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

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Roseau
Can Weight Watchers really help with Eating Disorders?

We are in the UK and my young adult daughter is under secondary mental health services for depression. She has been severely restricting her food for well over a year, has lost a of weight but still thinks she's fat. Her GP thinks she has anorexia and made a referral but it is proving complicated to get her seen by a specialist ED service. She has just got a new general psychiatrist who suggested she enrol at Weight Watchers to get meal plans. This just seems wrong to me and would like other people's opinions.
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Enn

Hi there, looking back at your story you have been worried about an eating disorders for awhile. If the Gp thinks she now has an ED, then she needs a proper assessment from an Ed specialist so that is a positive development. Glad they have made the referral. I would suggest that your d stop seeing that psychiatrist!  And no I don’t think Weight Watchers is at all appropriate!
You know when we discuss  meal plans etc, ultimately the goal is to eat way more calories  than she is now no matter what that may be. I don’t anyone needs to really have a documented plan, and it usually is trial and error anyway as the resistance of the ED affects our approach. 

Will she let you support  her eating? I recall she was not with you, but away at university? 

I hope she gets in for assessment soon and gets on a good routine for eating and gaining ASAP. 

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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teecee
Absolutely no to Weight Watchers. Their very ethos is diet culture based and is not a healthy environment for an ED sufferer. Ditch the psychiatrist and see a specialised ED dietician for a meal plan. 
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Torie
Another "No" vote from me on Weight Watchers.  And the so-called professional who suggested that. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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PleaseEAT
Definate NO from me too
i would be searching high and low for a SPECIALISED ED psychiatrist (or getting the GP to refer) not easy I know in current covid crisis
ED are a very complex condition and obviously this general psychiatrist has no idea 
my d struggled until we finally got the specialised ED help she needed

i personally would NOT go back to that psychiatrist 

when no help is better than bad help 
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Foodsupport_AUS
Another no from me regarding weight watchers and a meal plan. At the same time I did use "weight loss" apps to help with calorie counting to help with weight gain. I think this can be helpful for us as parents but not so much for the person with the ED. There are numerous fairly simple meal plans around as starters, these then need to be added to depending on current intake and the rate of gain that is happening.
This link here is to the Maudsley hospital child and adolescent guide for eating disorders. https://www.national.slam.nhs.uk/wp-content/uploads/2011/11/Maudsley-Service-Manual-for-Child-and-Adolescent-Eating-Disorders-July-2016.pdf.
The adult meal plan is similarly set out into two parts https://www.kcl.ac.uk/ioppn/depts/pm/research/eatingdisorders/resources/restoringregulareating.pdf
On page 133 is an appendix for outpatient meal plans -- the first is a starter plan for those that have been severely restricting and is intended for only a few days. The second plan though is designed to help restore weight but needs to be adjusted up by the response. What I and many others don't like about these sorts of plans is that they are very prescriptive and seem to encourage measuring or weighing of foods. These plans also use semi skimmed milk instead of full cream milk. 

This article reviews meal strategies and why they are chosen and gives some information on exchanges https://www.verywellmind.com/restoring-nutritional-health-in-anorexia-nervosa-recovery-4115081

Hopefully you can use one of these to look at starting and then continuing on regular intake. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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MKR
Hi @Roseau,

Weight Watchers strategy is all about points, calories, trading off numbers - this would reinforce the rigidity and OCD and thus the eating disorder itself.

Our kids need to regain their hunger cues and eventually eat intuitively again.

I'm afraid that means a No to WW, from me as well.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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melstevUK
Hi Roseau,

What an ignorant response from a clinician who should know better, even if he is not a specialist ed psychiatrist.

What would be worth doing is asking for the GP to make an urgent referral to a community dietician.  My d had a lovely one who was helping her make progress until unfortunately she went on maternity leave.
I don't now how they would schedule meetings during the lockdown, but this is a much better option than Weightwatchers.
Believe you can and you're halfway there.
Theodore Roosevelt.
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KLB
I found this on the WW FAQs

Weight Watchers is not a medical organisation and cannot meet the needs of those with eating disorders. For this reason, those with a current medical diagnosis of an eating disorder are not eligible for membership in the Weight Watchers programme.
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Roseau
Thank you everyone for confirming my intutition that Weight Watchers is not suitable for someone who is severely restricting their eating. She is already counting calories so doesn't need help from anyone else to do so!

To answer people's questions, my daughter is at Uni in a different country from me. I was seeing her every few weeks but haven't seen her for two and a half months now because of lockdowns and have no idea when I am going to be able to see her again. I can therefore make suggestions but I have no control over what she eats. Thank you for the links FoodSupport_Aus, which I found interesting reading. Unfortunately she has never drunk milk (I breastfed her until she was two and she refused cows milk as a drink and got calcium from yoghurts etc.) and she has been a vegetarian since long before the ED started so the plans you linked to would need major changes. Like so many, she also has only a very small number of safe foods that she will actually eat.  She says herself (in her more lucid moments) that she no longer knows what normal eating looks like. She refuses to listen to me but her GP has convinced her to add two new foods to her "safe foods" over the past month so I think part of her does want help. She says she thinks a dietician would be helpful but I am aware that if someone is putting real pressure on her to eat she may well change her mind.

Her GP said NHS dieticians won't accept any new referrals until the lockdown is lifted whereas the ED service will, which is why the GP was hoping that the psychiatrist would refer her to one. She did put a tiny bit of weight back on a couple of weeks ago but that led to a major melt-down and caused her to start restricting even more severely, which is why both I and the GP think she needs specialist help. She is malnourished and has had anemia for six months (her iron levels are still falling because she won't take the iron tablets).

Unfortunately she can't change psychiatrists. This is a new one (the old one who I had finally managed to convince that my daughter had an ED left in January, a week after we saw her). I had hoped he would be more knowledgeable about EDs than the previous one but this doesn't appear to be the case. She has had one 30 minute phonecall with him but has been promised a one hour face to face appointment with him sometime in July.
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Foodsupport_AUS
I am so sorry that your D is getting such dreadful treatment and you are left across the border unable to do anything about it. It does sound as though the situation is quite dire. You mention that you are in the UK but then mention your daughter and the NHS, do you mind confirming which country your D is in? The terror of weight gain is a core fear of the illness, and is often irrational. It is hard to convince anyone to do something they are terrified of. To recover however she will need to eat non safe foods, and she will need to gain weight. I hope as lockdown restrictions ease you will get to be there with her and help her move forward. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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Roseau
She is in the UK and I am abroad.
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