Sunday 10 July 2011

"Experiments", "choices" and "mistakes"... aaarrrggghh!

If I had £10 for every time these words have been mentioned over the last 20 months of eating disorder treatment, I'd be rich! I believe our slow progress on the weight gain front, indeed the lack of progress on the weight gain front, is entirely due to our treatment team's insistence on letting Ben "make his own choices". All the modern evidence points towards this as being the anorexia treatment equivalent of being prescribed leeches "to draw out ill humors from the blood"...

So, once again, Ben has lost weight. On Friday his weight was down by just over 1kg which means he has, essentially, maintained weight since early April (after an initial weight gain which came as a result of me introducing the Contract).

Consistently over the past 20 months we've been told that Ben "needs to experiment to see what works and what doesn't and make his own choices based on the results... sometimes he will make the wrong decisions and other times he will make the right decisions..." etc etc etc. But, basically, the essence according to CAMHS is that Ben needs to do this independently, himself. It won't work if it's me that's "enforcing" it "as was proven by Ben's initial weight gain when he obviously wasn't ready for it".

One year ago the team swapped my 'no compromise' 3 x meals, 3 x snacks eating plan approach for an approach where the "control" was gradually handed back to Ben. Despite the fact that there followed 7 months of consistent weight LOSS, this initial weight gain period is viewed as a "wrong choice" on my part, as a parent. In other words, I was forcing Ben to eat when he "obviously wasn't ready" to do it.

Now that Ben is almost entirely "making his own choices" he's "learning from his mistakes" apparently.

This "wrong choice / right choice" approach simply threw Ben into a yo-yo kind of Limbo. Which is where we ended up at the beginning of 2011. He was crying out to the treatment team that he was finding it incredibly hard to move forwards. Their answer to this was to simply continue the "experimental" approach so, at this point, I decided to introduce a Contract. It wasn't their idea; they'd never heard of Contracts; it was mine - thanks to some excellent advice and experience from fellow ATDT forum members and sample Contracts on the FEAST website.

The Contract was my cunning 'cloak and dagger' way of getting us back on the weight gain track. Because there had been so much 'bad press' from Ben and our team on my initial insistence on a 3 x meals, 3 x snacks Eating Plan, I had to find another, 'creative' way of achieving the same thing. Because I knew if I did nothing, we would never leave Limboland.

And the fantastic thing was, the Contract worked - and he willingly and enthusiastically cooperated!!

But the team simply saw this as happening "because Ben is obviously now ready to make the right choices".

No, treatment team, he is not. And I need more support to push towards a proper daily calorie intake. I don't believe my son is unusual in that he needs LESS calories per day than the 2500+ calories recommended for adult men to MAINTAIN their weight, let alone increase - and this is being proven by the fact that Ben is once again losing / maintaining weight rather than showing a consistent increase.

Why oh why couldn't they have insisted from the start that he needs 3000 calories-a-day or whatever it is he needs to increase his weight at an average of 0.5kg a week, consistently, until he is weight restored?

Why can't they see that it is THEY that are making the "wrong choices" by permitting everyone to watch while this weight loss and sometimes maintenance continues until whatever time it is that Ben starts "making the right decisions" and convinces himself that, yes, he does need significantly more calories than he is currently eating?

Time and time again I have produced my chart which shows that Ben has lost weight since the start of treatment 20 months ago - for a condition that is supposed to be all about weight GAIN. And I've also produced various other charts which show that Ben is still underweight for his height and age. Plus photos that show his 'strapping', sporty physique prior to ED rearing its ugly head which show that Ben never was and was never supposed to be 'Mr Puniverse'.

I believe he will CONTINUE to stay yo-yo-ing up and down with a gradual downward trend if they don't support me in going for full-on calorie increase - whilst also supporting me with insisting that Ben DOES actually need a higher WR BMI than they think he does.

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