Getting your child through an eating disorder is damn tough, we all know that. But what happens when they reach their set weight / Weight Restored? What no-one told me is how they come to terms with something that is very difficult for them to come to terms with. Their weight is okay, but obviously it's been going up for some time. What if it continues to go up? What if it never stops?
CAMHS always said to Ben: "Don't worry, we'll never let your weight spiral out of control once you are Weight Restored."
Fine.
The trouble is, when that finally happened - i.e. within the last month or so - CAMHS were no longer around. Ben was discharged in February because he was 18 and because the psych was leaving.
And, for two years now, Ben has been eating with a view to weight gain. His weight has gone up and down, as you would expect, but the general trend has been upwards, especially over the past few months. So much so that he now looks just like the old Ben. Without the 7-days a week training / Rugby physique (because exercise became a compulsion, so he's had to keep it to the bare minimum), but definitely absolutely fine.
He is finding it very hard to come to terms with where he is now. He loves food and doesn't want to eat less than he's been doing. Yet something inside him (the 'Anorexia Demon?') is telling him that if he continues like this he will continue to pile on the pounds and get fat.
In his mind, his weight gain diet was restrictive. In other words, he would like to have eaten even more than he did. And the prospect of eating less than he's eating now in order to maintain his weight has sent his mood plummeting.
The experts always said that Recovery is all about getting to a place where you don't think about things like this any more. Food, and thoughts about food, begins to take its normal place in everyday life rather than dominating it. Gaining the odd extra pound or two is no longer a worry. But what "they" didn't say is how you get from where Ben is now - Weight Restored and anxious about continuing to put on weight - to where he should be - Weight Restored and content.
A bit like in the Bad Old Days, right at the start, when "they" tell you your child has to eat cream cakes and custard, etc in order to put on weight, but fail to tell you how the hell you're supposed to get cream cakes and custard, etc past their rammed-closed mouth.
So I have put a post on the Around The Dinner Table forum to see how other parents of young people recovering from eating disorders coped with this stage.
Watch this space...
Looking for information on eating disorders in boys? Worried that your son has an eating disorder? How can you tell if a boy has an eating disorder? In 2009 my 15-year-old son developed anorexia. Now, aged 28, he is recovered & studying psychology in order to help others. This blog tells the story of my son's recovery from anorexia as well as raising awareness of eating disorders in boys.
No easy answer to this and it would depend on the individual. I can only say that the fear of the weight gain not stopping is very real, for me the gradual increase I could see was easier to accept. Education from a dietician was very helpful especially when my weight was settling on places I didn't like!!!
ReplyDeleteI also used to say to myself, 'this too shall pass." hope all goes well. Xx
You've described this predicament perfectly...I hope you'll let us know if you find out any 'answers', because I'm in almost the exact same situation as Ben and I've no idea how to handle it. In fact, I've been weight-restored and left in this situation three times over the past 8 years and each time I have relapsed horribly, because I thought "well if I have to restrict I may as well do it 'properly'"...NOT something I plan on doing again (and I'm sure Ben wouldn't; he's lucky to have you to confide in and to help him handle it - the worst thing is feeling alone with it) - but anyway, thank you for the post and I look forward to the update!
ReplyDeleteHi Batty, it Cathy Z here. I will try to shed some light on the situation from the perspective of being a Physiologist...
ReplyDeleteBen may well crave food because he has not yet achieved his adult height and weight. The AN has delayed his development, and physically, his body may be equivalent to that of a 16 year old body rather than an 18 year old man. It is NORMAL for teenage boys to be very hungry and often to consume in excess of 3,000 kcal per day. If he is consuming less than that he will feel hungry, because (put simply), his brain and body are 'programmed' to grow. That extra energy is needed for bone and muscle development - and it is likely that if he does consistently consume > 3,000 kcal per day he will simply grow and develop more muscularity.
Have you thought about asking his GP for a DXA scan? This scan doesn't just measure bone mineral density (that is often low in AN, or after AN), but the data from the DXA scan can also be used to predict bone age. It is also possible to estimate what his adult height 'should' be.
Perhaps if Ben can be convinced, through science and bone scans that he needs extra energy to grow and develop, he may be less concerned that the extra energy will simply be laid down as fat?
At the moment, his brain is 'instructing' him to eat because he needs to grow more! The problem is that he is resisting this increase in appetite because he is fearful that he will gain too much weight, too quickly, and not be able to stop. That is unlikely to happen. Once he is taking in enough energy and has achieved normal development his appetite, in theory, will stabilise.
The usual reason for craving food in an ED (and enjoying food vicariously - e.g. cooking a lot, or reading recipe books) is because the body needs more energy to grow and/or repair itself, as well as to maintain an energy balance without shutting down some systems and reducing metabolic rate. Metabolic rate increases with an increase in energy intake and a bigger body.
Thanks, Cathy, that's excellent. You certainly know your stuff! I'll probably read it to him.
DeleteThanks everyone else for your comments, too!