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nerd

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Reply with quote  #26 
Unfortunately, she heard a doctor speak on adults with AN, and he claimed that people who have been sick a while with no tx (5+ yrs) could only get palliative care, like a diabetes patient--no full recovery.
So now ED tells her there's no point; all she can do is harm reduction.
mjkz

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Reply with quote  #27 
She is going to have every excuse in the book and some will actually sound logical.  She can get more than palliative care and she can get better but it is a true leap of faith and scary because it is a whole lifestyle overhaul.   Not many people want to do that no matter what reason. It is the same things as someone who has lung cancer and keeps smoking.  Lifestyle changes are the hardest to make and maintain.  For every single reason you come up with for her to recover, she'll have a reason or excuse why she can't or something someone has told her that supported her belief so she clings to them.
nerd

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Reply with quote  #28 
You're right about that.
Oh, and she heard the phrase "you can't make a fat person thin, or vice versa." So she thinks any weight she ends up at is natural.
tina72

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Reply with quote  #29 
"She has also heard that some foods in the US will make people gain, whereas in Europe and elsewhere the same foods won't, likely because of the additives. So she thinks those in the US can never know their true set point."
That are ED thoughts. Doesn´t make sense to comment it.
Tina72
Torie

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Reply with quote  #30 
Quote:
Originally Posted by nerd
When she hears that once she gets weight restored she won't obsess over food and want to lose weight anymore, she asks me why, then, she wanted to lose in the 1st place. Good question. 


I think the folks who have said she will have excuse after excuse for not taking this on are correct.  But as to your question, I have wondered that, too.  In reality, I think very few people love their size and shape and always wish they had more here and less there.   So that won't magically change because of recovery from ED.  But it does go back to he normal amount of dissatisfaction, in keeping with how most of us feel about our hair or our noses or whatever.  So sad. xx

-Torie

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

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Reply with quote  #31 
OK, thank you both.
She is restricting from 9pm to 1pm every day now. It's called intermittent fasting 16:8 method (16 hours of not eating, 8 hours of eating during a day). She says it's OK because you don't count cals, but I know she still does. If she's at home, she has a big meal at 1pm and another at 8pm, which is a good start, I guess, but how much can she eat in one go? I know not a lot.
 
 
Foodsupport_AUS

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Reply with quote  #32 
Nerd it strikes me that your friend is going round in circles. As someone who has had an eating disorder for many years she knows that she needs to eat meals regularly, she knows that she needs to gain weight, she knows that she needs to stop disordered eating behaviours and related behaviours. So when she is only eating for eight hours a day, she knows that is not right. 
Perhaps the time is to let her know that you will support her to do what needs to be done, not what she wants to do. 

__________________
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.
tina72

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Reply with quote  #33 
The problem is if you eat not regularly (every 4-5 hours) your blood sugar level is going up and down and that makes it worse. It is very important to keep the blood sugar level constant during the day so she will not feel hungry (that feeling that she loves so much which is not helpful at that stage).
Tina72
nerd

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Reply with quote  #34 
Thank you both.
So how do I establish boundaries with a woman nearly 50?
tina72

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Reply with quote  #35 
You need a network of people that are nearby and helping. You can make a contract. There are things that she likes. Maybe she would like to visit a concert with you for example. Than you could work out a contract. "If you make it to eat 5 times a day from a mealplan for a week, than we go to that concert" or something like that. She must be compliant to do this and she must be compliant to change her life. Can you get her on a trip for 2-3 weeks with you so you could get in charge for meals?
Tina72
Mamaroo

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Reply with quote  #36 
Good day Nerd

You are a great friend to worry about your friend. It is very hard to treat this illness in an adult. The fact that she is setting rules about when to eat is very typical ED behaviour. One way of breaking that is to substitute her 'rules' with a proper mealplan. At Kartini clinic they follow a mealplan consisting of 3 meals and a snack. I've attached it for you. They concentrate on fresh ingredients and avoid all hyper palatable food for the first year. I more or less followed their recommendations except my D had to eat 6 times a day and her total calories were higher.

How to get your friend to follow this mealplan, I don't know. I used incentives such as ipad time and pocket money to motivate her. You can tell her that you are concerned about her health. Is she on medication? There are plenty of good over the counter anti anxiety and stress medication available. Here is a website with natural remedies: https://draxe.com/natural-remedies-anxiety/

Best of luck!

 
Attached Files
pdf Kartini__Home_meal_plan_3-1-.pdf (54.06 KB, 24 views)


__________________
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. Challenging fear foods now.

Kali

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Reply with quote  #37 
Hi Nerd,

You are a good friend to be concerned and to try to learn more about the illness so that you can support your friend.

It is likely that your friend could benefit from having someone live with her and organize and eat regular meals with her. I don't know if that is a possibility? The fact that she lives alone means that she can skip meals when she wants and engage freely in any eating disorder behaviors she wants to. 

Many of us have had the experience that when we eat with the sufferer and encourage full nutrition, sometimes for a very long period of time, that they make progress against the illness. 

If you are in the US, there is also a program in Ohio which is very well regarded and is specifically for adults and their support person(s). It runs for a week. There have been ATDT families with older sufferers who have benefited from the program. 

http://www.centerforbalancedliving.org/new-fed-tr

Here are a couple of discussions on the board regarding peoples experiences there. One was a very long time sufferer who was able to, with the support of her partner, make progress.

https://www.aroundthedinnertable.org/post/center-for-balanced-living-info-8159568?highlight=center+balanced+living&pid=1293240295

https://www.aroundthedinnertable.org/post/new-here-need-advice-and-just-help-how-can-i-recruit-my-wifes-parents-to-7937890?trail=50&highlight=center+balanced+living#gsc.tab=0

If finances are an issue, there is an organization called Project Heal which works to help people afford treatment by giving grants, which she/you can apply for.

http://theprojectheal.org/

They have information sessions on the phone if you and she want to learn more about the program.

And here is a link to an article written by Carrie Arnold, with more info:
https://www.theatlantic.com/health/archive/2016/03/treating-anorexia-in-adults/475845/

best wishes, 

Kali


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Food=Love
nerd

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Reply with quote  #38 
Good idea, in principle. Her boyfriend made promises that he didn't deliver, though, so I think that type of motivation is shot. He's an enabler, anyway. (Maybe that's why he didn't deliver--so she'd go back to her habits.) I asked her friend, who is also her building manager, to check on her every now and then. It's over a year later and he didn't do it once. Her cat is sick, so she won't be able to travel for a while. I'll ask around. She must be compliant, as you say. Not sure if that would happen.

 
Quote:
Originally Posted by tina72
You need a network of people that are nearby and helping. You can make a contract. There are things that she likes. Maybe she would like to visit a concert with you for example. Than you could work out a contract. "If you make it to eat 5 times a day from a mealplan for a week, than we go to that concert" or something like that. She must be compliant to do this and she must be compliant to change her life. Can you get her on a trip for 2-3 weeks with you so you could get in charge for meals?
Tina72
nerd

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Posts: 40
Reply with quote  #39 
Thank you. At least this meal plan has non-scary (to her) foods. I can try. I can't imagine her being OK with more cals, though. She actually isn't eating too little by a casual dieter's standards, but for the rest of us it would be too little. She is on meds for her moods and anxiety. She is recovered from Borderline Personality Disorder, and while she no longer shows outward symptoms, she is still suicidal--but she has other disorders which may account for it, plus the AN.

Quote:
Originally Posted by Mamaroo
Good day Nerd You are a great friend to worry about your friend. It is very hard to treat this illness in an adult. The fact that she is setting rules about when to eat is very typical ED behaviour. One way of breaking that is to substitute her 'rules' with a proper mealplan. At Kartini clinic they follow a mealplan consisting of 3 meals and a snack. I've attached it for you. They concentrate on fresh ingredients and avoid all hyper palatable food for the first year. I more or less followed their recommendations except my D had to eat 6 times a day and her total calories were higher. How to get your friend to follow this mealplan, I don't know. I used incentives such as ipad time and pocket money to motivate her. You can tell her that you are concerned about her health. Is she on medication? There are plenty of good over the counter anti anxiety and stress medication available. Here is a website with natural remedies: https://draxe.com/natural-remedies-anxiety/ Best of luck!
nerd

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Posts: 40
Reply with quote  #40 
Hi--thank you.
Her boyfriend won't spend the night because after her being hypomanic or manic a few times, he stopped wanting to do so, since it interferes with his sleep. He takes her out to restaurants, but that's because he loves to eat (as do many people), and not because he's interested in helping her recover. He is less of an enabler when her weight puts her close to death, fortunately. But don't most who die of ED die at a normal weight with normal labs? That's what I read.

Quote:
Originally Posted by Kali
Hi Nerd,

You are a good friend to be concerned and to try to learn more about the illness so that you can support your friend.

It is likely that your friend could benefit from having someone live with her and organize and eat regular meals with her. I don't know if that is a possibility? The fact that she lives alone means that she can skip meals when she wants and engage freely in any eating disorder behaviors she wants to. 

Many of us have had the experience that when we eat with the sufferer and encourage full nutrition, sometimes for a very long period of time, that they make progress against the illness. 

If you are in the US, there is also a program in Ohio which is very well regarded and is specifically for adults and their support person(s). It runs for a week. There have been ATDT families with older sufferers who have benefited from the program. 

http://www.centerforbalancedliving.org/new-fed-tr

Here are a couple of discussions on the board regarding peoples experiences there. One was a very long time sufferer who was able to, with the support of her partner, make progress.

https://www.aroundthedinnertable.org/post/center-for-balanced-living-info-8159568?highlight=center+balanced+living&pid=1293240295

https://www.aroundthedinnertable.org/post/new-here-need-advice-and-just-help-how-can-i-recruit-my-wifes-parents-to-7937890?trail=50&highlight=center+balanced+living#gsc.tab=0

If finances are an issue, there is an organization called Project Heal which works to help people afford treatment by giving grants, which she/you can apply for.

http://theprojectheal.org/

They have information sessions on the phone if you and she want to learn more about the program.

And here is a link to an article written by Carrie Arnold, with more info:
https://www.theatlantic.com/health/archive/2016/03/treating-anorexia-in-adults/475845/

best wishes, 

Kali

nerd

Caregiver
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Posts: 40
Reply with quote  #41 
I think the conclusion of this is: she has to want the help. She can't be coaxed right now. She's going to continue like this or die.
ninhursag

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Reply with quote  #42 
I'd say more adults have internal motivation and notice there's an issue than your typical teenager but adjusting your eating habits is really really difficult for anyone never mind someone with a deadly mental illness.

Ultimately the problem is it feels good and natural to engage in ED behaviors even as they kill you and it feels painful and unnatural to not. It is a lot easier to integrate the heavy levels of support needed to get past that if you have legal authority as a parent or if the sufferer's healthy brain is on the same page as you.

As the spouse of an adult in partial remission my only thought would be that your friend needs to be able to see a life beyond the ED to work toward. A dream of a life that's worth the work and the huge leaps of faith to do the rewiring to get to remission.
nerd

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Posts: 40
Reply with quote  #43 
Thank you.
Another thing is, it's not just her bf, who incidentally buys her diet pills, who is the enabler. She gets paid for her illness to work as a model. Some companies care more about size than age, so even at 49-50, she gets work, because she has somehow held up well--except when she's been sicker. Then, she looks her age. So she models and does other things in the arts, and is content with that as a life. She basically lives for her cat, who is sick. She knows she could die and her cat could be alone (with the bf, and the bf does love the cat) but ED helps her cope with her cat's illness.
Mamaroo

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Posts: 129
Reply with quote  #44 
Hi Nerd

Here is a video from a recent Eating Disorder conference:


It is about treatment options for people who have been ill for many years and could be considered to have 'chronic' anorexia. It is very informative. Your friend may be interested in watching it.

__________________
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. Challenging fear foods now.
nerd

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Posts: 40
Reply with quote  #45 
Great, Mamaroo, thank you!
Mamaroo

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Posts: 129
Reply with quote  #46 
I found some more videos relating to adult treatments. They come from the At Home with Eating Disorders conference:
https://www.youtube.com/playlist?list=PLwAiWzISIlS1fBg3e6ljzeGDI7XAIC1LH&app=desktop

Hope you find them informative.

__________________
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. Challenging fear foods now.
nerd

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Posts: 40
Reply with quote  #47 
Thank you.
She had to get an operation and the nurse told her she looked good and shouldn't gain weight. She knew this was wrong but is using it against those who tell her she should eat.
deenl

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Posts: 828
Reply with quote  #48 
Hi nerd,

One uninformed passing comment is just that - an uninformed passing comment.

The valuable opinions are the patient's deep down knowledge that she needs to gain weight and well informed friends like you who understand the full picture.

I don't know if you've read Carrier Arnold's recovery blog. She recovered after more than a decade of illness. http://edbites.com/

Or June Alexander who recovered after decades. https://www.psychologytoday.com/blog/eating-disorders-news/201112/june-alexander-recovered-long-term-eating-disorder-and-so-can-you

http://www.junealexander.com/category/eating-disorders/

Your friend needs to keep taking any steps she can every day towards recovery and reaching out to friends and professionals who can support her.

Warm wishes
D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
deenl

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Registered:
Posts: 828
Reply with quote  #49 
Hi nerd,

One uninformed passicng comment is just THAT - an uninformed passing comment.

The valuable opinions are the patient's deep down knowledge that she needs to gain weight and well informed friends like you who understand the full picture.

I don't know if you've read Carrier Arnold's recovery blog. She recovered after more than a decade of illness. http://edbites.com/

Or June Alexander who recovered after decades. https://www.psychologytoday.com/blog/eating-disorders-news/201112/june-alexander-recovered-long-term-eating-disorder-and-so-can-you

http://www.junealexander.com/category/eating-disorders/

Warm wishes
D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
nerd

Caregiver
Registered:
Posts: 40
Reply with quote  #50 
Thank you, Deeni.
She knows adults can recover, but only believed on 2 occasions that she could--while in IP after refeeding, and once while out, after an alternative treatment, but that only lasted a day and she was hypomanic.
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