Inpatient Treatment in UK

I have been in recovery from anorexia since January after suffering with it for 2 years. My calories have been gradually increased and I'm now at around 1600 a day. I weigh 39kg / 86lbs and am 5'5" (my weight has been continuing to drop since Jan despite how much more I've been eating).

Although I've made a lot of improvement in terms of the calories I'm consuming (I started on below 200 a day), I've got to a point where emotionally I feel like I've moved backwards - I dont know whether I really want recovery or if Im just doing it to please my mum and family. The ED voice in my head has been getting louder and I dont feel strong enough to fight it at home any more... I end up not eating all my food/secretly exercising because my parents arent there 24/7 to monitor me. I don't know what to do any more :(

I confided some of this to my mum last night and she said she thought we should look into IP. My clinician had given this to me as an option a few weeks ago but I refused it... now im wandering if maybe it would be the right choice?

So anyway... I was wandering if there was anyone who had any knowledge/experience of IP treatment for anorexia in the UK? As I'm over 18 would I be able to discharge myself when I wanted or would I be obliged to stay for a set time period/ until a set amount of weight was gained?

Also, I have quite bad eating habits, namely slow eating - it takes me about an hour and a half to eat a meal and about an hour for a snack... I dont know how this would go down in an eatoing disorder unit?

Thanks in advance to any advice/experience shared.

I wanted to say to you 'go for it'.... but do so wholeheartedly.   You're over 18, responsible for your own health,  and this is the time to make up your own mind and do the right thing.  If you think you're doing anything just to please your mum or your clinician you won't engage with it any more than you are already.  If you start out by thinking it'll be a problem that you eat slowly and if you're already planning to discharge yourself early then that's giving yourself get-outs and anticipating failure before you even begin.  Probably not the right way to approach it.  

IP ED units don't care how long it takes someone to eat a meal.... they'll just make sure it's the right amount and that it all gets eaten.  They're also 100% wise to the other ED tricks of the trade like secret exercising and hiding food ... so you wouldn't be able to get away with those.  They're also very encouraging when you make improvements and there are lots of other services they can provide on-site and in situ that are better than infrequent trips to a doctor.

Bottom line is this.... At the moment, being 6st 2lbs and dropping, you're dangerously ill.  (1600 is a weight-loss amount btw...)   Clearly, IP treatment is no longer optional, it's essential if you're to live.   

Not helpful, duckster.  That's like saying, "I wish a had cancer," or "I wish I had schizophrenia." 

Grapefruit - You say you're questioning whether you're just doing this for your family.  The question you should be asking is "Do I want to die?"  Because your body will not be able to hang on much longer. 

If you want to live, then stop wondering about early discharges and slow eating and check yourself into inpatient treatment ASAP. 

Your weight is dropping because you're eating what is a weightloss amount. You should be at 2500, or higher. But recovery is not just about weight and clearly your mind is out of the right place right now. In regards to eating times, they have set times for meals, and sets lengths of time for eating them.

A couple of months in hospital is nothing if you want to get the rest of your life back. Go into IP.

When I asked about discharging myself I didn't mean it in terms of chickening out and leaving early, I just wandered what your period of stay was based on - do you decide yourself when to leave / do you stay for a predetermined length of time / does a doctor decides when you leave?

And yes, I know that in IP they'd be wise to any form of manipulation. I'd be grateful for this as if I know I wont get away with stuff like hiding food/secret exercise I wouldn't do it... whereas at the moment I know I can do it without being caught, so I do it.

In a way the fact that I'm having so much trouble deciding whether its what I truly want makes me realise I need to be somewhere where I dont have a choice.

Hi.  I am sorry to hear you are struggling at the minute.  I have been an impatient in the UK 3 times - one 11 month admission, one 7 month admission and then another 8 month one.  My lowest weight was 3 stone 8lbs ( 50lbs ) so I was pretty accute.  I went in once on a section 2, once on a section 3 and once voluntarily.

I am now fully recovered and my periods have just returned after 10 years and have miraculously been like clockwork for the past three months ( touch wood! )  Anyway, I am not sure exactly what you want to know, but if I can be of any help please feel free to PM me.

Jem

Wow, congrats on getting your health and period back!

I spoke to my therapist and he is very keen for me to switch to inpatient asap. I'm feeling so anxious/nervous about it, could you just tell me a bit about what to expect - will they straight away increase my calories to a really high level? how much weight are you expected to gain each week? what kind of foods do they feed you?

Thanks for all your help

Hey,

I found each clinic to be different.  I had two admissions to the Priory and one to another London clinci and I found the approaches and meal plans varied.  When I was at my worst I was put on a phosphate diet for a week as they were worried I would be unable to digest anyhting rich or fiborous so I basically had to have Cornflakes or Rice Krispies, white toast and jam, mash potato, scrambled egg and peas and lots of whole milk and whole milk yogurt.  It was bland but manageable.  The meal plans then go up in stages at 500 calorie increments, as and when you key worker ( someone who asigned to work alongside you ) feels your head and body can cope with / need the next stage. 

Initially I was never allowed to see my weight for the first month as you tend to rehydrate and ' jump ' a little, but it soon jumps back down again.  Then they steadily expect you to gain 1-2 lbs a week.  I had weeks where I did not gain and even lost though, which you never really can quite believe - the body is funny.  It took me 11 months in one admission to get to an okay weight - borderline BMI too, so the weight gain is never as fast as you fear.

Do not worry about being thrown platefuls of food as soon as you get there - they start very slow, and completely understand that this is an illness where you fear food and the last thing they want to do is scar you mentally even further.  All I can say is be honest and take the help that is there.

Anytime you need a chat or things get to much I will help in any way I can.

Best of luck to you.  It may seem impossible, but all you need is a bit of faith, willpower and you will already be half way there.x

Thanks so much for your reply, it has relieved a little of the anxiety im getting over it. Im going to be referred to the priory in bristol... first im going to go for a visit there to see what its like. It just all seems so daunting!

Thanks again for your help and reassurance

Hey, how did you get on?  Did you go for a visit?  The Priorys are all very similar - I was at the one in Chelmsford.  They are really good at taking an individual approach to each person, instead of stereotyping people as ' food phobic and needing to be fed up '! 

If you go in you will get a keyworker who will work very closely to help you.  The best advice I can give is to be 100% to them from the day you go in.  Also, take advantage of all the group therapies they have - it really helps unearth the emotions and feelings that stirred up the eating disorder in the first place - and you may be suprised to find it may all have stemmed from something you never even consciously thought about!

Good luck and well done for acknowledging the need to seek help.  If ever you need to talk you know where I am!

Jem.