difficulty in recovery

Mental health
1

i'm 13 years old and last week i went to visit an eating disorders clinic. they confirmed that i was anorexic and had an eating disorder. they said that i'm not allowed to play sport and i have to have 3 meals and 3 snacks. i am reallyy struggling because everytime i eat i am constanlty obsessed with calories and how much fat. i used to love milk and now i just refuse it and im really worried becaue i want to recover bbut not gain weight. i currenlty weigh 38kg ive lot 1kg since last week and i was weighed yesterday. i am finding it really difficult and i have no energy and im always freezing cold. i need some advice for how to recover in the first week or 2 weeks. 

(sorry for really long message!)

2

Hi lovely. It sounds like you're in a really difficult place right now.

Have you thought about what motivates you or what your goals are in recovery?

One of my recovery goals was surrounding getting back into gymnastics, because I used to do gymnastics, but like you when my anorexia took over I was barred from sport.

Perhaps if you really enjoy sport this could be a really positive incentive; but there are also small stepping stones you could build in along the way such as a trip to the cinema or a nice holiday.

It's great that you're getting treatment, and you need to remember that everyone in your team (your GP, the clinic, your family and friends) all want to see you get better. Sometimes you might disagree with the approach they are taking, such as eating more or drinking milk or even increasing your weight.

There are reasons for this all, and they will know where you stand medically and will probably have seen your blood test results.

Milk isn't there to help you gain weight, it is actually there because it's very important when salts are imbalanced in your body when your underweight and you start eating again, to neutralise the reaction - not to put too much pressure on your heart.

Remember these are medical experts and their plan for you is to get you better.

One of the things I've found helpful is why I'm concerned about eating more food, or gaining weight, and working through those emotions with my therapist.

When you follow your meal plan then it's worth writing down exactly how you're feeling. It's also worth being brutally honest. e.g. Today I didn't feel like getting up for school today. Mum made me so I didn't bother with breakfast because I was angry.

(Think about why you didn't want to go to school)

I bought packet of chocolate on the way home from school and ate it all. Feel really guilty for doing this, and now want to get rid of it. Feel compelled to weigh myself and I know it's gone up. Feel angry and upset and like I've let myself down. I'm not eating dinner.

And so on...

As you get better, you'll find you get better at rationalising some of these thought processes. e.g. Breakfast is the most important meal of the day, and helps to stabilise my mood and keep my weight down.

I ended up snacking because my body was craving energy; if I'd eaten regular meals I wouldn't have binged. I'm experiencing mood swings because I'm eating irregularly.

The scales only reflect mass, and weight can fluctuate by 3kg over a month. Weighing myself regularly helps to reinforce by eating disorder thoughts.

And then you can plan to solve this.

Tomorrow I will only weigh myself once.

After eating I will sit down and watch a film to distract myself from the difficult feelings I am experiencing.

I will plan how I will manage my lunch at school because it is a source of anxiety.

---

Does any of this help?

3

Thank you SOOO much this really helps me!

Yesterday I ate so little and before k went to bed i started to shake a little bit. I got really scared and so my mum suggested having a sugary a snack and a glass of milk with honey. It helped and for once i didn't feel guilty because I was so scared at how little I ate that day.

I am working on building goals and targets. I do triathlon and tennis competitively, but at the moment I'm only doing triathlon once a week. I love sport and when I was younger I was struggling with friends and sport really helped me but I now know that only food can help me!

I have a goal already because were going on holiday at half term and I'm not allowed to go unless I gain some weight this makes me so angry because I want to go so badly.

Are there any foods you suggest for snacks because I'm trying to eat some more but I don't really know what's right and not! I have an appointment with a dietien for the first time next week so hopefully something positive comes out of that!

Thank you so much for you help! It was really useful and helpful I hear from someone else who's been through the same thing!

4

Hi Issy, I too have had anorexia for more years than I care to remember, and I would give anything to have the early intervention that you are being offered.  Katlouise gave you some very good advice.  I just wanted to add a few comments if you don't mind.  As was mentioned earlier about milk being good for you, I would like to say also that it is crucial to your development, particularly at your age to have regular milk based drinks.  This will give you much needed calcium, a nutrient that is vital at your age, and even moreso because you are so athletic.  A lot of high performing athletes develop osteoporosis, and that can happen even with a well balanced diet.  So please at least try to keep up with the milk as a good step, so when you are recovered your bones will be strong enough for you to compete again.  I am pleased to hear that you had milk and honey yesterday, that is really good.  

You also asked about snacks, banana's are a good source of pottasium which is vital for keeping your heart healthy, if you find that a normal banana is too much at first, many stores now sell small bananas for childrens lunch boxes.  Some more good snacks are dried fruit and nuts (not the salty kind), yoghurt is a really nice snack to have because it doesn't feel heavy on your tummy, and again it has calcium and protein.  

The reason you have no energy is because your body has been in starvation mode too long, and even when you are eating more, the energy will take time to return as your organs and muscles need the nutrients.  Basically you need to rest.  Katlouise also came up with more good advice about keeping yourself distracted after you have eaten, even if it's listening to your favourite music or painting your nails or even craftwork.

Keep positive and I hope that with the support you have, that you make a good recovery.  Focus on your goals, triathlon and sports, you can go back to that once you become healthy.  I hope that some of this is of help. 

5

Again, thank you so much! It really means a lot to know that there is someone out there who's been throught the same thing. 

This is morning was "ok", I had some mango and strawberries with no fat total yogurt.i just finished lunch and I had some soup and a rice cake with a bit of cream cheese, which I was incredibly reluctant to eat. I just had half a bear Apple yoyo. I feel so guilty and bloated and want to burn it off but I just can't because I feel weak and exhausted. Tonight I'm going to try and have for a snack a banana milkshake as I think this will be a good starting point. Tomorrow I am being weighed which scares me because I know that I've probably lost more weight (38-37kg is my guess). I am worried that I will have to go into hospital. This week I have not been at school apart from Monday, which was an awful day tbh. 

Thank you you for your advice. One last question!? How do you deal with your anxiety and managing meals like calorie intake. At the moment I am eating about 300kcal a day. I'm aiming for 600kcal because 1000 is a push? 

Thank you again for your support it means a lot. 

Wgen you you had anorexia did you go to school? 

X

6

Hiya.

No problem at all and happy I can help.

I agree with what's been said. Bananas are a great source of potassium and yoghurt I have found manageable if other things were proving challenging.

The smoothie was a really good idea, why not try some soup this evening, it can be so nice and warming on an evening like this. A butternut squash or carrot soup (half of a covent garden pot) is usually a good guidance.

Snacks I would try something you enjoy. My dietician got me trying low cal hot chocolate as a snack because it was something I enjoyed, likewise you might find hummus is something that you enjoy.

Remember recovery isnt straightforward. You'll find some days are really hard and you want to go back. Actually thats been me lately as Ive been finding my end of treatment hard to deal with.

But you get better at managing the challenges and picking yourself up.

If you are eating as little as you say you are you will continue to lose weight and end up in hospital.

To avoid hospital you need to show commitment to eating and recovery. It may be you need hospital and that this is too much for you at present to do alone.

But if you can manage as an outpatient you will cope better for longer (hospital is really mean).

I get my ed quiet for ages but when my school found out there was leniency about attendance and lessons on the basis that I was trying to get better.

I then missed months because I was in hospital.

Schools are generally better at dealing with this now than they were then and my school managed my situation very well.

7

Hi again,

It sounds as though you are making a good start.  I found that I wanted to eat all the time but couldn't allow myself to, I then put a meal plan in place which helped, it will and does make you feel bloated but that does start to subside.  I used to put a heated wheat bag on my stomach after eating (or hot water bottle), it gives me comfort after eating.  I also keep foods in my kitchen that I can go and have a snack on when I need to which is pretty much every day.

Sorry to hear that you are having a tough time at school, is there a teacher that you feel able to talk to?  They might be able to unload some of the burden for you.  I imagine that your concentration isn't as good as it should be.  I hope you did manage to have your evening meal.  If it helps, think of food as medicine that will make you feel better and operate better.  A car can't run without any fuel, and we aren't designed to go hungry.

I wasn't diagnosed when I was in school, but it did start in my teens.  If you can manage not to go in hospital by gradually increasing your intake, it will be far better than ending up in hospital or an ED unit.  There you don't have any control over what you eat, but if you do need that help as an inpatient I would say to you that everybody else there knows how you feel and make use of the staff for reassurance.

Another way of coping when I feel full is to keep a diary, also I had bought myself a small notepad in which I would write something positive everyday.  You might find finding a positive thought hard at first, but in mine, I would put, my bmi has increased today and this means that I am now allowed out for 15 minutes a day, or, today I had enough energy to play with my dog.  Even notes like I ate all of my meal today, turning it into something positive.  I also agree that smoothies are a good way of getting the right nutrients.

<3

8

Also, sometimes it can get a lot at school. You're lucky that your family know; I wish mine had known sooner, but I was too afraid to tell them - too afraid because I didn't think I was ill enough, and wouldn't tell people till I was.

Because they know it makes it so much easier. They'll be good days and bad days. You'll argue, but they'll also be there for you, so remember that on the rubbish days.

I also kept postponing getting help and telling people because there was always this music course, or this holiday or my GCSEs and so on...eventually when I had lots to lose (and more recently everything to lose) my body gave up on me.

Allow the people around you to treat you, while you are still thinking rationally.

At this point you can engage in decisions about your treatment and you can engage in therapy.

Imagine if you weren't allowed to do that either? Imagine if someone had to watch you 24/7 including when you went to the bathroom, and kept checking on your sleeping in case you tried to exercise in the night?

And actually at that point you don't sleep much either, because your body never feels comfortable; but you still feel enormous; you constantly feel in pain and the world around you is a constant blur. You are always miserable. In fact the only thing that cheers you up is seeing the number on the scale go down...but that's been taken away from you now, because someone is monitoring that, and if you don't eat, THEY make sure you have nutrition in some form.

Then eventually, you feel it might be better if you start eating because actually being on 1:1 support and permanent bed rest is a complete waste of time, and it's really sunny outside and you're feeling claustrophic in your hospital cell, but your consultant still isn't happy with your weight, and won't discuss with you when she/he thinks you might be ready to move to the next phase. You think you're going mad, and actually it would be better if you confronted everything and started therapy, but you're not actually allowed to do this until you're eating properly, which is ridiculous, because how are you supposed to manage to eat, if you don't get help solving the problems?!

You're ridiculously bored.

Eventually you're allowed to eat meals with everyone else, but it's so structured and they have ridiculous rules about how long you can take over each meal, and not leaving anything...

You start making friends with everyone and try and find ways to escape and get round the regime because you swear it's making everything worse.

Then you get found out (that you've downgraded your snack etc.) and are put on meal supplements and 1:1 again.

I won't bore you with weigh-ins. Hospital is NOT worth it. Outpatient support is a real struggle. When I was admitted as an inpatient, my consultant told me that if I'd carried on the way I was I'd be dead in a week. I tried to convince myself she was lying, because I wasn't thin enough. But she had my bloods and ECG results. You can never be thin enough. Everyone is different.

I really hope you can manage this as an outpatient. It's really tough, but if you can achieve this out of hospital it makes things a lot easier.

9

Thank you!

I definitely don't want to go to hospital. I get very homesick and would cry every hour! Being away from my mum scares me because we are so close. All my family are worried about me and I feel really guilty and awful for making them feel upset. One of my grandmas came up this week, and last night I refused a snack and she went and cried. I didn't mean to make her cry and it made me feel really terrible. Both my parents work so when they're not at home i eat as little as possible. 

Toda i I am seeing my therapist for a weight check and weekly therapy. I know that I've lost weight because I feel so week and my jeans won't stay up (I got them at Christmas)

I hope today goes well because I am really worried. But fingers crossed!🙏

10

Thank you!

i love the idea of thinking of food as medicine and me being a car. My mummy told me that eg. Say I had cancer I wouldn't be refusing the drugs/medicine  (in my case food) because I know that it would increase my chances of not getting better. 

My therapist last week gave me a food diary, but I find it really difficult to write all my meals down because I always forget! 

I have been trying to eat soups because 1.i 💖love soup! And 2.i find it not so difficult to eat! 

Asi I mentioned to katlouise, I have a meet using my therapist today and i hope It goes well, but I know I've lost weight! So fingers crossed

11

You are very welcome, you are in a scary situation at the moment and need a lot of support.  I am glad that you have a close relationship with your mum, she must be very worried about you.

I hope that your appointment goes better for you than you think it will.  There isn't anything you can do about getting weighed today, but as you said yourself, you know you have lost weight.  

Soup is great, it makes me feel nice and warm inside.  Do you think you could increase the portion or maybe have a slice of bread with it?

I will be thinking about you today and wish you the best with your appointment.  If you feel upto it, feel free to post again, katlouise seems to be a really nice person and I am sure she doesn't mind talking to you, also I am happy to talk to you as well.  Take care. x

12

Hi Issy - couldn't help but think about you. Hope you're doing ok and the meeting with the therapist went better than you thought.

Stay strong. You can beat this.