with full nutrition and weight gain but we don't know what happens to neural pathways during this shrinkage/growth cycle.
FUNCTION:  the brain goes into a kind of 'sleep mode' during malnutrition.  It shuts down non-essential services, like emotions.  The brain shows up as very quiet on fMRI scans.  When the brain comes back online, I think of it as that pins and needles feeling when your arm falls asleep and wakes back up.  It creates a lot of emotional dysregulation.

So for both reasons, w/r is just the first step toward full brain healing.  For many sufferers, lots of time and continued nutrition (don't back down on calories and fats!) are enough to return to a normal state.  For others, more intervention is needed--therapy, medications, etc.  Lock (of Lock and LeGrange fame) recommends waiting six months post w/r before dealing with co-morbid issues that might still linger.

I think of this brain injury like a broken leg:  w/r is like setting the bone.  You wouldn't expect your d to be able to dance or run on a broken leg right after it was set just because it looked straight.  You'd know that it takes time, rest and the proper kind of support (a cast) to allow the bone to heal.  And once it has healed, she may still need physical therapy to rebuild the disused atrophied muscles and regain her balance and strength.  Same for ED.  She's made the first step in brain healing.  Continue nutrition and rest with outside support (YOU are the cast that keeps her behaviors in check!).  It takes a long time.  My orthopedic surgeon friend tells me it takes 18 months for a femur to fully heal.  If it takes that long for something as simple as a bone to heal, how long does it take for something as complicated as a brain?  But like the broken femur, it isn't awful the entire time.  The pain and disability is greatest at the beginning, and things get better slowly over time.  If you're like a lot of parents here, you'll see more and more frequent glimpses of the girl you knew before, and these will come to be the norm.

There is great hope!  You've done the hard work of refeeding; now stay the course and keep going!!  Really proud of you.

Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
We were weight restored fairly quickly,around 10 weeks, and like already said the higher weight brought on more anxiety. But we kept going and between the good weight,full nutrition with plenty of fats and TIME we've seen most of the ED behaviours slip away and along with them the anxiety. We are in a much better place mentally as well and getting better each day...hang in there it will get better.

Colleen you need to write a book of analogies cos you are the Queen of them!
Failure is NOT an option.....