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Reply with quote  #1 
This is my first post on this forum. My daughter was diagnosed with anorexia in the Spring of 2016. She was at the time a pretty typical 14 year old high schooler who spent 1/2 of her day at a Culinary School (hindsight) The rest of our story is mirrored in so many of the posts on this forum from total lack of knowledge on the part of our very educated pediatrician to an ineffective therapist and nutritionist team (she got worse and worse). Her period ceased and she became very withdrawn. When I decided through research that FBT made sense to me, I found an FBT therapist and away we went. Although my daughter hated going and FBT was shocking and scary, she is currently weight restored., mood good and period returned. My question is this: We technically only made it through Phase 1 (she will not go back and I too believe that the sessions stopped being effective) She now chooses her own breakfast, I make her lunch and we eat dinner together. She chooses her snacks. I weigh her weekly with a contract that if she doesn't stay in the recommended range or skips a period we will begin to give her meals again and no physical activity (soccer). We've had to do that 1 time. She eats welll but still not ltotally like a normal teenager if there is such a thing. She still talks about eating "healthy" but eats a wide range of food willingly. I am wondering if there is a reason not to continue in this manner regarding the fact that we are doing this unsupervised.

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Reply with quote  #2 

Don't mess with success.  You are doing pretty well for just a year in.  The one thing I say to everyone at this stage is don't move too fast.  It takes a LOT of time for truly intuitive eating to return.  For a lucky few it's within 12-18 months, but I will say that based on my 4 years here, this is very much the exception but not the rule.  Average probably runs 2.5 to 3 years.  Our case was almost precisely 3 years when the switch truly seemed to flip on.  We spent about a year in the trenches, but then progress stalled.  Not really going backwards, but also  not moving ahead.  We kept plodding along, giving small levels of control back little by little.  

So, I would say you are doing a great job.  If it's working, and she keeps being able to take more and more control, then you are on the right path.  If you stall, there are wonderful options for pushing you over the finish line.

One other thing....since you seem well versed in this stuff, I'm assuming that you are aware that her weight needs to continue to increase each and every year.  So, being in the "same" range is losing ground.  Teens gain weight each and every year until they reach their early 20's.  Our ultimate success happened when we pushed a range that seemed ok when we first reached it but then "stalled."  We added 10 pounds to that range, and it made an enormous difference.  I had mistakenly assumed that the range given when she was 13 was still good at 15 or 17.  Not.  :-)

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.  :-)

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Posts: 4,095
Reply with quote  #3 
Welcome, gubs.  Sounds like you and your d are doing really well.  Congrats!!

I agree with mnmom in that it's important not to rush things.  You want your d in the strongest recovery possible when she hits that magic age of 18 (or 17) and prepares to spread her wings - sounds like you have plenty of time, but it will be here before you know it.  So it's prudent to stay vigilant - very vigilant - to try to nip any backslide in the bud.  One step at a time - slow but sure wins the race.

I trust you are aware that you need to take precautions when weighing so that this vile illness has no opportunity to trick you into thinking she weighs more than she does.  So many have been taken by surprise on that.

Please feel free to ask all the questions you like - we're glad you found us. xx


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

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Posts: 778
Reply with quote  #4 
Hi there,
Welcome and congratulations on getting this far in such a short time.
So your D is now 15, right.
My advice to you is to plate and semi supervise as many meals as possible until she leaves home.
It takes a very long time to heal the brain.

I have read articles on this by  Prof Janet Treasure and Dr Julie O'Toole AND BOTH advise that you do not hand back control until they are much much later into recovery or leaving home. Pity I just cannot find the articles right now.

Her is a similar one though.

One other thing, a lot our our kids were given recovery bmi targets of around 19, including my son. This is not high enough for many of our kids, and stalls real recovery sometimes.....just thought I would mention it..

Son,DX with AN, (purging type) age 13 in October 2015 ,  (4 months immediate inpatient) ,  Now Phase  2 , making progress every day. Living life to the full like a normal teen. We are not out of the woods yet, but we can see the light at the end of the tunnel, thanks to ATDT.

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Reply with quote  #5 
Welcome to the forum!
You have done a great job so far. One thing my years on the forum have taught me is that there is no one right way to do this. Traditionally phase one of FBT is re-feeding and is not at all adolescent focused, phase two is handing back control of food so that the young person is eating independently again, while phase three is resolving any issues the young person may have. It is only in phase three that you would necessarily expect D to feel that she was benefiting from her therapy. That is not to say that you need to complete the course, but her lack of "benefit" may be because she has not completed it. 
If things are going well and she is continuing to gain and slowly develop independence in eating then she is doing what she needs to, you can always go back to therapy later if needs be. As others have said though many need more weight than "expected" and ED has a bad habit of lurking in the background presenting as relapse some years down the track so it is essential to stay vigilant. 

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.
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