Answering Anon's comment on my last entry...

After I published my last post, Anon sent me an interesting comment : "I was just wondering, with Ben during his recovery has he ever been taking any supplements such as ensure plus, resource, benecalorie etc? And what have his portion sizes been like for meals? Has he ever been eating large portions e.g large portions of meat, large plates full at dinner etc?"


To answer her/his first question about supplements:

No, Ben never took any supplements. He refused. During the early days when I was panicking about getting the calories into him I bought a tonne of Complan powder to make into high calorie shakes (bit like Ensure). But, Ben being Ben, he refused point blank to touch it.

All he would drink were milkshakes which he made himself (with skimmed milk...). Anything else was refused. I also had some fantastic recipes which other mums gave me for mega-high-calorie shakes which were refused as well.

At first he agreed reluctantly to drink fruit juice or fruit smoothies instead of water or black tea / coffee. But after the first 6 or 8 weeks of the initial re-feeding, he refused these as well.

The result was that we had to get a tonne of calories into him by other means. And, when you refuse to eat most fats, carbs, etc this means that not only do you get a very unbalanced nutritional intake; you have to eat a heck of a lot of bulk to make up the calories, all of which left Ben feeling bloated and horrible. This was a real problem during the early days.

I say 'early days' because, if you check back over my 2011 blog PDF, you will see that after the first 6 or 8 weeks of the initial re-feeding plan, Ben 'downed tools' violently and refused to stick to the eating plan any longer. Nothing we or CAMHS did would make him eat the required calories. Also at this time we lost the services of our (excellent) Dietitian which made things even more difficult. Over the next half year or so Ben's weight headed south and, with it, his ED rages and depression went wild...

To answer her/his second question about portion sizes:

I'm thrilled to say that, ever since Ben turned a corner in October 2010, his portion sizes have been normal, if not on the large side. He almost always has at least 600 calories in his evening meal followed by a further 500 or so for his pudding followed by yet more calories for his 'supper' before he goes to bed.

But it wasn't always like this...

In the Bad Old Days of the anorexia, portion sizes were a real issue. Initially our dietitian tried to get Ben to eat normal portion sizes instead of counting calories. It didn't work. Being shown pictures of typical portion sizes failed miserably for Ben as he was tempted to underestimate hugely. In the end I insisted we count calories rather than do portion sizes as it was the only way to ensure Ben got sufficient food without cutting back and losing more weight.

Also in the Bad Old Days he'd get really confused as to what constituted a 'normal' plate of food. It was as if his brain had switched off the ability to gauge whether what was on his plate was too much, just right or too little.

Every meal time I'd dread putting his plate in front of him for fear of his reaction. Normally he'd slam down his knife and fork, sometimes throwing the food or plate around too, storm out and have an almighty head-bashing and howling ED rage that put the fear of God into me.

Another thing that would set him off would be if any of our portions appeared to be smaller than his. We even got to a stage where I would WEIGH OUT everyone's portions to 'prove' to Ben that they were all the same and he wasn't getting a nano-gram more than us.

Large 600+ calorie portions like this weren't a problem for my husband, but they were for me. I'm only tiny and cramming all this food into my own stomach was really hard. If I left anything at all on my plate it would send Ben off into an ED rage again. The amount of times I'd wail "I'm female, middle aged, my metabolism is rock bottom and I'm only 5ft 3 inches!!!" Remember that at this time we couldn't 'condense calories' as we now call it; Ben wouldn't eat fats or some carbs which meant a 600+ calorie meal was pretty huge.

Thank God we are now long past this stage.

Since October 2010 Ben has been eating 2500-ish calories a day which has (very, very, very) gradually increased his weight. He is no longer terrified of fats or carbs. He will eat almost anything and he often 'condenses calories' so there isn't so much bulk.

For the past 15 or 16 months his meals have comprised:

• Breakfast: cereal / dried fruit / yoghurt / nut combo followed by 2 slices of toast with jam or similar
• Lunch: sandwich with soup or crisps (chips) and other bits and pieces followed by a large pudding and sometimes a shake
• Evening meal: 600+ calorie main course followed by large pudding
• Late evening: supper snack and drink

Importantly, over this period, his nutritional intake has been incredibly well balanced. These days I can eat smaller portions than him without comment because he knows how much he needs to keep his weight up and heading towards recovery. And these days meals with Ben are a pleasure, not something I dread.

I hope the above has answered your questions, Anon. If not, shout!!