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Anorexia Bulimia Care
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Worried about my daughters regain of weight after limiting food

My daughter is 15 and for 5 weeks in Feb and March she limited her calorie intake to about 700 cal a day or less on the days she did football/PE or dance - after referral to nhs clinic after being about 9lb below her normal wright they said she is very underweight so no school or sport - 5 weeks later and she is managing 1600-1900 calories a day with meals and 3 snacks but still no weight gain and therefore her mental health is poor as everything she enjoys has been taken away - is the non-weight gain normal - are they right to stop all school - we are told just get her to eat even though in her head she still wants to limit?

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My daughter was secretly doing hundreds of extreme squats a day. Could your daughter be burning off the calories like this?

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It takes a lot more calories than that for someone with an ED to recover their weight. Suggest you check out the Around the Dinner Table forum for parents of children with EDs.

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My daughter was only of 500 a day when we found out and exercises like mad. It is a nightmare to fight. If she is not gaining weight she is either exercising more than she is eat or she is hiding food or being sick after meals or laxatives or a combination of both. In order to fight this disease they need at least 2,000 cals per day but in reality 3000 is the best with fats and carbs. Watch check every time she eats she does not go to loo to be sick and also does not fill her stomach with water. You will have to limit her exercise if needed. It has taken us a year to be totally weight restored she was there the first time after 6 months but slipped back. When she is weight restored she will need therapy as its a long road and mental recovery is long after that. We are stil on that pathx good luck

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Definitely needs way more calories to gain weight. 2000 probably for a week then 3000. Should be monitored by ED professional and GP to prevent refeeding syndrome but if she's been on 1600-1900 for a while she should be fine. But yes definitely up to at least 3000!

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They are doing the right thing bc anorexia has obvs got a hold on her and as others have suggested she may be secretly exercising

because she is 15 they will monitor her closely, which is very helpful for you this is a horrible illness and you need all the help you can get to stop it asap

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suggest you give ABC helpline a ring and talk to them about the best way forward. She needs specialist counselling alongside the diet increase to help her recover. Keep an eye on her and make sure she's not exercising in some other way (I know this sounds like spying - but when I was at my worst I exercised in secret), Gaining weight is only part of the story unless the mental issues around the cause of her wanting to cut back are dealt with the difficulties ultimately re-surface. Good luck.

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Thank you - you are right but the nhs do not offer counselling to weight gain so we are really stuck

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As I said - contact ABC and talk to them about it.

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Personally when I was 15 I was in a similar situation. I had gained back 30 of the 40 lb I lost. This put me at the low end of a healthy weight for my height. Over the summer I was running with my schools CX team an my weight stabilized however my doctor wanted me to gain back the final 10 lb to get to my pre-anorexia weight, so when school started she decided not to let me run with the team. This had disasterous results. I was angry and isolated. My only friend group and outlet from school was the team. I defiantly began running on my own which became compulsive and spiraled out of control to the point of me running up to 20-30 miles every day. I lost tons of weight even though I was eating and had severe electrolyte imbalances that resulted in a month of hospitalization and 9 months of residential treatment.

Had she not kept me from training with the team I don’t think this would have happened as I would have been running in a controlled environment with a group of people who would have helped me stay social. Now, 6 years later I’m still struggling with PTSD from that. I’ve relapsed a couple times but never to the point of getting too underweight. For me having a reasonable exercise routine helps me stay in recovery and be able to eat more because it motivates me to take care of my body. I can’t say what’s best for your child, but for me my mental health was more important that the number on the scale

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Dear friend - thank you♦️♦️ At last someone who does not make us feel that we are in the wrong - the nhs say make Tash eat more but in the next breath say but we know there is a voice saying don’t eat but will not address that - Tash needs to be back in a normal environment with friends not sitting at home thinking about food 24/7 this makes her more stressed - she has added so many new foods lately too - nuts, jacket potatoes, salmon, tortollini hardly someone against food per se - I hope you continue your positivity xxx

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Also Tasha’s weight only dropped 8 pounds below her normal weight when she limited for 4/5 weeks.

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They don't want to address the voice because they can't quantify or understand it the voice aka Ana will not go away even with strong antipsychotic drugs which get rid of scizophrenic voices which are hallucinatory but it seems Ana is real some even say Ana / anorexia voices are demonic entites which sounds far fetched but they don't have any other explanation

When my daughter was under NHS care I was grateful , but they used to have a theory that girls got anorexia bc of dominant mothers ! ? You may be frustrated by NHS but you can't do it by yourself you need intervention and back up to fight Ana it is the worst thing in the world to see your daughter turn into a skeleton hopefully with the help of NHS you are going to nip this in the bud and save your daughter from the deathly evil clutches of Ana

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Do you mind sharing which CAMHS trust your daughter is under?

I recognise the sense of just being told to get your daughter to eat more, without any help to do so.

It’s worth talking regularly with your daughter’s GP, and getting him/her to push CAMHS. CAMHS may tell you they don’t have resources to offer you more support, which is not really true. But of course, as your daughter is maintaining just now, their first option is the current FBT without further intervention.

Many girls DO recover this way, but as Tash does seem to be stuck you MUST get her more help, quickly. My daughter was in a similar situation 9 months ago, albeit I think after rather more weight loss. She is now at a healthy weight, but is now a psychiatric inpatient with all sorts of new symptoms that we feel would have been avoided if she could have been kept out of hospital.

One last point. It is so important to get your daughter help now that if at all possible I’d urge you to consider private therapy. Don’t be shy to ask family and friends for help with this, or to borrow money if that’s what it takes. Don’t abandon the NHS though!!

Good luck.

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Dear friend - my daughter is under Essex services - we are now getting private counselling - they didn’t like that - my daughter is fine in herself but at present at home and thinking about food continually and it is very stressful when we crash over us trying to get her to eat more in a day then say 1800-2000 calories - affecting all our mental health - I had a 30 minute conversation with them yesterday putting off our next appointment and telling them I was not happy and them as usual saying how underweight she is (it’s half a stone) and wanting a blood test when her test was fine from our doctor but saying they need it again ...

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Sounds at least hopeful. I would say that blood results can change quite quickly, so don't go too long between them.

Your GP will be an ally in any arguments about CAMHS continuing to care for your daughter while she has any private intervention. They can't refuse, but they may pretend thay can.

All the best

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Only problem with bloods is that Tash got so scared of needle and it took 20 minutes with a really persuasive doctor to do it - she was like a child possessed she was so scared - never needed it before - not sure how we can go through that again - can we say we are dealing with it privately the nhs aren’t helping!

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