Expert: Ryan Hale - 5/26/2010

Question
My daughter has very rapidly developed anorexia we think as a result of a punishing fitness regime due to playing football at a high level followed by a bitter disappointment due to injury. She started calorie counting about 10 weeks ago and has been reducing her intake and portions drastically. She has gone from a healthy 112lb to 92lbs in a few weeks. She gets very tired, cold and her personality is unrecognisable. We are getting professional help and are trying to encourage her to gradually increase her intake again. She knows she has a problem and does not want it. She wants her life back. It beggars belief that this illness can have taken hold of her so quickly. If she is unable to play football next season I am terrified that she will feel there is nothing to live for. football is her life, it is who she is and she wants to play more than anything. There has been much muscle wastage over the last few weeks. What can I do? Her BMI is only 15 and the doctor has told her she cannot exercise. I am afraid for her. She wants to get better, that is a step in the right direction I know but is it possible to get back to a training weight in time for the new season? If she can start doing some exercise I believe it may encourage her to fight harder. Without exercise she is reluctant to increase her calorie intake. It is a vicious circle. Can I introduce some low impact exercise as an incentive? Help, I am going out of my mind with worry.

Answer
Alison-  unfortunately your doctor's recommendation of no exercise is a sound one.  Most people who die from an eating disorder, die from heart arrhythmia and exercise can induce that.  With her weight and BMI, she is in a serious condition.  You can hold that out as an incentive.  The better she gets, the more likely she will be to be able to return.  Many anorexics don't have the exercise incentive but athletes do so perhaps it will work in her favor.  As an athlete, her body is used to getting into condition, performing, recovering and doing it all again with months of time for each segment of the season... she will hopefully be accustomed to long term goals like that, that take months and years to achieve.  This too will take small steps and long term goals.  Your attention should not be on next season however.  Eating disorders have the highest rate of death of all mental conditions including depression.  Yoga is the only exercise that can be allowed, however, if she is in a poor state, even some of the positions in yoga can cause blackouts and heart strain.  You must consult her doctor first, but it is something to work toward.