so i got the chance to sit on a counseling session for a patient with anorexia last week and it was super interesting. when i got to work this morning, the RD i'm working with said another anorexia patient came in over the night so she was ours to follow. i was pretty excited to see how they handle things inpatient because of how strict the protocol for anorexia really is. this patient is very young, and weighs all but 80 pounds. so sad. but seems very open to trying things and doesn't seem to have too many food aversions (things they simply will not eat), which is good. a lot of patients are obsessive about what they will and will not eat and that makes things very difficult.
these patients come in and are kind of thrown into the therapy they do inpatient without having any idea what exactly it is and it's very shocking, especially for the young ones and to the parents. every privilege these patients have revolve around them eating, the therapy they use is called the Maudsley approach. they are weighed every morning (are not told their weight) at the same time in a gown and after they have gone to the bathroom. they are allowed three aversion foods, or three foods they REFUSE to eat. other than that, the RD's pick everything they eat while in the hospital. we start at a very low calorie level, (800-1200 cal) depending on what they have been used to eating at home. we increase calories by 200 each day, working usually up to 2600 cal/day which is what most of them need to steadily gain weight back. if they don't eat all their food (which is eaten in a nurse's office with someone), they must take the equivalent in calories of what they didn't eat in Ensure (a supplement drink). they have 30 min to eat everything and have to stay in this office for 30 min after eating to ensure it stays in their stomachs. if they do well and eat everything, they get phone privileges & a hour of visitation. if not, they get these taken away.
there's a lot more to this protocol, this is just a snapshot of what happens initially. there is no messing around with this, it's so serious and a lot parents think it will just go away and get better. this is a lifelong struggle for these girls, its heartbreaking. i really enjoy working with this population though. frustrating, but very interesting. i love food to much to not be able to eat it haha keep praying for a sweet little baby waiting for a heart, she needs it badly!