Well I whipped out the (huge A3 version of the) photo and thrust it onto the desk in front of the psychiatrist. She could see my point. She also told me that it was obvious to her that his bone structure / build needs to carry more flesh.
The long and the short of it is that yes she does realise that Ben needs to be heavier, but first he needs to adjust to his present weight, just as in the past he's been given "time to adjust to lower weights" before moving onwards and upwards.
Push for too rapid a weight gain and you risk things going pear-shaped, maybe even unintentionally encouraging some purging, she said. She's seen that happen quite a lot.
I could see her point.
But what I didn't understand was why she keeps implying to Ben that his weight is OK as it is now. Why does she have to say anything at all?
I said that he believes he is now fully Weight Restored and that it's OK to remain at this weight for ever and ever Amen.
So I asked her to stop doing this. It's counterproductive and it could make things harder for us when we push for additional weight gain.
The trouble is - she leaves in March for maternity leave and we have just 4 or 5 sessions until then. So it will probably be me that has to push him a little higher.
I told her that Ben respects her advice enormously and I know that the need for this extra weight would come better from her.
We talked for a whole hour - about weight, about the photo, about the future, about Ben's transition to university, about formulating a relapse prevention scheme.
But again I reminded myself that we have just a handful of sessions before she leaves to do all this...
We will be seeing someone else whose job it is to smooth out the transition between treatment and major life changes like going to university or moving into Adult Services, so that's good. Or at least I hope it is.
Anyway, I made my point at the meeting. I kept the photograph in front of us, often interrupting her as I returned again and again to "the perfect physique" from 2008. And I emphasised that, by implying to Ben that his present weight is Weight Restored, we risk settling for "good enough" instead of "excellent".