We are refeeding my 16-year-old daughter and she has recovered some of her lost weight. She has experienced a lot of bloating and distention, along with constipation. It makes it very hard for her to eat enough. She constantly says she “feels fat.” What can we do?
Kara Fitzpatrick, PhD responds:
Delayed gastric emptying is a frequent challenge in the early stages of renourishment efforts. Because the body has slowed in its responses food moves through the bowel more slowly and many individuals experience constipation, bloating and abdominal discomfort. This can lead to feelings of early fullness, just when you want your child to be eating even more! There are several things you might to do ease this distress: First, have your medical team evaluate for gastro-intestinal difficulties, just to be safe. They may prescribe a mild laxative to help if your child has gone too long without a bowel movement. Do not do this on your own, however, as it can be dangerous. While there, check in with them to discuss whether your child may require more fluids than she is getting right now and whether this might assist with constipation. You can also apply warm compresses after meals to ease immediate discomfort. Do not, however, be tempted to cut back on meals or portions! In fact, this can exacerbate difficulties, as the body will resort to starvation mode, slowing the system further. Rather, know that this will pass and the shift toward more normal GI functioning can provide a wonderful early marker of the ways in which your child’s body is beginning to re-nourish and re-gain health.
Kara Fitzpatrick, PhD
Dr. Fitzpatrick is a psychologist working with Eating Disorders at Stanford University/Lucile Packard Children's Hospital and serves as clinical advisor to Maudsley Parents. She is widely trained in a variety of models for treatment and performs research in applied clinical treatments for adolescents and neuropsychological factors associated with eating disorders.