Eating Disorders: How Slow Should I Go in Re-Feeding My Child?

What does "low and slow" mean when it comes to re-feeding your child? And will the "low and slow" philosophy get you the best results?"

Current American Psychological Association (APA) re-feeding guidelines for in-patient settings suggest starting with a lower amount of calories (1200 per day). Then slowly increase calorie amounts by 200 calories per day every other day; thus dubbed, "start low and go slow."

The University of California, San Francisco completed a study that was discussed in the Eating Disorder Review. They found that current re-feeding guidelines were not effective with a group of 35 mostly Caucasian girls. Even though 94% of the teens studied were given less than 1400 calories per day; the study did include diets that ranged from 800 calories to 2200 calories per day. This range was done in order to analyze the effects of increasing calories.

Eighty three percent of the teens on the lower calorie diets lost a significant amount of weight the first week of treatment and did not gain any weight until the eighth treatment day. Overall those who were on the low-calorie meal plans lost much more weight than those on the higher calorie plans.

The encouraging result is the teens getting higher calories initially had shorter hospital stays. Additionally; for every added 100 calories to the initial meal plan, there was one day less spent in the hospital.

The researchers believe that these results give reason to question the effectiveness of the current re-feeding guidelines. More specifically that the number of calories given in the first phase of treatment are too cautious (J Adolescent Health, January 2012).

Sorry for the dry research information; but I believe these results have great meaning for parents who are re-feeding at home. I hear from many parents they are afraid to increase their child's calories too quickly for fear they will push their child over the edge or make things worse.

The reality is though, this data shows moving too slowly can actually result in more initial weight loss and a deeper hole for your child to dig her way out of. It is important for you to work with a physician so she can help determine a safe number of calories for the initial meal plan. This will prevent any risk to your child's health as you begin to re-feed.

So "low and slow" may not be the most effective approach to get the best results. These are decisions you can make with the help of your treatment team; based on what you believe is best for your child and what you believe you can realistically accomplish.

Do you want to learn more about eating disorders?

If so, download my free e-book "Eating Disorder Basics for Parents" here http://www.why-my-daughter.com/edb.html

Lynn Moore educates, coaches, and consults parents on how to help their adolescent with eating disorder behavior. She will help you figure out what kind of help you need and what you can do to help your child.

Also look for Lynn's new book called "Girl Lost: Finding Your Voice Through Eating Disorder Recovery" at http://amzn.to/vfoSwL

This information is not a substitute for consultation with health care professionals. Each child's health issues should be evaluated by a qualified professional. Never read one article and try to implement what you read without more research and help; either from a coach or therapist.

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