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amomma4

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Reply with quote  #1 
We are about a year in to this horrible disease. My D is now 14, diganois at 13. We have been through three inpatient stays, UCSD family intensive treatment, PHP program, 6 weeks of residential, and we are now back to outpatient treatment. We just made a switch from one program back to our original team. With our last team we were told we are close to phase 2 (which I don't think so). The team we are with now have not said that yet. My D is at her goal weight but I have just pushed with our team now and we have upped her goal weight range. Honestly, I have been receiving help from a mother on this site who has been a God sent angel to me. I always felt the medical professionals know what they are doing so I should trust them. I always sat back and just did what the suggested. She showed me that I know my daughter best, I need to advocate for her and question. She also has showed me so much research that goal weights are often set low so that is why I'm pushing for an increase in her goal weight and won't stop trying to push her weight up. (Which I am struggling with but trying. We have only been maintaining for about 6 weeks).

So in the last month I have been doing so much reading, listening to podcast, reading this forum, and research. I know weight is the big key. But my question is is thee any evidence based treatment for attacking ED behaviors? I have found nothing. I have found the FBT phases, info on weight restoration, but nothing on fighting ED behaviors. Any help on this would be great!

We have taken things away from my daughter and it never really worked. We are seeing our D more and more but she still doesn't really have much to take away. She is never on her phone, rarely hangs out with friends beside at church and school (I would love her to do this more but meals plays into this). She puts all her time into homework. She does love music and plays in a band. But it's hard to take that away because it is social interaction I want her to have. (she has always been very shy and a little socially awkward). We are working on movement, measuring, taking bites of food, screaming at meal times, timing obsession of meals...

Thanks for all help!
toothfairy

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Reply with quote  #2 
Hi there,
When I started to add butter & cream to just about everything, adding a extra 1000-1500 in butter, cream , canola oil, ground nuts, & upped my kids calls to over 4000 calories per day, & then got him up from his target bmi ( ridiculously low, keeping him in his illness,) of 19 right up to bmi 24/25 then I saw recovery, true recovery.
The behaviours simply started melting away like a miracle.
THe behaviours are a symptom of the anorexia.

Since I fired our anorexia specialist dietitian, we have never looked back.

My kid is in solid recovery doing just great! He is just like any other teen, he has just come in from school & asked for a snack of chili beef nachos, he will eat anything with no bother, no fear! Its truly amazing.
He still needs over 4000 cals per day.
I will post some good links for you.
TF

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #3 


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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #4 


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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #5 


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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #6 
https://www.kartiniclinic.com/blog/post/setting-goal-weights/


https://www.kartiniclinic.com/blog/post/the-dangers-of-staying-slightly-below-weight/


http://www.feast-ed.org/?page=SettingTargetWeight

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #7 

http://www.blog.drsarahravin.com/eating-disorders/weight-gain-predicts-psychological-improvement-in-anorexia-nervosa/

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #8 

http://www.blog.drsarahravin.com/eating-disorders/10-common-mistakes-in-eating-disorder-treatment/

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #9 

https://www.eatingrecoverycenter.com/blog/2016/05/31/truth-anxiety-anorexia-treatment-dr-anna-vinter/

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #10 

http://tabithafarrar.com/podcast/tabitha-talks-emily-overshoot-eating-disorder-recovery/

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #11 

http://adulteatingdisorderrecovery.com/en/component/blogfactory/post/10/minnesota-starvation-study-in-under-4-mins-video

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
EC_Mom

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Reply with quote  #12 
Amomma, good for you for getting support and advice and ditching bad advice!

Fighting ED behaviors means fighting the resistance to eating--the compulsions that postpone, slow down, and resist eating? Those are the only behaviors you have to fight now, it seems. And in my experience SHORT term leverage is crucial. Not punishment, not "taking away" things except in a very immediate way, e.g. "As soon as you've had lunch we will leave for band practice!" and NOT "If you don't eat lunch then I'll cancel band for the week." 

ED won't allow your d to respond to these long-term punishments. You need to coax your d to fight ED "this one time" (not saying that out loud of course) with the plum of a reward. I let my d use her phone WHILE eating, it helped distract her, but if she wasn't yet eating (and it was mealtime) she couldn't use it.

My d was also a perfectionist about school, so I used that as short-term leverage: "As soon as you've had the snack you can start on your homework."

The reward has to be RIGHT in front of them, not anywhere down the line. No threats that you can't follow through on, and as "logical" as you can make the reward as possible--"Your church friends are driving up here, let's get you snack before they arrive."


momupnorth

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Reply with quote  #13 
as to your question about specific treatment/therapy for ED...I fully agree with the above advice regarding immediates - my d has always responded well to immediate consequence/gratification.
Also, there is a type of DBT work (dialectical behaviour therapy) which deals more specifically with anorexia.  This type of therapy does not focus so much on the why as to teaching kids the skills they need to manage their emotions and behaviours in the moment.  My d is currently involved in this type of therapy in combination with CBT. 
may be worth looking into...
mom up north 

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Mom Up North
HateEDwithApassion

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Reply with quote  #14 
Another therapy that my D is working with right now is ACT therapy. Similar to DBT in that they are encouraged to identify the values that matter to them... family, honestly, joy, achievement, etc. and then use those as motivating factors to push back against the ED voice and compulsions. I think that may be a bit more relevant for older patients who are in college and know what their long-term values are. But something to consider...



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17 yo D. Diagnosed in July 2013. W/R in Sept. 2013 and has remained so. Roller coaster on and off since, mainly with ED under control but co-morbid depression and other negative coping mechanisms making our life hell. Trusting in God for daily strength and wisdom.
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