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bakeyser

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Reply with quote  #1 
Hi,

We are new parents of a beautiful daughter who has recently been diagnosed with Anorexia.
We are working our way through the refeeding process, about two weeks now, but have some questions about how to get her to eat her meals/snacks.

She loves to ride horses and work at a nearby barn, clean some stalls, help feed the horses, etc.
We are wondering, as discipline, should we take away her privelege of going to the barn?

We have already taken it away a few times, but I feel horrible afterwards, after reading some things on this wonderful resource board and watching some of the videos about how a child with ED really feels and thinks.

We would be open and gratefully appreciate any responses!  

Thanks so much and God bless,

The K's
tina72

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Reply with quote  #2 
Hi bakeyser,
first I want to send you a very warm welcome from Germany!
I am glad that you found us although I am sorry that you have to join us. You will find great help here.

My thoughts about your question:
I think you could not find a better incentive to use. If she really loves that, she might love it more than anorexia. So you can use it. For example you could say "If you finish your breakfast, you can go to the stable". Say it as an incentive and not as punishment.
What you must think about is that cleaning the boxes is very exhausting for someone underweight. I know what I am talking about as I cleaned 3 boxes every weekend with my d for 7 years. So if she is severly underweight I would stop that part until she is gaining weight in a constant matter. Same with riding, it is exhausting and might destroy all your refeeding work if she eats not enough. I would not stop riding unless she is in a really bad state (what I don´t know from your post), but think about combining it with an extra snack. "If you want to ride for an hour tomorrow, you need to have that extra snack today". Something like that.

Tina72
tina72

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Reply with quote  #3 
I forgot something:
please be aware that this is a public forum and don´t use real names as they can be found by using a search machine.
If this already happened (using real names) and you want to change that, please contact for your nickname a moderator. The names in the post you can easily delete or change by "edit".
Tina72
bakeyser

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Reply with quote  #4 
Tina72, 

Thanks so much for your input.  One question, if I may ask you, in this situation, we could use it as a reward if she eats her breakfast/lunch, etc well, but what if she doesn't?

Does it make sense to withhold horse as a punishment?  I value your input.

Thanks so much,

The K's
Torie

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Reply with quote  #5 
Quote:
Originally Posted by bakeyser
Does it make sense to withhold horse as a punishment?


I don't think it is punishment any more than staying home from school when you have the flu is punishment.  If she can eat her breakfast, she is well enough (and has enough fuel) to visit the horse.  If she isn't well enough to finish her breakfast, she needs to stay home and rest. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
tina72

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Reply with quote  #6 
I think Torie is right, if she doesn´t finish breakfast, she is not healthy enough to go to the stable because that needs energy.
But I would not see or say it as punishment. I would say something like "oh, I see that you are poor to have anorexia and I am very sorry for that, but you need to stay at home because you are too sick to visit the stable without breakfast". Something like that. Blame it on anorexia without punishing your d. Try to seperate both.
Tina72
teecee

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Reply with quote  #7 
Dear bakeyser
Welcome here but I am so sorry you are here.
My thoughts are that I would stop all exercise. Our team at CAMHS explained that sitting and lifting your arm above your head burns energy. Just walking up the stairs burns energy even studying/reading burns energy.
In the early days of refeeding believe me you need to be careful what she burns energy on or else you will find that as soon as you are putting input in, it will be going out quickly in output...if that makes sense!!
Prior to diagnosis my D had played high performance sport from the age of 6yrs (now 16). The week before she was diagnosed she was sprinting around circuit training, doing spin classes and kettlebells with a big smile on her face. We now know that was false. She was in severe pain and fully miserable. AN was driving her in to the ground. A week later and she could not walk up the stairs without being severely fatigued. It was hard to get our heads round as you think your eyes don’t lie. We were completely hoodwinked.
It took weeks and weeks of refeeding before we could start doing GENTLE exercise (a saunter around the village we live in/stretching...)
I don’t say this to worry you I just don’t want you to undo all the hard work you are putting in.
Our daughter really wanted to get back to normal and do a little exercise (supervised light not compulsive) but we had to make her aware that for health reasons this wasn’t possible. Apart from the fact that she was exhausted after about 2 hours studying in school - we just used these episodes as evidence for her to help her understand.
Take care and love and strength to you. X
teecee

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Reply with quote  #8 
....also ‘food is medicine’ ....if she doesn’t take her medicine life as she knows it has to stop until she does take it. That was my mantra... xx
meadow

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Reply with quote  #9 
Hi and welcome too.

I would agree with Teecee about stopping all exercise BUT once your daughter's a bit further into refeeding then it seems like a brilliant ready-made incentive.

We banned absolutely all exercise. My daughter wasn't to walk to school (half a mile), up the road, or even up the stairs unless essential. At the refeeding stage every calorie counts.

I understand the pain when you have to make decisions that upset your child. It really helped us to think about it in terms of being in battle with ED, and not our wonderful daughter. X
Mamaroo

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Reply with quote  #10 
Hi Bakeyser

Welcome to this forum. Animals are really good companionship for children with eating disorders. When we were new to all this and were waiting for the hospital to admit us into the ed program, my d went to 'look after' horses. It was mainly just 'grooming' his main (just for pleasure, the horse's main was already in top condition) or plaiting the tail. No cleaning, no riding, nothing that would even cause her to exert more energy than sitting in class doing school work. Is it possible to do something similar, maybe at a different time than when all the work is being done to avoid temptation on her side to sneak in some work. I would do this as a weekly excursion and not as a punishment or reward.

Only when she has gain a lot to weight (that is she is starting to grow again) would I let her return to her horse duties as they seem to be quite energy consuming.

My d was in such a bad state that very little in the world would interest her or motivate her. I had to organise playdates, excursion to the shops (would push her around in a trolley to prevent her expending the little bit of calories she would consume at that stage) and one day we would just happen to go to the cat café close to the hospital. All these activities my d would not do out of her own. I had to bring life to her.

"We are working our way through the refeeding process, about two weeks now, but have some questions about how to get her to eat her meals/snacks."

Have a meal plan handy with all the meals (Monday is spaghetti bolognaise, Tuesday - fish and chips, Wednesday - chicken etc) already written it. This will reduce her anxiety. Include all meals and snacks as well as the times the meals would be served. See the blank meal plan I've attached. She has to get into the habit of eating regular meals again. You choose what she eats (the only say she has is when she chooses the flavour, but I would limit her choice for now). Remember the 4 C's: Be Calm (so that she knows you are in control as she very much feels out of control), be Consistent (present meals at the same time every day even if it means getting up early over weekends and organising activities around meal and snack times), have Compassion (separate your d from the illness, it is ED that screams and kicks not your d) and Confident (fake confidence until you have it - it will reduce her stress as well). See Eva Musby's video below:



Sending you lots of hugs!!!

 
Attached Files
docx weekly meal plan blank.docx (13.51 KB, 8 views)


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D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.

Foodsupport_AUS

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Reply with quote  #11 
Welcome to the forum. Sorry that you have had to find your way here. 

Working at stables is definitely hard physical work, and ideally I would agree with those that have suggested that this only be restarted again when she is gaining weight and out of physical danger. I would also recommend that when she goes that she needs to have an increased intake. 

This is not at all about punishment. Although it is an incentive for your D because it is what she loves to do, the fact is that if she is struggling to eat she is not fit to do hard physical work or ride horses. It is a risk to her health - she may faint, fall or be injured - in the short term. I would not mention it to her but it will also be much harder to get her to gain weight/maintain weight if she is going. We as parents are charged with setting boundaries for our kids and should not feel guilty about doing so. It is not a punishment. 

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
bakeyser

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Reply with quote  #12 
Wow,

Thank you all so much for your great and timely responses.  It is such a relief as to how to try and seperate my child from the ED.  I like the thought that most of you responded by having parameters set up, and then if everything is eaten, there is a reward, in this case, riding horse.  If the parameters are not met, then no horse riding.  

Thanks so much for the meal planning tips as well as worksheets, these will be a great help!

I appreciate each on on this forum and greatly hope that someday we will all be talking about ED, and referring to it in the past tense!!

Thank you so much!

The K's
martican

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Reply with quote  #13 
Hello bakeyser. I used the same analogy even for school - if she didn't finish her breakfast, I would not let her go (my D is motivated by school). She would not have proper energy to be there. Same with the stables plus those entail some manual work and a lot of standing. My D couldn't even lift the saddle when she was deep in AN (she was doing care around horses at that time). That was before I knew about this forum and wise moms. Not sure how sick is your D, after that experience I  waited close to her WR before allowing her to go for short walks at least. 
meadow

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Reply with quote  #14 
Yes Bakeyser, one day you'll be talking about it in the past tense.

Our daughter (now 9) is fully recovered 18m after diagnosis thanks to the support we got here. We were perhaps luckier than most as we caught it incredibly early, but nonetheless she was very ill.

Keep coming here for advice and support x
jennifereden

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Reply with quote  #15 
Quote:
Originally Posted by bakeyser
Hi,

We are new parents of a beautiful daughter who has recently been diagnosed with Anorexia.
We are working our way through the refeeding process, about two weeks now, but have some questions about how to get her to eat her meals/snacks.

She loves to ride horses and work at a nearby barn, clean some stalls, help feed the horses, etc.
We are wondering, as discipline, should we take away her privelege of going to the barn?

We have already taken it away a few times, but I feel horrible afterwards, after reading some things on this wonderful resource board and watching some of the videos about how a child with ED really feels and thinks.

We would be open and gratefully appreciate any responses!  

Thanks so much and God bless,

The K's
jennifereden

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Reply with quote  #16 
It is my understanding ( read Eva Musby's Anorexia and Other Eating Disorders)that we should not punish our kids because they are separate from ED. It is Ed that is keeping her from eating, not, your daughter. We too, had taken away privileges in the beginning and it had no effect. My D gave us her phone and computer willingly and still would not eat.

[image] 
needhelp

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Reply with quote  #17 
Hello Bakeyser, and welcome -although, as everyone else has mentioned, I am sorry that you needed to find us.

I did a similar thing with driving- except I told her that she did not have the right to put others in danger because she had not eaten breakfast and therefore wasn’t alert enough to be safe for others. That made sense to her. If you wanted, you could apply that to being near the horses. Having been around horses almost my whole life, I know full well how alert you must be because you never know what might spook a horse. You are very fortunate to have a ready incentive. It really does make sense that she would need a certain level of nutrition before she could tend to the horse- even if tending at this time meant just petting and maybe light grooming, and of course feeding a treat (maybe they could even split an apple-I used to do that with my horse a lot). I wonder what your daughter would think about feeding the horse treats and having him eat out of her hand. Just normalizes eating in a different way. I may be overly positive, in that I think there are very few things a horse can’t help!

Wishing you the best.
toothfairy

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Reply with quote  #18 
Hi
Here is a really insightful video


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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,  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  #19 
Hi Bakeyser,
I just want to explain a few things.
The illness is vile and has impaired  her brain. The brain chemistry has changed so therefore her actions are the symptoms of the illness.
It is not that she is being " bad " and needs punishment, it is that her brain is telling her not to eat, and we need to counteract that by doing what we can to distract and motivate her to push through this.

It is not that she "wont" eat, she cant eat, and needs a huge amount of coaching and support to get through her meals. Every single meal every day needs to be supervised. Often we would have to adopt a policy of LSUYE, Life stops until you eat. Where she would not be allowed to do anything at all and nobody goes anywhere until that meal is eaten, no phone, no TV , nothing.

Here is an extract from a great book " Brave Girl Eating" By Harriet Brown, well worth buying.

https://www.nytimes.com/2006/11/26/magazine/26anorexia.html

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery,  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  #20 
I would strongly advise you to take a look at Eva Musby's website, listen to all her videos, read all her blogs and buy her book. It will teach you so much at the re-feeding stage you are at.
https://anorexiafamily.com/

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery,  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.
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