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amalr

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Reply with quote  #1 
Hi, I am new here and reeling from the diagnosis my 14 year old daughter received last week (atypical anorexia). Since our appointment she has eaten every scrap of breakfast, lunch and dinner, the latter which has been very varied and normal (e.g., lasagne, chicken & cashew curry, BBQ inc sausage, garlic bread etc). She happily has a big slice of cake or 2 choc biscuits mid morning and fruit for pudding after lunch but will not shift on pm snack, pudding after dinner or nighttime snack. Also only drinks green tea, water or black coffee. I feel awful as I have discouraged sugary drinks and too many snacks. She has done so well and is eating twice what she was, but I can’t seem to get myself in charge of what she won’t do and have failed to help her with what she/ED can’t/won’t do. Any advice?
Foodsupport_AUS

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Reply with quote  #2 
Welcome to the forum and sorry that you have had to find your way here. 
It is great that you have made a good start on re-feeding and that her food intake has markedly increased. 

Her inability to drink other things or have certain snacks is not your fault. Most of us have been indoctrinated into "healthy" eating at some point or another. Her illness though is the cause of these symptoms at the moment. Can I suggest that you limit her to two caffeinated drinks per day - green tea or coffee? These are commonly used as hunger suppressants or to give more energy and so ideally should be limited. At present if only water so be it, but perhaps start putting soups and smoothies into some of her meal or snack choices too. 
Many of us have successfully instigated life-stops-until-you-eat or magic plate. I am not one of them. This means you preparing the food (without any input from your D) and then insisting that she eats it. Calmly waiting /staying put until she has done so. No other activities until food is eaten. Replacing lost/thrown food, preventing her from getting up, following if she manages to. 



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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.
Mamaroo

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Reply with quote  #3 
Hi Amalr

You have done a great job up to now! It took me weeks before my child would follow her mealplan and then she would only take ensures. It would take many more months before she was able to eat food again.

So what is the good? You are able to feed your child 3 main meals and 1 snacks. That is terrific! Not only that, but she is eating normally and not restricting (for example being a vegetarian).

So what I'm seeing is that you would like to include a snack after lunch (afternoon tea) and snack after dinner (supper)?

I found that during refeeding my d got off to a great start in the morning, but as the day progressed it became more and more difficult for her to eat and that dinner and supper were harder. It may be the same for your d. It is important that she eats every 2-4 hours so that her blood sugar level doesn't drop and to be able to fit in all the calories. 

I would suggest printing a weekly mealplan (which I have attached), complete it and place it on the fridge. Serve the meals and snacks every day around the same time with the expectation she would complete it. Don't be discourage if she doesn't immediately comply. Use incentives, such as extra time on her tablet or pocket money or tokens towards crafts (whatever interests her) everytime she is able to have a snack.

Ask her what she would be able to try first, afternoon tea or supper. I found that having supper later (say 9pm) my d was able to have it. It was as if she got a second wind later at night. Some carers here have found that a firm approach works for them (follow the meal plan from the beginning and using LSUYE - life stops until you eat), others have found that a more gradual approach works best for them (like me). So we introduced a small snacks one by one. When she is able to have a small snack (even if it is just a muffin), then you can increase the amount (muffin and a smoothie). Do this every day until she is able to have 6 meals and snacks. it took my d 7 weeks before she was able to have 6 meals a day, so be patient and calm (even if you have to fake it at first).

If she struggles to eat those snacks, get her just to taste it the first day, then take another bite the second day and build it up until she is able to manage the whole snack. The refeeding process is a marathon and not a sprint. It took my d 1 year of refeeding before she was back on her historic weight % curve.

Best of luck!

__________________
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.
tina72

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Reply with quote  #4 
Hi,
a very warm welcome from Germany and great that you found us. You will get a lot of help here, this forum was a lifesaver for us.
It is great that she eats better and that will help her to recover, but you need to fight all the things that she is still restricting. She needs to bea able to drink juice and milk again and she needs to regain the lost weight. Her brain needs fat and glucose to recover and work well again so please don´t cut out any food (she needs sugary drinks and snacks).
Remember: there is no unhealthy food, it is a question of amounts.
Why is it so important to have regular meals/snacks around the whole day?
AN patients often have problems with low blood sugar. If it increases quickly and gets down quickly again, they feel bad (we call that "shut down"). So therefor it is important to have at least every 4-5 hours something eaten (better every 3-4 at the start). That keeps the blood sugar level constant through the day and their mood gets better.

Ask whatever you need, here are always nice parents from all over the world nearly 24/7.
Tina72
teecee

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Reply with quote  #5 
Welcome amalr

You are off to a flying start. Very well done for introducing what you have so far. My D just drinks green tea (decaffinated now as per dietician advice - something to do with absorption of nutrients) and water.

Is she struggling to sleep at night and waking up hungry through the night or very early to have breakfast?

My D was extremely tired from sleep being disturbed so we helped her to understand that hunger through the night would go away if she had complex carbs for supper (between 8 and 10pm) - so porridge, whole meal bread/toast.

Keep going it will get better.
Virtual hugs. Xx
debra18

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Reply with quote  #6 
Does she have a problem eating at night? My daughter did. My husband always said it's not healthy to eat at night and this got stuck in her head. You will have to insist on it like you have to insist on fear foods and everything else.
amalr

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Reply with quote  #7 
Thanks to all of you for your words of wisdom. Had another unsuccessful night tonight and her distress breaks my heart, but I am trying to remember marathon not a sprint.
She says it is not about the time of day but I am not convinced. Maybe tomorrow.
Thanks again.
teecee

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Reply with quote  #8 
Well done for persevering. Gentle, calm insistence that “food is medicine” and that she needs to eat what you give is important.
I’m not sure if you are aware of Eva MUSBY’S book/website but if not I urge you to check out some of her you tube videos to encourage eating the ‘plate of snakes.’ Your D will be experiencing terror when she eats so it is our job as parents to reassure them that what you are giving is safe...much like you would do with a toddler trying to do something for the first time. Get her to copy you...if you have to sit there with a bowl of porridge at supper and show her what to do that’s fine. It’s worth a try.
Good luck. Xx
Mamaroo

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Reply with quote  #9 
Hi Amalr,

Eva Musby's book is just great. Here is a link to her website: https://anorexiafamily.com/ and one of her youtube videos:


I would suggest to keep her in the habit of having dinner and supper even if she is eating nothing at the moment. How are you eating at the moment? Is she sitting with the rest of the family and just not eating? My d couldn't eat with the family, so she ate in her room with me supervising or weather permitting outside on the varandah. I would tell my d she needs to try at the very least even if she just took a small bite. I would scoop a very small amount on the fork and then calmly tell her to place the fork in her mouth and eat the food. Incentives work well. Is there anything she would like to do instead of staring at a plate, such as playing on her tablet/phone, watching tv etc? My d would eat so that she could play on the tablet. The incentive should be something she can enjoy immediately after she had her meal.

If she continues to be distressed it is best to tell her to calm down in her room and that you would be back in half an hours time to try again. My d couldn't eat if she is very upset, so there was no point continuing.

Is she on any sort of anti anxiety medication? That might be something, which could help your d.

Hope today is better.

Sending you plenty of hugs!!!

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

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Reply with quote  #10 
Quote:
Originally Posted by amalr
She says it is not about the time of day but I am not convinced.


Most seem to find that ED gets stronger as the day progresses.  

I wonder if it would help for you to spoonfeed your d like you did when she was a toddler.  I was skeptical about that, but it really did help my d during the most difficult times.  And rewards helped.

Thinking of you. xx

-Torie

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