Wednesday 28 December 2011

While we're on the subject of 'wanting' to recover and 'making choices'...

Over Christmas I've been thinking that no matter how much I like our treatment team (now just one person: our psychiatrist) and no matter how much we are 'on the same page' of the 'same hymn sheet' these days, there is still one sticking point - and, the more I think about it, the more it seems to be a pretty big sticking point.

It is the fact that Ben has been asked 'to choose a target weight' he 'feels comfortable with'. Some time ago, Ben chose 60kg as this target weight. He is now 60kg (BMI 20) (5ft 7 inches height). I have always believed this weight to be too low for Ben - especially when you consider what he was like before the ED - i.e. a Forward in the rugby team.

I believe he needs another 4 or 5kg at least. Or just until he 'looks right' rather than focusing on numbers at all.

The psych has emphasised that, although this is considered to be a 'healthy weight' it is at 'the low end of healthy'. This, of course, gives him minimal room for manoeuvre should he be unable to eat through illness, upheaval or whatever reason. A few kg lower and - ping! - the ED thoughts could return.

Never forget that, throughout his entire illness, his BMI was never mega-low. At its lowest it was 52.8kg (which was in February of this year). At the height of the ED behaviour it hovered around the 57 - 58kg range.

So, before our psych leaves in March, I need to have a serious talk with her about where she sees Ben's weight going from here - and I intend to do it this week.

She has also explained to Ben that as he grows older through his 20's, his weight will need to increase accordingly.

The trouble is, these important points were lost on Ben.

I believe that, without her pushing harder for a higher weight, he will stick with 60kg come hell or high water.

My point is that I do not believe he should ever have been asked to 'choose' a weight he felt 'comfortable with' as his 'final' weight.

I would argue that if you asked any anorexia sufferer to 'choose a weight they felt comfortable with' as their target weight they would choose a lower target.

What Ben SHOULD be saying, but isn't, is that he wants to be like he was directly before the ED hit - an athletic, muscular rugby player with a physique that used to turn girls weak at the knees and make me as proud as punch to be mum to such a healthy looking 'strapping' lad.

Instead he prefers to stick at a weight that is around the same as my weight - and I am 4 inches shorter than him.

And I still believe this is because he sees himself differently from how everyone else sees him.

He really does think he looks the same as he did before the ED. And he also comments on how skinny other blokes look e.g. on the TV when, to us, he looks skinnier. Ben's legs are still stick-thin.

So 2012 MUST be a time when we work on subtly changing Ben's mindset so a higher weight becomes 'normal' for him.

I believe this can work, given the right support from our psychiatrist. After all, this time last year he felt 54kg was an 'OK weight'...

But he shouldn't be allowed to CHOOSE.

Of course it may be that she is just allowing him to adjust to 60kg before pushing for something higher - which is why I need to have a private chat with her right now, setting our goals for 2012 and finding out what her plans are before she leaves in March.

And also pushing for a higher weight than he is now.

Not massively higher, but higher than he is.


  1. Totally agree. I'm recovering from AN and I happen to know that the target weight range that my dietitian and parents throw around (which would give me a BMI 18.5-19)is too low for me - having been restored to that weight several times, I know from experience that I have to seriously restrict to maintain it. Okay, it's a lot better than my current BMI of 14...and I realise they might be trying not to 'scare' me - but the only thing about it that scares me is the thought that they will think I've 'gone too far' if I get higher than that. Which obviously just reinforces my own very strong feeling of being fat at anything near a healthy weight. Luckily I'm at a point now where I'm ready to do what I know is right (i.e., gain to whatever weight is healthy and natural for me) but it would be a heck of a lot easier if I hadn't had these 'targets' given to me over and over again for the last 7 years. I'm glad that Ben has someone as savvy and caring as you to advocate for him.

  2. I could not agree more with your comments. My daughter is in the early stages of refeeding and has had a 3week admission to in-pt unit for a low heart rate. Whilst in hospital she had a Dexer scan which helps calculate "minimum healthy weight" range. This range was openly discussed with my daughter and she has hung onto that number with dear life. If her weight goes over her very minimum, there is a great deal of distress to contend with. I wish this weight was never discussed with her. Like you Batty i think she could do with a few extra kg's on her above the healthy weight,. TH

  3. Thank you for your comments, Anonymouses. I wish you every success in your journeys towards recovery. It is a real sticking point with me that, like the 2nd Anon's daughter, Ben plucked the weight of 60kg out of the ether when asked what target weight he 'would be happy with' and has stuck with this like glue. I worry that next time his weight goes slightly over this he will feel the need to adjust back down again. This is why I need to talk to our psych who, incidentally, has not returned my call from the other day.


  4. I am with you as well Matty. I don't know how often we were pointed to Vale's BMI as being "normal" although he was and is clearly underweight and at that time was having a struggle staying awake all day, feeling dizzy and extremely low energy. Vale is a 14 year old male who burns off whatever calories he happens to consume nearly as fast as he consumes them. Sticking a number on an ED patient is like asking someone how much taxes they would like to pay. They're never going to pick a higher number!

  5. That is such a brilliant analogy, VM. I am astonished that the professionals don't cotton on to this fact too. In fact I might just use that analogy in the meeting I'm planning with our psych (when I finally hear from her...)