Thursday 27 December 2012

Why do they insist on doing it?

Yet again I'm hearing of a family where the treatment team is insisting on what the parents believe to be a sub-optimum weight for their daughter as far as full Weight Restoration is concerned. I can't count the number of similar complaints I've heard from families, ours included. So why do eating disorder treatment teams insist on doing it?

At one point, my H and I gave our team the benefit of the doubt. As they'd always gone on about drip-feeding scary concepts to my anorexic son so they didn't freak him out, we assumed - for a while at any rate - that maybe this was their plan with references to his WR weight. In other words, they'd get him to the next level before drip-feeding the concept of moving onwards and upwards.

Maybe they were. The problem was that my son was discharged almost a year ago once he reached 18. So the drip-feeding - if indeed that's what was planned - was never followed through. Instead my son was left insisting that it's perfectly acceptable to aim for and remain at a weight "he feels comfortable with", a weight that is just within the so-called "safe" or "healthy" range. Yes, he agrees his weight will need to increase slightly as he grows older, but only in relation to his current weight i.e. 2kg more between now and his 20th birthday in 12 months time.

Yet over Christmas he lost 2kg which pushed him back into the "unhealthy" weight range which just goes to show how easy it is to slip back again.

Not only this, but if you try to maintain your weight at a sub-optiminal level I assume your body will always be fighting to attain its natural set weight which could actually be far higher.

And someone who is still terrified of edging their weight up by a few kilo is someone that isn't fully recovered, is it?

As someone once said when I blogged about the time one of our treatment team said: "Some young people choose to remain at a low weight and if that's what they want, then that's perfectly okay" (or something along those lines)... read "Some young people choose to remain sick".

Before the eating disorder muscled its way into Ben's life he was a strapping 12 stone rugby player. He played Number Three in the team - a position given to the bigger, stronger, more muscular boys. This was when he was 14 / 15 years old. He looked fantastic!

12 stones equals 76kg. Mention this to him these days and you risk your head being bitten off as he barks: "That was purely because of the rugby. I don't play rugby any more or do any sport for that matter [except the odd run and free weights sessions] so you can't expect me to be that weight again!"

Fair enough.

But we can expect his "set weight" to be significantly higher than it is at the moment - and this is the massive challenge facing us this year. And it's not as if I can go along to the GP and ask the GP to "prove" to him that he needs to weigh more because each time we attempt to get a medical professional to do this they can't see any problem with his current weight.

As CAMHS said to me shortly before we were discharged: "There isn't a GP in the land who will argue that  Ben's weight is too low." The reason being because "the charts" say he is within the "healthy range".

Which leaves my H and me fighting a lone battle - just as other families are doing as their children hover around the "healthy" weight range, dipping in and out every time they lose weight for whatever reason: illness, Christmas anxiety, other anxieties, etc.

For the record, [an edited section from] Ben's CAMHS discharge letter reads: "At his highest, he weighed 12 stone, which may not have been significantly overweight for his height at the time, but at which weight he considered himself fat, and recalled being teased... Now at a healthy BMI of 20.2... he feels content with his appearance..."


  1. Ugh, they make it sound like as long as he's content with his appearance, things are okay, regardless of whether he's fully physically and psychologically recovered! This may be a bit of a generalization, but to my mind if someone who is NOT fully recovered is "content with their appearance" that is probably a sign that that their weight is lower than it should be. When did you ever hear of an anorexia sufferer who was okay with their weight at an optimal level? - at least initially, it requires discomfort (until you get used to it, of course). As my boyfriend says to me when I'm confused about how much to eat and end up restricting, "if the amount you're having feels comfortable to you, you're not having enough."

    Anyway, I share your frustration - all the doctors and psychiatrists (even ED specialists) I've been to are perfectly happy for me to be at 18.5 or 19 BMI, regardless of the fact that I'm a fully-grown 25 year-old and need to restrict to maintain that weight. It has made it really hard for me to push through and force myself to restore the last few kilos, as I already feel it's "unnecessary" and all the messages I'm getting, including from my family (except from ONE person, my boyfriend) agree with that. I wish you didn't have to shoulder it alone, but Ben's lucky to have you; your support and understanding about what he needs and deserves may make the difference for him between full and partial recovery.

    Oops I'd better stop this comment before it really turns into an essay!

  2. It's ridiculous. I don't understand how they expect people to recover. My target weight in IP was a BMI of 17.5. They said I couldn't hope for better than that. Had I listened to them I'd still be ill (and them putting that idea in my mind was something I struggled against for a long time). It staggers me that professionals sometimes have such a little grasp of what it takes to get well and for what it's worth I'd imagine most people need to be around BMI 23 i.e. middle of normal.