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hopeful2017

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Reply with quote  #1 
Hi everyone,
I'm new to the site. My d is 13 and weighted in at 103.6lbs when we realized there was an ED. We just found a ED psychotherapist and have met withe her once. I was given a meal plan based on servings and food groups to aim for. We've been following it for just under a week, and before that we were aiming for the food guide (not having anything else as a resource). My d weighs at 107lbs now.

I have so many questions, most of them on nutrition. I've seen on the site posts that aim for a bmi of 20. Should that be the healthy goal? So she needs to gain 21lbs? Is that what is optimal or should it be less or more?

When I computed the calorie intake following the meal plan I have, it comes up to 2100 calories a day and based on what I'm reading, this may not be enough to gain weight?

My daughters fear is weight gain. She went from eating healthy to eliminating some foods (e.g. Sugar) to tiny portion sizes. Last thing was obsessive serving counting, including use of measuring cups for everything. What we give her now is a fight and she counts everything behind me to make sure I'm not going over the plan.
I feel like this is hindering her healing - by sticking to a serving size plan because she counts servings. But if I don't do that, she will freak out because She says I want to "fatten her up".

Should I go by serving sizes/recommended food group counts or by calorie counts? I don't think I can give her more food to eat - if I need to increase calories how can I do that? A friend suggested protine shakes - is that appropriate? Will getting her to a BMI of 20 cure her from ED? Or is there more to it? How long will it take for her to heal? Months or years?

She currently goes to school and even thou we are doing FBT, we have not pulled her out. I'm borderline on this- I feel it gives her a chance to distract her anxiety but then I can't keep a close eye on her. She has a diagnosed AN girl in her class. She compares herself to other girls and sees her self fat, and that she eats more than them, but she is the thinnest of all.

Thank you for any advice and support
Torie

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Reply with quote  #2 
Hello. newbie.  Welcome to the club no one wants to join.

This vile illness is so confusing, so counterintuitive, so horrible in every way.  But there are some great folks here to help see you through.

What you describe sounds pretty classic.  You're in good company here.  And it sounds like you're off to a GREAT start with refeeding.

There's really no way to know how much weight will be enough until she gets to that weight.  We can help you create a guesstimate, but then you will just have to see if she starts making progress when she reaches that, or if she needs more weight.  Almost certainly, she will need to regain all the weight she has lost and get back to her previous highest weight.  And then she'll need a little more than that because some time has passed, and she should be gaining each year through teen and young adult years.  And then a little more on top of that because it's a really bad idea for an ED-kid to hang around at the lowest possible healthy weight. (Stuff happens, and they lose a few pounds with illness, travel, whatever.)

Most here have found it helpful to ban Ed-kid from the grocery store and the kitchen,  It's your job to plan, shop, prepare, plate meals and her only job is to eat them.  The whole meal - every bite, sip, smear, and crumb.  Do you think that would be worth a try?

Most here have also found that canola oil (rapeseed oil in UK) and heavy whipping cream (double cream) are our best friends.  And butter.  Adding a few tablespoonfuls of oil or butter to a dish can significantly increase the caloric value without increasing the portion size much.  If you add oil to yogurt or soup, it will disappear if you stir vigorously.  It's good to experiment to see how much you can add.

Full fat milk, yogurt, cheese, ice cream, etc. increase nutrition without increasing portion size.

When you make grilled cheese, butter both sides of the bread.  Make oatmeal with cream and brown sugar.  Put nuts in the blender and grind into a powder - you can then add them to lots of things.

Many here make daily shakes for our Ed-kids.  Mine are premium ice cream + heavy whipping cream until consistency is right.  Others make things they call smoothies that have fruit.  Lots of recipes on the high calorie thread.

Please feel free to ask all the questions you like. xx

-Torie

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

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Reply with quote  #3 
Hi hopeful, welcome here.

Your questions are almost identical to the ones I had three months ago when we started on this awful journey. You will get amazing advice and support here.

Torie has suggested some great ways to add calories (and I agree that you will need to try to ban D from the kitchen - will that be possible?). We added full-fat cream to anything that we could and shopped around for the highest calorie brand of everything. We also gave D a high-calorie drink called Fortisip (others will correct me if I'm wrong but think this is Ensure in the US).

We also stopped D from doing any exercise whatsoever. No walking to school, no walking round the supermarket, no playground (she's 8), no PE. At one point I didn't even let her walk upstairs to fetch things.

A combination of these things helped D put on weight straight away, but we also had to increase portion sizes. Hers were tiny too. This was (and still is) tough. For us a gradual approach worked best - increasing portion size a little at a time, but it was still extreme distressing for D. She screamed, hit, spat, threw things at me. It was hideous, and I hate to say it but these things are very common when you're doing refeeding. This came as a shock to us, but it helped infinitely to remember that it was the ED that was behaving in this awful way and not my D.

What kind of support do you have locally? It would take us around two hours at the start of refeeding to get snacks or meals in. We enlisted some help with our other D, ordered groceries in etc. We kept D at school but we liaise very closely with the staff and they are able to supervise her meals and snacks to some extent. Other parents on the forum have gone in at lunchtime to sit with their children.

What is your D's height now, as that will affect how many calories she will need as well. They all vary - our D (who is tiny) needs about 1800 calories (with no exercise) to gain weight, but some kids have faster metabolisms and need a lot more. Mamabear's D, for example, needed around 6000 I believe.

As for how long, that was one of my questions too! I've learned since coming here and also from professionals that around three years seems to be a kind of magic number. They may look and seem better by then, but with some residual issues around food. But the refeeding is only one stage. And it DOES get easier. We had around six weeks of sheer hell with our D at the start, but now things are already infinitely better.

Good luck and keep us posted! You're doing great already x
Torie

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Reply with quote  #4 
Quote:
Originally Posted by hopeful2017
What we give her now is a fight and she counts everything behind me to make sure I'm not going over the plan. I feel like this is hindering her healing - by sticking to a serving size plan because she counts servings. But if I don't do that, she will freak out because She says I want to "fatten her up". Should I go by serving sizes/recommended food group counts or by calorie counts? I don't think I can give her more food to eat - if I need to increase calories how can I do that?  


A couple things I forgot to say:

You will almost certainly need to increase portion size.  Yes, it will be awful for everyone (most of all for your d) - one of the many awful things about this vile illness.  When she has finished her meal, distract distract distract.  And have her use the bathroom before each meal so she can stay with you for at least an hour afterwards - you don't even want to deal with a kid who develops purging.

And I completely understand why you feel her counting everything on the meal plan is hindering her healing - because it is.  Some here have tole their ED kid something like, "What we're aiming for is normal eating.  It isn't normal for a 13-year-old to have a meal plan, and it isn't normal to count everything like that.  So we're not going to do that anymore."

And then brace for the fallout, which will be considerable, but so, too, will the progress be when you get through the first weeks.

Just an idea - what works for some is a non-starter for others.  But if you want to lose the meal plan, you can find a lot of support and suggestions here.

It's helpful to develop a few mantras to use in response to the "You're trying to fatten me up" comments.  Maybe something like, "I just want you to eat like a normal kid," or "This is what you need, please take a bite."  Or whatever works.  It's not that it helps the kid - it helps you the parent not have to think of a response each time you're accused of the same thing.

I learned here that "normal" is a great word.  Their minds twist "healthy" into "fat" or some such, but even our AN kids accept the idea of "normal."

Oh, and "ignore" is another word you'll hear a lot here.  And "change the subject."  They are quite simply irrational about food, weight, eating and the like.  THere is nothing to be gained by arguing with an irrational person, so it's great to have a few subject-changers in mind at all times.  ("Do you like my new socks?" is kind of a classic here.)

Here's a fabulous video by forum member Eva Musby:



Keep swimming.  xx

-Torie

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

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Reply with quote  #5 
Welcome to the forum, sorry that you have had to find us here. 
As others have said, what you are describing sounds normal and typical from your D. The anxiety, the insisting on watching everything being prepared, the fear of gaining weight. 

We can't tell you what your D needs to weigh, it is different for everyone, but most kids don't just get better with weight gain alone. A few do. Some need ongoing therapy and lots of time. Even at a great weight it can take a long time for recovery to happen for some. There is a great blog by an ED paediatrician talking about weight restoration here . Even when you get there though it is likely your D will need to gain weight well into her 20's cause that is normal. 

Eva Musby's video very succinctly explains the reasons you need to learn to zone out from ED talk, have a mantra and just keep on going. Your D is terrified at the moment, that is normal, but the only way is through that fear. Your confidence that that is what needs to be done, with ongoing support (even when she screams and yells or does other awful things) is what is going to get her through this. 

The amount of food needed for gain is very individual, some rapidly become hypermetabolic and seemingly evaporate food, others gain on modest increases. Keep feeding till you see the gains you are needing, but expect it will change over time. They need plenty of food for some time after weight restoration as they lose easily at that point. 

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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.
mdmama

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Reply with quote  #6 

Hi, Hopeful:

Echoing the others-- I am sorry that you need to be here, but glad that you found this forum because it's invaluable.

My own D was diagnosed just before she turned 12, and is now 13. Are you in the U.S.? (Many members here are in the U.K. or Australia/NZ.) Here in the U.S. there are a few suppliments-- in addition to the invaluable heavy cream, butter, and canola oil mentioned above-- that can be helpful. We used (and occasionally still use) Boost Plus, which is available at regular grocery stores (I buy the chocolate)-- it has 360 calories in an 8-oz bottle. I removed the label on the bottle before giving them to my D, and shook them well, and they taste sort of like chocolate milk. She had one of these every day for a a midmorning snack at school and I still give them to her once in a while. At the beginning I also used these if she could not finish an actual meal-- the consequence for not finishing a meal was a supplemental drink. She hated them but they were sometimes easier to get down (especially if they were very cold) than a meal that needed to be chewed.

Even better (from a caloric standpoint) than the Boost Plus is a product that I ordered by the case on Amazon-- it's called Boost VHC (very high calorie). It comes in little boxes that look like children's juice boxes-- 8 oz each-- and it's vanilla flavored. One box has 530 calories! Again, my D did not enjoy these but when she was briefly hospitalized, this is what she had to drink if she could not finish a meal (even if she'd eaten 95% of the meal!) and so I purchased a bunch as soon as she came home.

Finally, there's something called Benecalorie that you can also buy on Amazon-- they are little tubs, just 1.5 ounces, of a creamy substance with little flavor (it's very slightly sweet) than can be added to milkshakes, smoothies, cream soups, oatmeal, etc. Each tub has 330 calories! https://www.amazon.com/Benecalorie-1-5-Ounce-liquid-Cups-Pack/dp/B001W6RHOS/ref=sr_1_1_a_it?ie=UTF8&qid=1488291354&sr=8-1&keywords=benecalorie

Again, if you're in the U.S., Trader Joe's has some wonderful high-cal items that have been invaluable to me. Full-fat greek yogurt, premium ice cream, nuts, etc.

I agree with Torie that talking about a "meal plan" is not going to be helpful-- and in fact, may be quite harmful-- if you have a child who is trying to measure portions and pay attention to a pre-ordained plan. I think that you as the parent do need to be counting the calories and aiming for a high number daily (for us it was about 3,000 calories/day; D was 12 but weighed less than 70 pounds when she was diagnosed, but the number of calories required varies greatly from child to child). But Torie's language about "normal"-- telling your child that it is not normal to eat according to a meal plan-- is right on target. Again, in your own mind, certainly keep track of how you are providing a variety of proteins, fats (especially fats!), carbs, fruit/veggie, etc-- but your D doesn't need to know how you are measuring or divvying up these categories. Hide the measuring cups! Keep her out of the kitchen if at all possible! All she needs to do (SO much easier to say than to enforce) is to eat what you give her.

Refeeding is SO hard (and I had a child who never lashed out or was violent during refeeding, although she did sob through meals, which broke my heart) but it is SO worthwhile to hit this disease with everything you've got, while your child is still relatively young and weight is not too dangerously low. 3.5 pounds in your first week is awesome progress! Keep up the hard work and keep coming back here for advice and support. You can do this!



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D diagnosed with AN November 2015 , the week she turned 12. Gaining slowly but steadily, fingers crossed...
iHateED

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Reply with quote  #7 
Hello and welcome to the group, though so sorry you need to be here.  You have been given great advice so far.  I strongly want to discourage using a meal plan or counting calories in front of your D or with her knowledge.  In my opinion, this just adds further to the OCD of this illness.  It is also not normal for a 13 year old to be counting portions or calories -- and your goal is to get back to normal eating.   Do your best to figure out approx. calories in your head when you are serving food so you know the day's totals and to know if she is having enough calories to gain weight -- but don't talk about portion size or meal plans or calories at all.    Just serve the food like you're not even thinking about it. 

My d was 16 at the time and needed between 3500 and 4000 calories a day, every day, to gain a pound or two each week.  Each person is different and each week can be different too.  At the age of 13, you are also faced with getting your D through puberty and a time of tremendous growth both inside and out.  You will need to feed more to keep up with this growth.   You mentioned protein shakes in your post.  I would not call them protein shakes to your D, but it would be great if you could get a daily shake going!   Mine were a full fat yogurt like Liberte or Nosa brand, heavy whipping cream, 3-4 tablespoons of canola oil (tasteless and blends in completely), some frozen fruit and a little juice to thin it out.  I made them daily in a single serve blender so it didn't look that big.  I never made it in front of D of course!!!   She stayed in high school (when she wasn't in PHP or UCSD) and I drove to the school parking lot everyday to meet her for lunch.  She would come out to my car to eat and couldn't return until she was totally finished.  She also didn't want to miss school so she would eat fairly quickly so that she could return to school.  We did this for most of junior year and part of senior year.  Not easy but totally worth it.   Are you in the US?  If so, I suggest looking into having your D be put on a 504 plan at school.    Hang in there!
aboncosk

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Reply with quote  #8 
First of all, I am sorry to hear you are here.  You will find helpful information as you read through posts.  It can be daunting and overwhelming (and sometimes depressing when you see the ages and how young some of these kids affected by this demon illness are). 

My d is 16 and was diagnosed in January 2015 (at 15 years old).  We caught the anorexia within two weeks of the restriction starting.  She went through a PHP/IOP program for nine weeks.  They subscribed to the "meal plan" method.  It did the job - it got weight back on her but - yes, there's a but; it also reinforced bad ED behaviors.  The dietician and hospital provided us with a booklet that told us what each food serving counted towards.  Example, 1 cup of raw carrots equals one serving of vegetables.  One cup of milk equals one serving of dairy/protein.  I will tell you I never agreed with this and here's why.  Anorexia and the voice that control your child will use this to its advantage.  By knowing one cup of carrots equals a serving - they also compute calories and its not hard for the kids to look this information up on their iPads, smartphones, etc.  Plus, the program we used wanted her to continue using this method for as long as possible. We met with a doctor at the University of Chicago who deals with eating disorders (she was an adolescent pediatrician and FBT advocate) who said - why would a treatment center do this?  Most 16 year olds don't go around measuring their food (and if you think about it - most adults don't either). We continued to see the dietician after discharge from that program though summer but we were finding she was saying the same thing at each visit:  you need to add a snack.  We both were discouraged and found it wasn't helping.  So we figured we will do this on our own.  That went okay for a bit but school resumed and this is a difficult year (she is a Junior) and so the anxiety resumed and then it was a pound here, a pound there and suddenly we are at 92 pounds.

Our family just went to the University of California San Diego's Intensive Family Treatment program. One week - and it's helped turn things around.  They advocate the Maudsley approach and I will tell you it is hard to take away control of eating from your child.  It doesn't seem logical or rational but it is.  We learned to explain, "this is what we are having" and "there is no negotiating".  In our week there, they didn't focus on calories or suggest a daily calorie number to strive for but they did analyze her growth charts and came up with a weight restoration weight for us.  They project 1-2 pounds of weight gain per week and here's the approach - feed your daughter what she was eating BEFORE the eating disorder.  Yes, easier said than done.  But, it works.  Now, granted we had one week of implementing this with professionals before we returned home so we were able to address any fears/meltdowns/outbursts/etc (our daughter has not reacted that way for us thankfully).  The second day of treatment - I increased her food.  She looked at her breakfast plate and I could see the fear.  She told me "Mom, that's a lot of food".  I said this is what you're having and it's not negotiable.  Brilliant.  It worked and it is still working.  One thing that UCSD told us was to give her what we thought was enough food.  Of course, this is a bit unnerving when all we are trying to do is help our child gain weight.  But, that's what we did while we were there and that's what we are still doing.  UCSD did give us a guideline for number of calories based on our child's current weight and where she needs to end up based on gaining 1-2 pounds per week.  The most interesting facts we learned at UCSD was that the brain actually shrinks in anorexics due to malnutrition and that in order to recover; physical recovery must take place first and then the mental recovery can begin.  As they begin gaining the weight back, their brain growth resumes. 

Look for nutrient dense foods to help your daughter.  Some of the suggestions listed are great ways to add calories without adding more food to their plate.  I sometimes add olive oil to her scrambled eggs for breakfast or peanut butter on her bagels/toast.  We use Orgain Organic Nutritional Shakes purely as a supplement and/or snack.  Didn't like all the chemicals/junk that Ensure has nor did she like the taste.  Not sure about Boost although that was what was used as a consequence for patients at UCSD for not finishing meals.  One thing we were able to get our daughter to try while we were at UCSD was CLIF bars.  She is PICKY - was picky before the ED so this makes refeeding even more challenging.  But, a CLIF bar has 250 calories.  Add a chocolate milk or a boost/shake and there's almost 500 calories and it doesn't overwhelm the child because the amount of food isn't that much. 

Now, we are only four weeks into Maudsley and quite a ways off from weight restoration.  Our daughter's biggest issue is body image.  So, we may be facing different demons as she continues to gain weight and her body changes. We are working with an individual therapist and still searching for an FBT therapist in our area.

If you haven't read "Eating with Your Anorexic" by Laura Collins - I recommend it.  It documents their journey and struggles they faced in their anorexia treatment.  They ended up using Maudsley for their daughter and aided in her recovery.

One of the most difficult things you will face as a parent with this is time.  There is no prescribed time frame for recovery.  Some information you find will say 3-5 years from initial onset.  Many continue to struggle after weight restoration.  We are a little over a year into this journey and I finally feel like we have hope.  You will need to be her advocate.  If the therapist isn't in agreement with what you are doing or doesn't keep you involved - find one that will.  Parent involvement is CRUCIAL to recovery and the sooner this happens the better off you will ALL be.  This illness wreaks havoc on all members of your family [frown]  It's hard to stay patient when you see your child suffering and all you want to do is help them get better.  This is a mental illness with physical consequences - and it is so hard to know what your child is dealing with internally as the disordered thoughts plague them daily. 

Hang in there Mom - it does get better <3  Feel free to reach out any time.  Happy to offer support if I can.

mnmomUSA

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Reply with quote  #9 
Welcome to the club no one wants to join.  I'm sorry you have to join us here, but you have found an excellent resource as you battle the monster that is ED.

My daughter is now about 4 years from diagnosis, at age 13.  We were fortunate that from the beginning, we were treated by a team that adheres to true family based therapy.  As such, we were never given a meal plan.  We were told what the weight gain goal was per week (2 pounds was our target) and told that we, her parents, knew what to do.  She was slowly ramped up in calories (rough count....not precise at all) per week, starting from around 2000.  We added about 300-500 every 2-3 days until we reached a sustained level of weight gain that met our target, ending at 4000-4500 per day which we kept up until she reached a weight good for her.  I never measured or portioned anything.  I eyeballed it all.  Personally, I think measuring and portioning just prolongs the agony of this disease, and gives the ED monster something else to fixate on.  All that matters in the early days is getting calories in, however and wherever you can.  With the target number being so high, I wasn't going to get there with broccoli and lean protein.  LOL.  So, lipids (fats) were added everywhere. Canola oil was stirred into lots of dishes.  I bought heavy whipping cream by the 1/2 gallon (Costco has the best price, BTW).  She was fed 6 times per day.  Breakfast (800-1000 calories), mid morning snack (300-500), lunch (800-1000), mid afternoon snack (300-500), dinner (800-1000), and evening snack (300-500).  It was an all-consuming task to plan, prepare, supervise, clean up, and start over.  I did nothing (stopped exercising, stopped all volunteer activities, rarely saw friends, never went out to eat) for months.  

But, hitting this thing HARD at the beginning is key to victory.   My daughter was not permitted in the kitchen at all during meal preparation and plating.  My husband would keep her occupied during meal prep (or I would if he was cooking) to keep her out of the kitchen.  Her ONLY job was to eat what was put in front of her.  To this day, I'm not certain that she knows the things I poured and stirred into her meals.  Nor does it matter now that she is in recovery.  Ironically, the more weight she put on, the less she cared about "knowing" what she was eating.  I will also say that casseroles were my best friend.  It made it very hard for her to dissect and "count" in her head what she was eating.  Easier for me to add extra oil, butter etc too.  Questions about what was in something were met with the same calm statement:  It's what you need.  Repeated over and over and over.  I don't mean to make any of this sound easy, because it is most definitely NOT easy.  Super hard.  And, there were moments (of course) where I completely lost it with her and this disease, yelling at her to just eat her damn food and stop asking questions!  I learned to forgive myself these lapses.  We are only human.  Remaining calm, consistent, and compassionate are key, however, to winning against this disease.

The other thing to know is that it takes time...a lot of time....to heal the brain of an anorexic.  My daughter was weight restored for a long time before she truly was recovered.  While the true horror of this disease was put behind us in relatively short order (relative peace and calm being restored in 6-8 months), she was still mentally wrapped up in this disease until we hit about year 3 (a year ago at this time).  She was still obsessed with not eating one morsel more than I required/asked her to eat.  Now, with the passage of time, sustained nutrition, and vigilance, she is truly in a good place.  Eating freely as a normal teen would eat.  However, I will stress again....it takes a long time to get there.  So, prepare yourself for a marathon, not a sprint.  

What is the proper amount of weight?  The most complex and confounding question ever.  If you have a good record of her growth charts and where she fell over time, this is a good place to start (most in the US do as pediatricians routinely plot this).  So, for example, if your child always tracked at the 70th percentile for weight given her height, this is where she should track now, whatever BMI that might be.  I will warn you, however, that this alone might not be the final answer.  My daughter, from the time she was a baby, tracked at about 25th to 30th percentile weight for height.  Always pretty long and lean.  So, we initially brought her to this level.  The ED thoughts were still quite persistent.  So, we added more weight.  Voila.  As she approached the 50th percentile for her height, something amazing happened.  She got better.  Lots and lots better.  And, finally, recovery was possible.  The biggest regret I have in my battle with ED is not adding this weight sooner.  I was so wrapped up in my own thinking about "thinner is better."  Why was it necessary for my daughter to gain more than her "historic" level?  I do not know the answer to that.  It's probably multi-faceted, but part of it may be simply that she stunted her "true" height by restricting heavily at a critical period in her growth.  She might have been destined to be 1-2 inches taller than where she has, in fact, leveled out and her body needed to reach the weight for the height she was destined to be rather than where her ED caused her to be.  I've seen at least some research to suggest this.  

In the end, once she has reached a good weight, you will see her start to get better emotionally.  I would not have a pre-determined weight in mind, but rather be guided by her state.  It may be more (or in rare cases, less) than you initially think.  And, in the early days, it isn't even all that important.  Weight must go on. 

Finally, you should know that a cruel irony of this disease is that the weight added in early days tends to congregate around the vital organs (gut).  My daughter got quite "poofy" and it was very distressing for her (as you can imagine).  Others report quite a bit of "roundness" to the face (we didn't have this so much).  I was assured by the wise parents here that this is only temporary, and they were right.  Slowly, the weight seems to redistribute itself, and now this "softness" around her middle seems to have vanished.  She is a gorgeous young woman now, inside and out.  With curves in all the right places.

__________________
D, age 17, first diagnosed March 20, 2013, RAN, at age 13 Hospitalized 3 weeks for medical stability. FBT at home since.  UCSD Multi-family Intensive June 2015. We've arrived on the other side.  :-)
hopeful2017

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Reply with quote  #10 
Hi everyone, a month and a half in and I wanted to provide an update, and seek some more advice. First off, thank you all who provided me your personal advice and experiences. I can't but tell you how reassuring it feels to know that I'm not alone in this war I'm fighting.

As you all know my daughter def developed an ED by restriction. We have been seeing the pshychotherapist weekly. At first it was more therapy to me than to my daughter as we talked how we are doing with fighting the ED. Now we're turning it around to be a therapy session for d, where the focus is on her.

We saw the fam dr 4 wks ago for support and she was totally not on board that d has ED, and suggested that it was a normal teenage anxiety :-( even said that dropping 30 lbs in 5 months was not a concern!! since then I've been on the hunt for a pediatrician with ED background and I think I'm finally going to connect with one soon. 

We started out with the meal plan to make sure she was getting the right amt of food she needs. As my previous post suggested, I was concerned that there was alot of measuring and counting. So we dropped the measuring and I started reassuring d that what i serve her is w/in normal range. She ate what we served her. It was a struggle, but it got better. Fast fwd 6 wks now. D's ED has diminished, tho not gone. I have not poured fat into her meals, instead she was eating what we were eating - 3 meals, 3 snacks and dessert. Her weight has remained constant. She's at about 110lbs and she is 5' 6". According to her fam dr, she's withing 'normal range' (which is 99lbs to 140lbs). yet I see my daughter as very slim, bones still protruding from her back and her waist abnormally shaped. I stopped worrying about weight gain since I saw improvement. She was getting her food in, no fights, anxiety seemed to lessen, she had more energy, and there was less talk about how big her stomach and thighs are. But the food has become routine. So she's having yogurt and 3 cookies for evening snack every day. Raw veggies for one snack at school etc. She asked if she could serve herself and I could monitor if it was enough, and I let her do that. She wants to regain more control over what she feeds herself and how much, and it is somewhat scary for me as part of me is fearful that I'm letting ED take over again? But I know my daughter is strong willed and wants to have her way and feel independent again. I've given her some leeway into picking snacks - like the cookie bar she takes, or the kind of fruit she picks, as long as I think it's enough. D tells me she's tried of having to eat when she's not hungry. Says she eats more than the girls in class do. We had the talk about her being at the low end of normal weight, and that she has to keep eating like she is to maintain it as we have no room for any weight loss. Then we had the talk about putting on some more weight, and if she did, she'd be able to make more food choices, as long as they were enough and not restricting. We discussed adding in a weight gaining shake and she is tinkering with the idea. She wants to 'be normal' and take control of what she eats. Will adding the shake and getting her weight up by 6-7lbs be enough for me to allow her to do that?

The idea that she wants to 'eat like everyone else' - I'm not sure if this is her hard head kicking in, wanting to be independent, or her ED telling her to regain control? I'm afraid of giving her more control. I still notice that she is very conscious about fats and sugar, so even tho she might make her pancakes on a buttered griddle, she uses butter sparingly. When I make oatmeal in the morning, she says to me she doesn't want it too sweet, and complains that I make it too sweet. These types of things that I can't figure out is part of ED or normal for her teen age to 'watch'.

She chomps food down so fast, as wanting to just get it over with. I ask her why she does that, she says because I give her too much food and she can't enjoy it. She she gulps it down. I'm thinking this is ED still there then?

We started her on zinc about a week ago. 50mg a day. We noticed better moods, but not much more (or can't tell). Anyone else have experience with zinc?

She's spaced out, and takes a while to get something done that she could whip in a few mins before.
Memory is a problem now, while it wasn't before. She can't memorize much of anything, and is forgetful at times, and sometimes it takes me 3 -4 times of me repeating something for her to sink in (like your scarf is in the coat closet). Any advice on how to help her get past this?

She wants to do swimming and 'tone' her body. Yesterday she shows me pics of slim girls on the internet and she says she wants to be like them. We then have the talk about how she needs to love herself for who she is and not look at others. This talk doesn't seem to sink it as she thinks her body is imperfect. She's still so conscious about her body image, looking at ideal being anything but what she is now and that she needs to do something about it. I think for a 14 yr old, that's not normal. What happened to just living her life and not worrying about body? Can I get her thinking like that eventually? Or is that ED playing games? So lost.

I guess my biggest question is still on weight. The fam dr says since she's w/in normal range for her weight, that I shouldn't focus on weight gain. But I keep reading that is part of healing and we're not focusing on gaining at all now. For a while I went with the fam dr, ensuring she is eating healthy and enough foods, and D has gotten better, but I can tell ED is still there. She is tiring of me having to 'feed her' and 'be diff than her siblings', and at times I feel like she puts up the act of 'being normal' and 'eating normal' so as to convince me she's ready to move on. She wants to move on, but I feel like she's frail. She can't put up with the idea that it might take many more months to heal. Am I being anxious because of the ED experience, should I let her have some space? Or should I hold on to the reigns and get her on the track to gain more weight? If you have any recipe recommendations for shakes that add 1000 calories a day, please share. Right now she's getting btwn 1800-2000 a day, which is just barely sustaining her weight.

Feeling tired and hopeless today. I just wish this disorder would go away.

Thank you for your time and advice. PS - we're in Canada.
hopeful2017

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Reply with quote  #11 
I will also add that she feels like a 'failure' when I serve her food and make choices for her, or decide how much cheese goes into her sandwich. The other day she put two cheese wedges into her toast to grill it for lunch, and I said it needed to be three. She cried over it, did what I said, and then gulped the sandwich down (literally in disgust). I asked her why she was doing that, she said because I can't taste the bread, it's all cheese, and she wants just to be over. 'You tell me I do everything wrong' when it comes to food, she says to me. Like the fact that I have to watch over her food, and decide how much goes into her lunch bag, is some threat to her dignity. She hates being the person in the house with a problem (ED), and wants to regain control of herself. But I feel like she's too weak for it, and that prompted the conversation about adding shakes in the morning to help her gain weight. And then perhaps she can have more say into what she eats. her biggest fear is that the extra pounds will sit on her stomach - she wants is to spread to the top (ribs, chest, etc) - but I have no control over that part, which doesn't help her feel good about the idea of gaining weight. Is this a new road to recovery, or a road for ED to take over?
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Reply with quote  #12 
Dear Hopeful - 

You are doing a great job helping your daughter.  Unfortunately, ED is a crafty beast and you have to fight it hard and kill it completely.  It IS totally possible, but it takes time.

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I think for a 14 yr old, that's not normal. What happened to just living her life and not worrying about body? Can I get her thinking like that eventually? Or is that ED playing games? 


You are right that this is not normal.  You CAN help her get to a place where she is not worrying about her body and is just living her life.  Again though, you are going to have to fight really hard to do it. I have a 15 year old son without an ED.  Not only could he care less how I prepare his food, he would let me feed it to him if I would.  Anything to make his life easier.  That is normal behavior for a non ED teenager around food.

A couple of questions/thoughts:

1 - So your daughter has gained about 6 lbs in 6 weeks? She is 5'6" and weighs 110? The way you figure out what her weight needs to be is to look at her historical weight range.  Since ED often is on the scene before we know it, most people suggest you go back two years from when ED was diagnosed. Do you have those records? It's a little challenging since your daughter would have been pre-pubescent then, but it's a place to start.  Most experts practicing evidence based care (and parents on this forum) believe you have to get back to or above the historical weight range before true brain healing and recovery can start.  Your daughter is still young and has lots of growing to do. She will need to continue to gain weight for quite some time, even once she gets back to HER historical range. The right weight for HER is only for HER.  It is not based on weight charts no matter what your doctor says. We had a similar experience with our pediatrician.  They are so worried about obesity, they don't know a thing about EDs.  It is very common, but very sad. Get rid of him. He is not helpful.  If you listen to him about your daughter's weight being OK now, she will never recover. That is the harsh reality. I am in the US, but there are many wise forum members in Canada and they may be able to help you with on the ground resources if you let them know where in Canada you are.

Here is a real life example about weight.  My daughter was older when diagnosed, 17.  She had tracked at 75th percentile for weight (per the Center for Disease Control weight for age charts - https://www.cdc.gov/growthcharts/data/set2clinical/cj41c072.pdf) her whole life. By the time we realized she had an ED, she had lost more than 30 lbs and was in the 30th percentile. I had not found the forum and like you had an uneducated pediatrician.  Everyone told me if we got her back to 50th percentile weight wise she would be fine. We did that, but the ED was still oh so strong.  She was self harming, having panic attacks and was very suicidal.  These were all things we had never dealt with before ED. 

It was not until I found this forum and learned what evidence based treatment looked like and how to find it, that we were able to get providers to help us get my daughter back to that 75th percentile weight.  In fact, she went above it for awhile.  It was awful and definitely got worse before it got better. The weight gain was not normally distributed at first.  She begged to exercise, but our providers would not let her.  She had been a lifelong dancer and danced with an elite pre professional troupe, but she had to give it up. She was 18 by now and it was very hard to exert our leverage to get her to the right weight.
However, once she got there and stayed there she actually grew almost two inches.  She was almost 19 by then and we thought had long finished growing. She had started her period at 13. As her body adjusted to the weight and the new inches it all was redistributed.  I make it sound easy and painless, but it was not.  It was very, very hard to see her suffer.  But we had tried the other way (appeasing the ED and letting her stay at a weight that was not right for HER body) and that had not worked either.  We figured given her age we were running out of time.

That was almost 4 years ago.  She has been ED free for about 3.5 years and is doing great.  She eats freely and without restriction.  Her weight goes up and down within about a 5 lb range naturally.  She exercises normally.  One day she might love to go to yoga and the next day she might decide to nap instead. Last night she shot baskets with her boyfriend!

Here is another great article from one of the premier ED doctors for younger sufferers about determining the proper weight.

https://www.kartiniclinic.com/blog/post/determining-ideal-body-weight/



2 - You say in an earlier post that you were doing FBT.  In true FBT, your d has no say in cooking or choosing or plating her food.  You do all of that for her. Given your story about her gulping down the sandwich it sounds like she needs this.  It usually is easier for most ED sufferers to make all food decisions for them because then they can tell the ED voice in their head that you - the big bad mother - are making her eat. It is WAY too early to give her any control. That comes long after she gets back to the right weight for HER body and then is done slowly and in an age appropriate way for her.  It might be normal for a 14 year old to make her own breakfast on a school morning but it is not normal for her to make her own dinner.  Can you tell her that from now on, you are in charge and you will determine what food and weight is right for her? Her job is to eat.

Do not expect her to be happy about it or to have any insight.  She can't now because the ED is still too strong.  Some day she will be able to have insight though and that insight will help her as a young adult stay in the recovery that you help her get to. Distraction when she gets upset before, during or after meals seems to help.  Many on the forum report playing card games, or other mind/word games, watching TV, crafts, etc.  When my daughter was sick we watched literally hundreds if not thousands of hours of netflix, during and after meals.  Whatever it took to get the food in. My daughter at 18 had to eat every meal at her IOP program or with me for almost 6 months before she could do it on her own.  It was not normal for an 18 year old that should have been getting ready to go to college and gain independence.  But my daughter needed that for that long to fight the ED. She is now getting ready to graduate from college in another state (in less than 3 weeks) and she lives a very age appropriate independent life. She even spent a semester studying abroad in South America last year and traveled all across the continent - loving every minute.  She couldn't do that though when she had an ED. My d has also been super independent and strong willed her whole life. I used to think the same as you, that it was her independent streak wanting control of her food.  It wasn't  - it was ED.  I can guarantee it is the same with your daughter. 

3 - One of the reasons it took me so long to get my d above 50th percentile for weight was because I couldn't stand to see her in the pain that the additional weight gain was causing.  It helped me to realize that the only way she was getting to the other side of ED was to gain the weight.  Many on the forum compare weight gain to chemo for a cancer patient.  It has horrible side effects and is very painful for the patient, but is totally necessary for recovery. It also helped me to realize that for someone with an ED gaining 1 lb is as painful as 10 lbs. 

You are your daughter's best chance at 100% recovery and a normal life.  When my d was sick many people told me that all I could hope for was that her ED would be something she managed her whole life. I refused to accept that.  When I found the forum I found the resources and support to ensure that my d could recover completely.  It will be very hard, but you can do it and everyone here will support you.


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hopeful2017

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Reply with quote  #13 
Dear hopefulmama,

thank you so much for your response. We're in Ottawa, Ontario. Any suggestions on pediatricians from those on the forum are much appreciated.

We started out with me planning and giving her food, no negotiations, it was hard, but got easier. At some point she asked if she could serve herself at dinner, and I could agree/disagree if it's enough (if not enough she would serve more). Then she asked if she could pick the fruit in her snack (i.e., today I want an apple). Since she asked for it, and was getting better, I let her do that. She's SOOO eager to pack her own lunch and pick her snacks, etc. I fear if I go back to not letting her have control, she will feel worse? When asked by her therapist if it's worse if I serve her or if she serves herself, she said it was worse if I did it. Is she not being truthful? Am I, by letting her have 'some control on choices', taken us several steps back from total healing?

The hard part of us is my d was over weight as she grew up. She was in the 90%+ when she was a kid, and by the time she hit 11, her weight had normalized but was still was in 80%, by 12 she got her period, and about 6m ago she was where I thought was her optimal weight (around 130lbs). Since then she developed ED and dropped to 101lbs. She regained to 110lbs in the first 2 wks of refeeding and getting back to normal meals. Next 4 weeks, she's had no gain in weight - just sustaining. She might have dropped a lb or two. It's harder for me to use history of percentile to gauge how much she should gain, since she was on the 'bigger' side growing up, and she doesn't want to go back to that. I agree with her not going to overweight, but what is the 'right weight' for her, we don't agree on (I think btwn 125-130lbs, she wants to keep herself at her current weight of 110lb). The challenging part of all this is me, as a mama, have also struggled with weight gain after having my 4th child. The other 3 kids in my house, my older son is a tad bit on the heavier side (85%), but nothing that worries doctors and he'll spurt out of it, my 7yr old is a bit on the 'bigger side' as well, but also not concerned because I know kids grow. My 5 yr old is 'normal' weight. All in all, the family is on the 'larger' side in the 80% range, and I fear my daughter views us as a 'fat' family and doesn't 'want to be like us'. This makes it so much harder, as I tend to feel weaker because of it. Instead of letting this take over me, I've started going to the gym and eating healthy, and I'm shedding weight and distressing at the same time - with the goal to show my daughter that if anything a person can put their mind to, is achievable.

In looking at the article you sent, my d would be in group 2, and it's more of a guessing game to get to the proper state. For her, she's missed her period for 6m, and perhaps once that returns, it's a sign that she's where she needs to be? Her hair has gotten healthier (it was shedding like crazy), she has more energy to get thru the day (while before it was hard), and I can tell her skin is healthier (has regained moisture). But all in all, I feel like she's not healed, primarily because her period hasn't returned, and because I still feel she tires easily.

What does evidence based treatment look like? Can you help point me to the right resource on that?
hopefulmama

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Reply with quote  #14 
Quote:
We started out with me planning and giving her food, no negotiations, it was hard, but got easier.


This model is the most age appropriate for your daughter and also gives her the best chance at full recovery. 

Quote:
I fear if I go back to not letting her have control, she will feel worse? When asked by her therapist if it's worse if I serve her or if she serves herself, she said it was worse if I did it. Is she not being truthful? Am I, by letting her have 'some control on choices', taken us several steps back from total healing?


It most likely will make it worse to go back to not giving her any choice or control over what she eats in the short term, but FBT (where parents are in charge of what their child eats) has the highest rate of recovery of any type of treatment.  In other words, it is your daughter's best chance at full recovery. Because her ED is so strong now any choice on her part is an ED based choice...no matter what she may tell you. 

Evidence based treatment means a treatment protocol that is supported by scientific evidence and effectiveness. 

If your d was 5'6" and 140 before she started losing weight (that is what I backed into), that is the first place you need to get back to. Based on the historical ranges you mention your d was not obese, just tracked at a higher percentile.  Since optimal body weights tend to run in families, it is possible your whole family may track along a higher percentile.  In other words, every body has a its own optimal weight.  It is the weight that the body can maintain without dieting or restriction.  It is your body's set point. 5'6" and 130 is very light and doesn't sound like it is enough for your d's body type. Part of recovery from anorexia is learning that you have to accept your body's predetermined ideal body weight.  In my years on the forum I have heard scores of stories where the parents worried that their child was gaining too much weight. The kid also was miserable at first.  Anorexia is such a counter-intuitive illness that the sufferer usually struggles less with body image at a higher weight (once they get there) than at a lower weight.

Not having a period is definitely a sign that her weight is too low, but many sufferers are in the throes of anorexia without ever losing their period or after they get it back. In other words, not having it is an issue, but having it does not ensure health or attainment of the proper body weight.

I have great empathy for what you say about struggles with your own weight and how that may skew what you see in your daughter. My mom has been more than 100 lbs overweight most of my life.  I grew up determined that would never happen to me or my kids.  I see now that my constant dieting and running marathons was an attempt to maintain a weight that was probably about 10 lbs less that my body's ideal weight. I also did not want my daughter to return to her pre ED weight because I thought she would be "happier" at a lower weight and I didn't want her to struggle with her weight like my mom had. I used to think the parents on this forum were obsessed with weight. Guess what? They are because weight is the only way out of this.  More often than not it is more weight than you are comfortable with at first.

I learned that "healthy" eating is all foods in moderation.  There are no "bad" foods. In order to stay in recovery your d will never be able to diet or restrict any food group. She will need them all throughout her life.  I finally realized that I had to totally change my ideas about weight and "healthy' eating in order for my d to recover.  In the process I learned that I don't really love to run marathons.  I do feel good when I exercise, but now I exercise to move my body and my heart and not to burn calories. If I feel like pasta, I eat it.  If I want dessert I eat it.  The funny thing is that over time when you remove all the restrictions you put on yourself you realize that sometimes you don't feel like dessert and sometimes you chose a salad because that is what you really feel like. I might weigh 10 lbs more than I used to, but I know that I am healthier and happier and it allowed me to model this acceptance for my d.  She is healthy and vibrant and glowing.

This is one of the hardest thing about this illness because you are swimming upstream against popular culture.  My daughter had to learn that she does what SHE needs to do to stay healthy, not her friends or what people on TV do.  

Have you read any of the books often recommended on this forum?  My two favorites were Brave Girl Eating by Harriet Brown and Decoding Anorexia by Carrie Arnold. Carrie also has a great blog at http://edbites.com/. I also found this blog very helpful http://www.blog.drsarahravin.com/.

It might help to read some of these to continue to gain an understanding of evidence based treatment and what is necessary for full and complete recovery.

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hopeful2017

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Reply with quote  #15 
hopefulmama, thank you very much for your insight and the articles.

My daughter had a meltdown yesterday, crying for fear of weight gain, stomach getting bigger, all the things we thought were now under control. It was a long night. Her ED had her thinking if she put up a decent act with us, and if she ignored it long enough, she would regain control of herself and her food. She could get this over in a few weeks. We realized last night that what we thought was success was just a show, and ED has been there all along guiding my D on what steps to take next.

Feeling low, feeling tired, feeling utter disappointment at where we are 6weeks in.

I've decided to press the reset button. We will go back to FBT, Phase I, where we control the food intake. She's going to fight again. She will cry again. The goal this time is that she must put on weight. Prior to this, I thought if I got her eating healthy enough, that she will recover. She hasn't.

I need help with determining how many calories she should consume, and ideas as to how to serve up those calories. I'm able to feed her what the rest of my kids eat. I'm having a hard time incorporating more calories into the diet, without adding 'more food', which she can't take. I will put out a post for help on how to prepare food, as I would like to toss out the plan of 6 grains, 4 dairy, 5 fruits/veg.. etc. out the door, and go with what will work at the fastest pace possible.

Tired, but I haven't given up. We will try this again and do it right this time.
sk8r31

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Reply with quote  #16 
It's so positive to hear you speak of 'hitting the reset button'.  It's what we've all had to do as parents...

It's often referred to as 'feedback not failure'.  When you are not getting the results needed, it's time to change things up.  

Each family and kid is a snowflake...many similarities of course, but what works for each one may be slightly different.  So you try a strategy & adjust as needed.  The folks on the forum are live savers for sharing their tips and ideas.  And ideas and strategies may change with age of kid and severity of illness.

For our d, 17 at the time, getting in a daily smoothie was a key piece that helped get her to WR.  She fought tooth & nail against it...for some reason totally fixated on not drinking one...

What finally tipped the scales was me laying out all the food she would need to eat instead of the smoothie.  It was the sheer volume of the food that made her finally agree to drink the smoothie.  Of course, no talk of calories etc...but a good 8 oz smoothie with full fat ice cream, a little oil or ground-up nuts, full fat milk & some frozen fruit can pack a wallop.

We negotiated on the time of day for the smoothie (evening, while watching a short 30 min comedy show with me).  Adding that daily smoothie was a key component of her 1-2 lb weekly gain.

It's hard to say how many calories your d may need to gain consistently.  Aiming for 1-2 lb weekly gain is an achievable goal.  Serving the same items to your d as the rest of the family, but adding in oil to a sauce, or extra cheese to her portion (all done with d out of the kitchen!) can be helpful. 

Hang in there!

Warmly,
sk8r31

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hopeful2017

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Reply with quote  #17 
Thank you sk8r31. Can you share some recipes for your smoothies? Is there a part of the forum that has info just on food and smoothie ideas? I'm still trying to navigate it all.

Also, should I be weighing her every week? I fear she will panic if I do. But how else will I know if we're making progress? Our therapist told us previously to toss the scale out because she would consistently get on it to check. So we did.
hopefulmama

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Reply with quote  #18 
I am so sorry last night was so hard.  I know all too well what those nights are like. Great for you for pushing the reset button. It took me over a year to get to where you are six weeks in - BRAVO!

As for weighing, most people find that it is easier for the kids to be weighed blindly.  Many on the forum have used a scale that has a handheld reader. You can also just have her get on the scale backwards as well. That is what we did.  You can keep it under lock and key and pull it out once a week to weigh your daughter and check progress. Be sure and don't let her know ahead that you are going to weigh her.  You do it first thing in the morning in her underwear or light PJs and right after she goes to the bathroom. Use your best poker face when you read the weight and don't give in to her pleas to know the weight or for her to negotiate with you in any way.  This part was really hard for me.  It helped me to have a couple of pat sayings or mantras in response to her pleas.  I would say, "I know this is hard for you, but it is my job to get you healthy so that you can lead the normal life you deserve. Right now food is your medicine." ED is a crafty negotiator.  I found that if I gave an inch ED took a mile - or two. Be kind, but firm.  Validate her distress at being weighed and gaining weight, (she will probably also throw in the personal indignity of it all) but then be firm that it is not up for negotiation and change the subject.  After one too many times that my own anxious response to my daughter's anxiety escalated the situation, I learned that it seemed to help me stay calm when I spoke softly and slowly.

I often felt that because of my own anxiety and how hard it was for me to see my daughter suffer, I could have not been more ill-suited to mother a child with anorexia.  If I can do it, anyone can!

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Don't give up hope!
hopeful2017

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Reply with quote  #19 
your posts mean alot to me. thank you for all your share to help me cope. this is really hard on me; my life is all about my children, and seeing my once perfect daughter (and i mean perfect is every way) suffer like this is just so hurtful to my sole. she's a strong gal. i know she will recover. I know it.

i love the idea of weighing her standing backwards. will do that for sure.

what do you say when my ED kid says 'how long will it take me to recover' and 'I want this to go away now' or 'I don't want to feel like the ill kid, I want to be like my siblings'. so far my response has been 'it took you 6m to get yourself into this, how do you expect it to go away in a snap? you have to be patient, you're strong and you'll get through this'. but she wants solid answers, solid time frames, etc. 'how much weight do i have to put on?' she asks. my husband says giving her a number is a disastrous idea. since my d was overweight growing up, she fears going back to being overweight. so my answer has been 'until your mind is at ease, until you get your period back, until you're not afraid of food or your stomach getting bigger.. etc' but nothing seems to ease her. is easing her fears not achievable with ED?
Torie

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Quote:
Originally Posted by hopeful2017
what do you say when my ED kid says 'how long will it take me to recover' and 'I want this to go away now' or 'I don't want to feel like the ill kid, I want to be like my siblings'.


I told my d quite simply that there was no way to know, but that I would always be there to help her.  She kept pushing and pushing and pushing and finally I told her I certainly hoped it would be sooner, but it could take years.  I think she was actually relieved that I wasn't being unrealistic.

Oh, and I would always tell her that it would get better - I just didn't know how long it would take.

Your mileage may vary. xx

-Torie

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hopefulmama

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Reply with quote  #21 
Your husband sounds like a gem!!!  He is exactly right. If you tell her she needs to gain until she gets her period back and then she gets her period back tomorrow...that's trouble.  I love some of the suggestions others have given as to how to respond to her questions.  You don't have to have an answer for her.  Validate her distress and then be firm and move on...change the subject.  I used to say that I knew what we were doing would work, I just didn't know how long it would take.  My daughter now says that my confidence (even if I was faking it) really helped her.  During the early days I would run around like Chicken Little exclaiming that I didn't know what to do.  This didn't help her. Another great saying on the forum is "fake it 'til you make it."

Quote:
is easing her fears not achievable with ED?
 BINGO!!! It is not possible to help her recover without extreme anxiety on her part.  Once I realized that it helped me to realize that all of my kids (including my non ED boys) have to learn how to handle adversity and they are going to struggle.  As our very wise family t that helped us with our daughter said, "she has to learn to live into the anxiety and beautiful imperfection and uncertainty of life." This is true of ED and non ED kids alike.  I know that when my daughter went to college and struggled academically at first in her intro chemistry classes, she said to me one day, "Mom, I am going to just keep at this until I get past it - like when I had an eating disorder." So yes, my d's ED caused her great pain, but conquering it has made her stronger. So much of what I have learned about helping my daughter walk through the fire of her ED has helped as I parent my two non ED boys as well....and one of them is an adult! [wink]

It used to cause me almost unmanageable pain when my kids were in distress.  I have been able to readjust my thinking and realize that their distress is necessary because they will learn how to get to the other side of the issue and then they will be stronger for it.  As we all know, life is imperfect.  When we prepare our kids (I am speaking to myself and not you) for a perfect life, we do them a disservice. 


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Enjoying my 21 year-old daughter's achievement of active recovery that was made possible by the resources and education I found on this forum.

Don't give up hope!
hopeful2017

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Reply with quote  #22 
toothfairy, thank you for that video! i watched it as well as others about modeling effective parenting. my jaw dropped as i watched these because all I can think is 'this is exactly what my D says, this is exactly how she responds'. it validates more that ED is ED and the symptoms/ED talk is the same, no matter who the kid is.

thank you Torie and hopefulmama... my h tends to be the tough one with ED, when things get hot and heavy with questions from d, and I tend to fall apart and start to answer questions logically (terrible thing, but total parenting habit). but i will remember to remain confident (even if I'm not on the inside)

hopefulmama, your insight on how the struggle will only make her stronger is so uplifting. we will all be stronger when this is all done.
sk8r31

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Reply with quote  #23 
There are great threads on the forum for snack ideas, including smoothie recipes, as well as a thread on high-cal meals.  It really helps to have some 'tried & true' meals/snacks to add to your repertoire.  I will  bump those up on the forum for you, & other newer forum members who may find them helpful.

For the smoothies I made, I used the highest fat count ice cream I could find...Hagen Daz is one brand, along with Trader Joe's.  They have 250 cal for 1/2 c, so you can use that, along with a 1/2 c. whipping cream & either juice or milk to thin a bit.  Then I added whatever frozen berries I had or a frozen banana.  Fruit flavors were what my d preferred.  Other ideas are adding peanut butter or chocolate.  Adding ground nuts or even a tbsp of oil can help too.

You should be able to get 500-800 cal in an 8 oz smoothie.  You may have to experiment a bit to find the flavor/consistency that it most acceptable to your d.  However, I would avoid trying to make the 'perfect' smoothie...ED can get hung up on using a certain cup or size or 'exactly' the right combo.  

Wishing you well as you move forward.

Warmly,
sk8r31

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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Foodsupport_AUS

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Reply with quote  #24 
One of the things that I have learnt about anxiety in managing this illness is that the more you reassure anxiety questions the more those questions become justified and the anxiety becomes justified. The questions about weight goals, how long, how much are all really anxiety. Learning to recognise this and how to respond can really be helpful. 

So when you hear these questions, reflecting back her frustration and anxiety, thereby acknowledging it but also accepting there is uncertainty will slowly help her move forward. For example "how much more do I have to gain?" 

"I can hear that this is worrying you. You will need to gain until you mind and body is healthy, and then some more as you grow into adulthood."  She will hate the answer, but any other non specific answer will do. Sometimes though the easiest thing is to keep on repeating the same thing. Giving numbers or exact time frames though are bound to be a problem in the future. 

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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.
K63

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Reply with quote  #25 
Hi hopeful 2017, ed is very sneaky sometimes it can almost fool us into thinking our kids are better than they are. You have got this and well done . Eg of what can be required three meals with some form of protein , carbohydrate and colour dietician said colour for fruit vey or salad for each meal . four snacks one being a piece of fruit and two nutriplen drinks they are nutritious drinks 125 mls 300 calories. So meal plan eg for one day. 9 am one poached egg , 2 slices of brown bread and some fruit followed by one nutriplen drink. 11 am a protein bar (fulfil ). 13.00 dinner meat veg and potatoes, or spaghetti bologna ise and salad with dressing . Followed by a nutriplen. 16.00 chocolate bar or desert . 18.00 tea . Bread roll and two sausages and salad . 21.00 bag of popcorn and an apple. In earlier days she found this all very difficult now she can manage with little anxiety. Her body needs this for recovery . Hope you find this helpful . All family eat same size portions of meals . If you want to add extra calories add double cream or butter to foods.
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Daughter started restricting in February 2014, tried re feeding at home hospital admission 4 1/2 months weight restored started restricting post discharge, back on meal plan full supervision weight restored april 2016. Starting to hand back responsibility for meals it's scary. 
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