Reading the body trackers
When to turn on the period, bowel, and movement trackers, how to raise what they show without making the patient log less, and what each alert does and doesn't mean.
The body trackers give you three signals between sessions. They only help if the patient keeps logging honestly, and that depends on how you respond.
If a patient logs a laxative or a compensatory session and your next message is a warning, they learn to stop logging, not to stop the behavior. Thank them for telling you first. The app does the same.
When to turn each one on
Period tracker. For anyone who menstruates and is restricting, underweight, or in weight restoration, especially when return of menses is part of setting their goal weight. Leave it off when talking about cycles is likely to distress the patient more than it helps. Remember that patients can also turn it on themselves.
Bowel tracker. During refeeding, when bloating or constipation is making it harder to eat, and whenever laxative misuse is suspected or known. Consider leaving it off for patients whose presentation includes bowel preoccupation or checking rituals.
Movement tracker. When compulsive or compensatory exercise is part of the picture, or while you are reintroducing movement in steps (for example with SEES). Leave it off for patients where the question would put exercise into their head when it isn't already there.
What each alert means, and what it doesn't
No period logged in N days. A prompt to check whether they've just stopped logging, then to talk about energy availability, bone health, and whether high-impact exercise is safe right now. It isn't a diagnosis. If they use hormonal contraception, the card says so, and the timeline doesn't tell you about their own cycle.
Period returned. Worth marking with the patient. It often comes months after weight restoration, so it's a milestone, not a finish line.
"Something else" taken to help. Ask what, how often, and what it's for. If it's a stimulant laxative for weight control, the usual approach is to stop rather than taper, with an osmotic agent for the rebound constipation, under medical guidance. Consider electrolytes. The patient chose to tell you, so thank them.
Mostly hard stools logged. Common and expected early in refeeding. Tell them it is temporary and that restricting to ease it makes it worse. Same-day red flags: severe abdominal pain, vomiting, marked distension.
Sessions logged to compensate. Talk about the pull behind it, not how much they did. Pair it with the meal pattern: compensatory exercise next to skipped meals or purging escalates to At risk for a reason.
Sessions with driven features. Explore the rules: what happens if they miss a session, whether they exercise when sick or injured, whether anyone knows. These are the CET's rule-driven and rigidity facets.
Absence isn't evidence
All three trackers are patient-initiated with no reminders. A quiet week can mean "nothing happened" or "didn't open the app". The cards say logged, never "had", for this reason.
Talking about it in session
- Start from what they chose to tell you: "I saw you logged a couple of runs this week and picked felt like I had to. Can you tell me about that?"
- Don't quote counts back at them. The app shows the patient no totals, and turning the dashboard into a scoreboard in session undoes that.
- Patient view hides the Body signals card, so a shared screen won't show it.