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lou7

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Reply with quote  #1 
My d has been battling RAN almost for four years now. She's 16. She was on a clinic two years ago and we did FBT quite successfully after that, or so I thought. This spring, she had a relapse/bump and we banned all sports (casual dance and tennis) but she gained back the 5 kg lost quickly and we let her join the dance group (1 x week) again. The weight has continued to go up, further than before (she knows her tricks with weighing but we have a system to prevent that, and the weight really shows now too; she looks great). She hasn't have period since autumn but it restarted a few weeks ago. She goes to school but we have lunch with her. 

Compulsive exercise has always been a problem with her. There was absolutely no control for that at the clinic and the staff just reported to us that "your daughter was caught today doing sit-ups" - like there was something we could have done! The problem seemed to go away when her weight went up the first time, especially after she was well enough to start with her sport hobbies. But now, when she is let alone for a while, we can tell that she does pushups on the floor in her room. We can tell that when she comes home from school alone (when her brother does not come with her like usually) or goes to meet a friend, she runs.

This does not affect her weight, so it's just "crazy", compulsive behaviour. She eats everything we require with no problem so this is ED's way of easing the anxiety from the eating. Her mood is really good for the most part - again probably also because she has this purging outlet. I know we should probably take her out of school, not go to work ourselves and stay and sleep with her 24/7. It just seems so counterintuitive, like a punishment, when she is at a good weight and not in immediate danger in any way.

Would you kind and good people have any advice for us?
toothfairy

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Reply with quote  #2 
Hi lou7.
It sounds like ED is firmly in control here. Yes I would consider this to be purging via exercise.
Firstly I would question is she really weight restored at all. What is her current bmi, many of us had to go way above our target to see recovery.
Secondly, she can probably comply because she is purging via exercise. If you take that away , I am guessing that the ED will really roar up again.

Compulsive exercise is very difficult to stop, and yes I would take her from school and sleep with her too. 
As she is 16, there is a short time to get her into recovery before she gets to 18 and can refuse treatment.

The other thing is that this behaviour is her ED beating her up telling her to do this, keeping ED alive ,and needs to be stopped.
Here are some links 
https://www.eatingdisorderhope.com/information/orthorexia-excessive-exercise/compulsive-exercising

http://tabithafarrar.com/2017/05/exercise-anorexia-case-cold-turkey/

Best wishes

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Food is the medicine. Recovery is possible.
scaredmom

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Reply with quote  #3 

I agree with toothfairy,
ED is still there and quite active. We had a lot of standing issues here. It is hard to extinguish this behaviour, but as with the food, it has to happen. Yes you may need to sleep with her. 
It is not punishment to not exercise, it is the care she needs to totally rid herself of ED.
Please look up mamabears threads her D has ++ issues with exercise and OCD. 
I wish you the best on this.
XXX

 

Foodsupport_AUS

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Reply with quote  #4 
I agree with the others if there is compulsive/secret exercise it needs to stop. It may be even best to stop all exercise again at present. If she was purging with vomiting you would be trying to stop that straight away. Because she is purging intake via exercise it seems more "normal" That is still however playing in her brain and keeping those compulsive circuits going. So whatever you can do to break that cycle is important. I suspect that when you attack the exercise the food may become more of an issue again.
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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 lou7,

It is great that you were able to refeed your d a couple of years ago and to get her weight on last spring.

I think we need to distinguish between normal exercise and compulsive exercise. It is normal to go to dance group once a week, or practice tennis once(?) a week, but it is not normal to do push ups in her room or run home from school.

In your shoes I would pick her up after school to remove the temptation to run (only on the days when her brother is not with her) and tell her it is not normal to run after school. Also I would keep her bedroom door open so that you can check if she is doing push ups. If that doesn't work, she needs to stay in the common areas (do her home work at the dining table for example), only take short bathroom breaks and if needs be you can sleep in the same room with her. I give my d tablets to help her sleep, it may be something to consider otherwise they would exercise during the night. You can consider giving her a mild anti-anxiety over the counter medication and see if it would help. 

If this soft approach doesn't work, I would stop the dancing and tennis, because any exercise might drive the compulsion and then consider anti-depression (prescription) medication to decrease her anxiety levels. Teenagers need to grow until their 20s and should gain around 1-2 kg a year. So her weight needs to go up the 5kg she has lost plus an additional 1 or 2 kg she was supposed to have gained in that time.

Does she have other interests such as art/craft/fashion design or music/singing? It might be a good idea to introduce other interests, which can replace the dancing and tennis if you need to stop them.

Good luck and 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.
lou7

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Reply with quote  #6 
You all are right of course. These past few days I have been following d everywhere (it's holiday here) and haven't let her out of my sight. H and me confronted her and told her we know what she is doing and she was very much onboard to stop it. Well yes, she might be but ED thinks otherwise.

I thought the movies would be a good idea today to distract her and she thought so too. Once there, she went to the loo, I went to the next booth and guess what - there was some odd leg movement going on so I had to knock on her door and tell her to stop. On the way home she had a fit, yelling that she I had forced her to eat too much at lunch - something I haven't heard in ages. Now she is throwing things, shouting at me and deliberately trying to hurt me. I know it's ED, not her, but I cannot help panicking. It sounds so familiar, an echo from two years ago, something I have only heard in nightmares since. This is so hard - having her "back", the real sweet loving girl, the good times, the girl talk and the laughs - and then seeing her being kidnapped again.

Just to clarify, we have stopped all sporty hobbies already and she has gained the kilos she lost plus some. Trying to still go up, but yeah, there's a battle ahead.

I guess there is no point in asking how the hell we got back here again. I just have to take a deep breath and put on those big girls pants.

Thank you everyone for your insight.
Torie

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Reply with quote  #7 
Oh dang, Lou, sorry you're having to face down the demon again.  Like they say, when you're getting flak, you're over the target.  Sounds like you are really on point,

Please remember that we're with you in spirit.  This too shall pass.

Keep swimming. xx

-Torie




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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
lou7

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Reply with quote  #8 
Thank you Torie. "This too shall pass" - you don't know how much that helps me. It is so difficult to believe now! And of course thank you everyone else too for encouragement.  I'm starting to lose hope, and when we lose hope I guess we have nothing. It's just that I have never heard of such erratic behaviour at such a "good" (maybe not good enough, but still) weight.
Doitagain

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Reply with quote  #9 
HI - you've done a brilliant job no doubt about that. You've got a bit to go though it seems. If compulsive exercise exists she is not better. There are many stories my D told me (four years down the line) about how even when everyone thought she was "better", "in recovery" etc etc - this was the last bastion . Boy, was that strong too. My D told me she used to run up and down the stairs every time we went out - she was allegedly "weight restored".. plus.. so..... In patient units are full of patients who either don't put on weight or do so so slowly it is almost unfathomable - in a highlysupervised situation. This is because Anorexia recovery and eating more to get there , in my experience , always involves also eradicating secret exercise - all of it - all of the time. No sport, no dancing - bet when she is better she doesn't even want it, If compulsive exercise persists it is just another way of shaving calories so no weight gain or "holding" at a secret set point. Nobody does it on purpose as it is part of the profile of that individual and that illness.
As I said you sound like the food is getting there - but this sadly, is like whack a mole. So that's the new task. You've done a brilliant job so far . Now you've got to get and keep her so busy she doesn't even want to exercise as much. I met with Lock and Le Grainge about this. They told me the only thing that replaces Anorexia ultimately is life itself. If she is weight restored that is half the battle. The other half? Well... walks with you, the cinema once per week school study in one subject she actually truly likes/loves, cards, hair, nails, a bar once a week with you or her dad, yoga, painting drawing, pick one show on television and watch it once per week , meditation, therapy weekly, driving, buy a pet , voluntary work once a week - get a "new" routine - fill it up! By degrees she will have to fit in the exercise around a very structured (but relaxed) timetable. It will lose its appeal because she will have other things to do. You'll have to force this in the beginning no doubt . I really really hope I sound kind and good here. This bit is equal and just as important as the food bit ! It is just the next stage and you have done soooo well with the first stage. Just allow the same again time wise for this and it will come good. Give it the time - truly - this Is the bit that in its own way is just as hard but truly is a growth stage . You'll find the six things that put a new "structure" and meaning to life. You can do this. Heroes work and you've been a supermomx
lou7

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Reply with quote  #10 
Thanks Doitagain! Since you have been there yourself: what do you think we should do about school? It seems a bit harsh to take her away just before exams when there is only a month to go - and she is not medically compromised. Then again, we have no idea what she does in there when she finds a free minute - running stairs like your d, not quite sitting/sitting on the edge of the seat to work the thighs etc...
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