After several months of dealing with the ups and downs of life with a teenager recovering from and eating disorder, we discovered that Emily was in fact not recovering, she was in a full blown eating disordered state again. She was restricting, purging, and exercising excessively. She had dropped nine pounds, was exhausted and fainted at school, was withdrawn and was spending hours obsessively planning her strategies for getting to her new goal weight of 76 lbs.
After the initial shock wore off, then came the excruciatingly painful question, how could we have let this happen right under our noses - again. How could her E.D. Team have let this happen while she was in treatment? The questions were tinged with a hint of that destructive 'blame game' mentality but thankfully my yoga practice has enabled me to develop a much healthier attitude, and very quickly I knew the answers to those questions were critical to us understanding and learning from the experience so that we could move forward with 'getting rid of Ed'.
What we learned was that we were relying too heavily on her weigh-ins, as a gauge of her mental health. For example:
1. We rationalized the odd behaviours that were emerging as just typical teenage behaviours, because after all her weight was still okay.
2. We fell for the many 'illness' excuses that she invented for avoiding finishing meals and activities she was too tired to do. It couldn't have been malnutrition induced fatigue because her weight was okay.
3. We relaxed the 'every meal, as a family, at the table' practice, at her request, and why wouldn't we revert to old habits when her weight was okay.
4. We assumed the comments she was making about having a bad day or a tough time, or wondering what would happen if she got really sick again, were just random comments resulting from random bad days. How could there have been a building tidal wave of full blown Ed when her weight was okay?
5. We knew she wasn't really connecting with the psychologist that was doing her CBT, so when she finally dissolved into tears in a session we assumed maybe she was starting to break down some emotional barriers. And we weren't alarmed enough to press for a different approach to the therapy because she appeared to be eating and maintaining her weight.
The problem was that she didn't weigh what we thought she weighed. We think she was weighting herself down for her weigh ins. Ed had us all fooled again. But here are some of the signs I will look out for now: gum chewing, an increased interest in grocery shopping, a desire for foods like rice cakes, and other low calorie low fat snacks, chronic illness complaints, baggy clothes, requests to have supper while watching TV, school lunches made and packed when I'm not in the room, a desire to walk to school, lack of interest in spending time with friends. I knew all these signs from the first time through and I know my mind ignored them the second time through, but they won't get by me another time. Ed will have to become even craftier to outwit me a third time. Sadly though I suspect he can.