How many who are suffering from anorexia are able to maintain their weight on just a few hundred calories and live a functioning life is a puzzling phenomenon to the medical profession, it contradicts the calorie-model. Another mystery used to be the much lower than expected weight gain in inpatient treatments, a „metabolic barrier to weight gain of unknown origins“ was hypothesized.
“Guidelines for anorexia nervosa (AN) inpatient treatment suggest weight gain of 0.5–1.0 kg per week. Data were collected retrospectively from hospital records for all underweight patients admitted to a specialised eating disorders unit. The mean weekly weight gain was 0.51 kg the first 11 weeks and 0.18 kg from week 12 to discharge. Conclusion: The rate of weekly weight gain was lower than recommended by guidelines for AN inpatient treatment.“pubmed
Recently the John Hopkins Treatment Center showed a weekly weight gain of four lbs is possible. This is their secret:
1. Negative emotions
Deprived of human touch contributes greatly to overeating or undereating, self-destructive habits. Touch deprivation creates a sense of feeling alienated from ourselves and isolated from other people. Being deprived of touch is connected to depression, anxiety disorders, low self-esteem, and illness. empirical findings suggest that touch deprivation may play a role in body image pathologies. Prematurely born infants that received three times daily a massage gained 47% more weight than infants not being touched, while consuming the equal amount of calories. Their weight gain seemed due to the effect of contact on their metabolism. Institutions are very touch-phobic. Where I was treated there was a touch prohibition, patients were strongly discouraged to even hug each other.
Doesn’t it make you feel like cattle if they only think in weight numbers and the financial costs (the financial burden)?
An important implication of this study is that finding cases earlier, and initiating treatment earlier in the course of weight loss, appear to diminish costs. This seems to make a strong case for aggressive early treatment.
First of all, why would they keep saying ”aggressive” treatment? ED sufferers are in need of compassion and empathy, not aggression. Obviously, waiting until the patient is half dead, before accepting them for inpatient treatment doesn’t save money. Nor does it save money, treating only the symptoms (weight restoration, CBT), which leads in many cases to multiple readmissions.
You can milk a cash cow only that long, I think that’s why they tracked back on calorie restriction, it was too obvious to many people that it was nonsensical. We’ll see if and when other changes are going to happen in future.