COMPULSIVE EXERCISING IS still top of our 'to do' list. I’m well aware that it’s bad, but I have no idea how extreme until one CAMHS session with Linda in early spring.
Ever since the October heart scare Ben has been banned from doing PE at school. Unfortunately he’s exercising at home to compensate and to ensure he doesn't 'put on massive amounts of weight'. It's a kind of purge, almost like a sufferer of bulimia might vomit to control their weight.
'Walk me through a typical day’s exercising,' says Linda [the CAMHS treatment team nurse] as she reaches for a pen and paper.
Just when we think he's listed all the '100 crunches, 100 sit-ups and 100 press-ups' for any one day he interrupts with 'I haven't finished yet!' Not once, but several times. School days differ from home days, weekends from week days. Ben is exercising from morning to night.
By the time he catches the school bus in the morning he's already done 100 crunches and sit-ups during the 60 minutes we rush to get up, showered, breakfasted and out of the house. Meanwhile at school he deliberately makes himself late for lessons so he can run from classroom to classroom.
One reason he's still only at school part-time is because he can't handle the thought of 'sitting around doing nothing' for the afternoon as well as the morning. When he gets home at lunchtime he pushes himself to do more crunches and repeats these throughout the afternoon - and before and after the evening meal. In addition he's still doing weight sessions most days and going for a couple of runs every week. Meanwhile he can't sleep because his mind is constantly racing as he tries to balance input and output.
The bland CAMHS consulting room feels like a bizarre confessional as Ben confesses his entire exercise regime and Linda's piece of paper becomes several pages. Our very urgent task is to find a way of breaking the cycle. It's a Big Ask. I sigh and look at Linda for an answer.
'What if we draw up some parameters?' she suggests to Ben. 'We allow you to do a limited amount of exercise every day and you agree not to exceed this.' It seems such a simple solution to a seemingly unsolvable problem. Between us we devise a structured regime of exercise over and above which Ben isn't permitted to go.
'Then, over the next few weeks, we'll monitor the effect it’s having on your weight to prove that less exercise doesn’t mean you'll get fat,' Linda adds.
Ben agrees to the trial.
The following week Ben and I walk around a local lake. Watching the wildfowl silhouetted against the setting sun, we talk about exercising and how he's making a real effort to cut back. Now he has the structured 'exercise plan', as he calls it, he's finding it much easier to manage. Instead of spiralling out of control he now has parameters and - incredibly - from Day One, he sticks to it. And the more he sticks to it, the easier it gets. And the easier it gets, the less exercise he feels compelled to do. I feel like shaking Linda by the hand.
On our walks Ben and I talk about easing him back into school. What are the biggest challenges? How might he overcome these? We talk about socialising and the importance of the friendships he's developing with his most supportive friends. We also talk about eating. What's been difficult? What's been easy? What challenges has he set himself? Have they been successful? We also look at the difference between Ben's eating several months ago and his eating now. And the way his pulse rate is now relatively normal. Most importantly we talk about why a life without anorexia feels so attainable whereas only a few months ago it seemed impossible. Best of all Ben admits that he's finally enjoying our walks for walking’s sake; not as a means of burning off calories.
We incorporated this exercise plan into our eating disorder Recovery Contract. You can read more about our Contract here...
Please note that exercising with an eating disorder can be potentially dangerous so be sure to check with your child's physician first.
In the meantime... here's what the Kartini Clinic says about exercise and anorexia.
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