Weight restoration, complete restoration: not optional!
Posted Nov 21 2011 10:22am
Parents, if you are not hearing this from your treatment providers, get a second opinion
WEIGHT NORMALIZATION TREATS COGNITIVE, MOOD, DYSMORPHIA, ANOSOGNOSIA, SOCIAL, AND BEHAVIORAL SYMPTOMS OF THE MENTAL ILLNESSES WE CALL EATING DISORDERS.
Does it cure eating disorder predisposition? No.
Is it a "any more is better" situation?" NO. (until you find the individual's sweet spot, it can be WORSE than being lower)
Does it work the same way for everyone? No.
Does this include bulimia and binge eating? Bulimia, yes, any weight suppression stops the clock. BED, we don't know.
Can you normalize by putting people in a hospital? No, unless they're going to live there indefinitely, and then you are causing a whole new set of problems.
Can hospitalization be necessary. Yes: for emergencies. Best idea: avoid emergencies with early intervention and have everyone on the same page on the non-negotiability of restoration: providers and family.
Can patients do this of their own volition? Rarely. And it's pretty unfair to ask them to. They need our support.
Cure pre-existing co-morbid conditions? No.
Can you use charts to figure out what normalization is? No.
Is there a single number we can find and focus on? No. Sorry.
Is it absolutely necessary to individualize the process of finding normalization? YES.
Fix society's obsession with weight loss? No.
Can families pursue this without specialized eating disorder professionals? Some do. We did at first, but it was harrowing. The risks are enormous, including making an already very dangerous illness worse, a much harder recovery, burnout, losing custody of your child, and alienating people in your life who could be supporting you. Professionals should be there to assist you, and there are incredibly skilled and effective clinicians out there. Find them. Listen to them. If your health system or insurance don't pay for it, you are in the majority.
Do the thoughts magically disappear at the moment of weight normalization? Sometimes, but don't expect it.
Does it still take months or more to repair the body and brain? Yes. Especially in a developing child or adolescent.
Do we still need psychotherapy? Usually.
Will the patient's insight after weight normalization last? Not unless it is maintained.
Do patients like weight restoration? Um. No.
Can patient choose their normalization level? See above.
Do mental symptoms get worse right before normalization? YES.
Does it matter how long someone has been marinating in malnourishment? Yes.