Yesterday Ben and I spent an hour with the new dietitian, putting her in the picture about Ben's anorexia and the stage he is at now - plus all the remaining challenges, as outlined in my previous blog post. It was really good and she 'got it' immediately. But, then, I expected she would. After all, she seems to be one of the region's leading eating disorder dietitians and has also been on the telly several times (talking about eating disorders and working with people with anorexia, etc). So a huge thank you to my dear late Dad for paying for these sessions.
Ben tends to be extremely cynical about clinicians. The only person he ever really trusted, and he came to trust her implicitly, was our CAMHS psychiatrist. As a result, he accepted everything she said as 'gospel'. But I have high hopes that the same will happen with this new clinician. She did a fabulous job of winning him over yesterday and gaining his trust. Without that, it would never work.
Already she introduced the concept that he will need to weigh more as he gets older i.e. between now and 21, and 25.
"But I'm not going to grow in height", he said.
"It doesn't work like that", she said, explaining that men between the ages of 18 and 25 'bulk out' - they develop muscle mass naturally, and muscle weighs more. In other words, he won't be "getting fat", he will just be building muscle and that this is something that happens naturally to older teenagers as they mature into full grown men.
She also covered a host of other issues that are worrying Ben. Like the worry that, if he doesn't count calories, he may eat "too much" or "too little". If he eats "too much", he "might not be able to stop", will balloon out and become obese.
And also the fact that, although people who were overweight as children do have a tendency to be overweight as adults, the fact is that the more you maintain your weight at the "right weight", the more the chance that your body will adjust to that as being your ideal weight, making ballooning out unlikely.
She pointed out that at this stage it's difficult to say what Ben's natural set weight as an adult should and will be. It's not an exact science and everyone is different, with different genetics, skeletal frame, muscle mass and so on. In other words, one-size-fits-all BMIs aren't helpful (to say the least!) when determining the right weight for you. Music to my ears...
She accepted that, yes, Ben does have a good understanding of nutrition. Yes, he does eat very sensibly and eats an excellent and very balanced diet. He also loves eating and isn't afraid of eating any more, or of eating the quantities required to keep his weight up.
So those are Good Things.
She will be working on the eating out socially issues, the problems he has with eating meals that haven't been prepared by him (and calorie counted), the problems of watching other people eat who may eat strangely or in a disordered way so it doesn't bother him as much as it does now, and loads of other things.
I can tell that Ben respected what she was saying, and accepted it as fact, just as he did with his psychiatrist once logic and rational thinking had returned to his mind.
It's very similar to the stuff our original dietitian talked about with Ben, right at the start, before she was withdrawn because of financial cuts. Our psychiatrist tried her hardest to take the dietitian's place, but - let's face it - she's a psychiatrist, not a dietitian so we missed out Big Style on all these dietetic facts that so appeal to Ben and will help him conquer his remaining irrational fears about getting fat, controlling calories, weighing stuff and eating certain foods.
So great stuff, all in all. Brilliant! I am one happy Mama!