Supervised weight restoration for anorexia nervosa

Strong evidence – there is lots of high-quality evidence that some young people find this treatment option helpful.

The first step in supervised weight restoration will be for your professional to figure out what is likely to be a healthy weight for you. This is a weight that allows your body to function normally. To figure this out they’ll think about:

  • your age
  • whether you have gone through puberty and finished growing
  • your pattern of weight and growth before you developed anorexia

Your professional will then put together a plan with you on how to get to a healthy weight. This plan will usually involve your parents or carers too. During this process your professional will monitor your weight. This usually happens once a week if you are at home and sometimes twice a week if you are staying in hospital.

Your professional will work with you and your parents or carers to draw up a meal plan. When putting together the meal plan, your professional will know that you might be fearful of eating more and that there might be foods that you have been avoiding. They will take these things into account, as well as any foods you generally don’t like. Your professional will also give you advice on a healthy level of exercise.

Your professional will know that this process can be very hard. Sometimes children and young people feel that the anorexia is like part of them or that they are letting the anorexia down by eating more. Your professional will work with you and your parents or carers to make sure that you are supported to manage these feelings.

It is likely that in the early stages of treatment your parents or carers might need to supervise your meals. This will be to offer you emotional support if you find meals difficult or if your anorexia might tempt you to miss out food. If you are admitted to hospital then your nurse will supervise your meals. As you progress with treatment and are more able to resist the temptation to skip food, then the need for someone to supervise your meals will decrease, although many young people still often want the emotional support.

Once you reach a healthy weight, your professional should work with you and your family on plans to maintain your weight and stay healthy.

Re-feeding syndrome

If you have been eating very little food then you might be at risk of re-feeding syndrome. This can happen in the early days of starting to restore weight if you have more food than your body can handle.

If your professional thinks you might be at risk of re-feeding syndrome then they will usually suggest that you start with a low calorie meal plan and increase this slowly. At the same time they will keep checking your physical health, which might include monitoring your blood pressure, electrocardiogram (ECG) and blood test results. Your professional should give you and your parents or carers advice about possible signs of re-feeding syndrome. Sometimes professionals suggest that young people have a stay in hospital for weight restoration, but this would only happen if there were risks for you doing this process at home. You can find more information about inpatient care here.

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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