We've put together this note because we strongly feel that at this stage Ben should not be allowed to take control of his breakfast.
At the moment, virtually the only thing he seems to be bringing out of the CAMHS sessions is weight information. He feels (wrongly, we believe) that he has arrived at his 'ideal weight' and wants to maintain. He also believes CAMHS have given him the green light to maintain (which I'm pretty sure you haven't!!) So the fact he has put on weight at all his recent weigh-ins has had a very negative effect on him.
After Friday's session he went into total meltdown, banging his head, shouting in his 'animal voice' and was on a mega downer for the entire weekend - all because of the weight gain.
He has been trying to cut out foods from his eating plan by avoiding them, taking smaller portions, leaving food on his plate or refusing to eat because he's 'too full'.
The anorexia is fighting to gain back control and things are really difficult. A worrying side-effect, too, is that his hair has started to come out in larger than normal quantities.
Knowing Ben as we do, we strongly believe that he has not reached his 'ideal weight'. 12 months ago he was a healthy looking, strapping rugby player, athlete and cyclist – not in the slightest bit overweight, just normal! The present Ben is NOT the same boy physically.
At the moment he risks losing weight again as the anorexia battles to take back control. Any move to allow Ben to control his own breakfast would be a green light for the anorexia. It would also 'prove' to Ben that we, as parents, had got it wrong all along – and he would lose his trust in us. It would be very difficult for us to get him to stick to any further eating plan.
The weight issue is something that needs to be addressed because, as I said above, it's the only thing he's really picking up on from the CAMHS sessions. Should he even be told how much the weight gain is? Or should he be 'blind' weighed?
We adults know that Ben’s weight gain is minimal – like you said it's the equivalent of maintaining weight. However it's purely because he is only eating 2400-2500 calories, not because his body /weight is regulating itself because it's arrived at its 'ideal weight'.
We would actually prefer to INCREASE his intake slightly to see a more noticeable weight gain as we worry that at current levels, he does risk simply maintaining or even losing. Should he be maintaining at a weight which is not his natural weight i.e. too low? The moment he starts to eat normally it risks leveling itself out at the higher weight with a risk of freaking him out and causing a relapse????
Also, he has this worrying obsession with fats. Contrary to what he implied on Friday, his fat intake is rock bottom. He is so micro-obsessed with fats that he even refuses to eat certain brands of food e.g. he will only eat McVities Digestives at 3.2g fat/0.3g sat fat per biscuit as opposed to Tesco brand at 3.5g fat/1.6g fat per biscuit.
Here's another note I wrote to the psych following our disastrous summer vacation in France:
Ben's weight loss
I am still not clear what CAMHS plan to do about this. At first it appeared that CAMHS would step in if Ben lost weight consistently. But this hasn't happened. At this stage, I would like to be clear about what action you plan to take next.
Ben's weight has gone down consistently since 28th May. This appears to be against the NICE guidelines which recommend a weight increase of 0.5kg per week. He may not be at a dangerous level now but he could be before too long.
He refuses to let us take control or even talk about food / eating / anorexia so we can't encourage him to increase his food intake.
As a weight gain regime this obviously isn't working and it could get serious if left unchecked.
If the plan is to change his mood first and with it will come the weight gain, then this could take months. Surely his weight could be at dangerous levels by then?
And with the weight loss comes mood deterioration and the return of old anorexic habits and behaviours
As a parent I am seriously worried and need to know what your plans are to turn this around.