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frazzledmum

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Reply with quote  #1 
I have been lurking here for a couple of weeks now, my D, 17, was diagnosed with anorexia at the end of July, I became worried during her exams and got her straight to the GP. We have been really well supported by the NHS and, reading other posts on here, feel so lucky, but it is still such hard work.
I have read that children should not help prepare meals but do not know how to get D out of the kitchen, as she is 17 she should be taking some responsibility for her own food, but at the same time it is impossible to sneak butter/cream etc into her food. I have also read that for older kids the 'not helping in the kitchen' rule can be modified and allowing her to help prepare meals makes it more likely she will finish them. Does anyone have any experience of how to handle this? Also, I know she should be eating full fat yogurt etc, but how do I do that when she reads all the labels (or finds them online if I hide the labels)? She doesn't always come shopping with me, but sometimes it's helpful as she is more likely to eat food that she has chosen. I have tried magic plate, that led to a 5 hour stand off, then she took an overdose and ended up in A&E, so I am unwilling to do that again. Negotiating a meal plan seems to be working a bit better. 
I have tried Eva Musby's calm encouraging voice and got told to stop talking like a robot, she's not 5.
After a meal, she is very angry with us (especially me) and herself for eating, and just withdraws. It's easier to handle her anxiety as then she wants to be close to be comforted.
She has lost about 12kg (20% of her body weight) in 2 1/2 months and we have been told she will be hospitalised next week if she doesn't stop losing weight, so now I feel like a failure, I mean, it's page 1 of how to be a parent-feed the kid, and I can't even do that.
Sorry for the ramble.
HateEDwithApassion

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Reply with quote  #2 
Hi,
I'm so sorry you are here. I just wanted to tell you that you should not feel like a failure. Magic plate and life stops work very well with younger children, but as kids get older and close to being young adults, it's harder to do it. A number of parents on here have accomplished it and many others - myself included - are not having success with our older kids like we did before.  My D too has refused to eat hardly anything for days. And is back in that place now.

So, please - this is not an easy disease and there are a lot of ways to "skin the cat" that have worked for all different families. Your child is different from mine and what works for one may not work for another. 

From a practical standpoint, if your D is willing to eat your meals, can you make some of them the night before - or at least partially - so you can add in whatever you need and don't have her standing there watching? I've made mac n cheese ahead of time and put it in the fridge. Or even oatmeal etc. That might be one way to alleviate some of her kitchen watching. 

Hang in there. Many other will be here to help. [smile]


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17 yo D. Diagnosed in July 2013. W/R in Sept. 2013 and has remained so. Roller coaster on and off since, mainly with ED under control but co-morbid depression and other negative coping mechanisms making our life hell. Trusting in God for daily strength and wisdom.
frazzledmum

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Reply with quote  #3 
Thank you so much for replying, I do appreciate it. I try to prepare meals when she is not there, but she just wants to eat 'plain' food, not processed, or even things that need to be 'put together'. Yesterday it was a drained tin of tuna and a boiled potato (very small, if I cut them up she refuses to eat them as it might be more than just the 1) for dinner. She only ate the tuna as the Dr told her she needs to eat fish or meat or eggs- she's been vegetarian for 18 months now. I really don't want to sound ungrateful for your reply.
Kali

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Reply with quote  #4 
Dear Frazzledmum,

I wanted to reach out to you because my daughter was also diagnosed at 17 and it sounds as though you are grappling with some similar things. As they say on ATDT, welcome to the club no one wants to join. Feel free to ask any questions you may have.

First, do not feel that you are somehow a failure because she is struggling so much to eat at the moment, and do not feel that you have failed if she needs to go into the hospital. She has an illness. My daughter was in the hospital/ed unit for nearly 3 months and I think it saved her life. In any case, it was the beginning of being able to help her make progress against the illness. Your daughter will need to be weight restored and start eating enough again, and it doesn't matter where it happens; at home, in the hospital, or in an eating disorder program. You ARE successfully helping her by making sure you have a professional team in place to monitor her, and trying your best to find out how to manage the situation and becoming well educated about eating disorders.

Quote:
I have read that children should not help prepare meals but do not know how to get D out of the kitchen, as she is 17 she should be taking some responsibility for her own food, but at the same time it is impossible to sneak butter/cream etc into her food. I have also read that for older kids the 'not helping in the kitchen' rule can be modified and allowing her to help prepare meals makes it more likely she will finish them.
 

I too thought in the beginning that it would be good for my d. to take more responsibility for cooking, shopping, etc since after all she was 17 and verging on adulthood and should learn how to feed herself. And in every way except for when the situation had anything to do with food, she was so sensible, articulate and intelligent. That makes sense, right? Only it didn't work. We argued about what was in the meals, and also had issues with loooonnng booooring arguments about 1% milk versus whole milk, etc that made me just want to bang my head against the wall. After realizing that we were going nowhere fast like this I just bought the full-fat products and served them. When she complained I told her that was what we had in the house and changed the subject to something that had nothing to do with food. I didn't serve the yogurt in the containers but put it in a bowl.

So get her out of the kitchen. Send her on an errand. Ask her to walk the dog if you have one. Encourage her to binge watch her favorite tv shows while you are cooking. "Friends" is a great TV distraction, for example, if you can get it where you are and it has 10 seasons. Encourage her to have her friends over in the late afternoons while you are making dinner. Make her breakfast before she gets up in the morning and wake her up to eat it. Give her a morning smoothie with yogurt, milk, honey and fruit.

And don't worry magic plate didn't work for us either at first when she was critically ill, but later on when she was further along in the process, she did finish her portions. After she was weight restored we did use a meal plan for a while however the meals had to have enough calories and be truly nutritional in order to be on the plan. I wouldn't let her negotiate for anything with lower calories, etc, but it seemed to help with her anxiety if she knew what to expect and we certainly chose recipes that she preferred eating.

Ok so she will eat tuna and potatoes, which is great. Can you get a fresh piece of tuna and serve it broiled with some lemon and dill or a caper sauce? And accompanied by a french potato salad (doesn't have mayo) but tastes really good?

Here are some recipes (just substitute the chicken broth with veggie broth):
http://www.foodnetwork.com/recipes/ina-garten/french-potato-salad-recipe-1914223

https://www.thespruce.com/broiled-tuna-with-lemon-caper-sauce-3056855

serve with some oven roasted asparagus (drizzle the asparagus with olive oil, salt and pepper).

If she complains that things are not how she wants them, (plain tuna and one small potato cut up) try saying "This is what we have" then change the subject to something else that your daughter finds interesting. Or ask her to put some of her favorite music on if she has her phone handy that you and she can listen to while eating for example. Or talk about something fun she has planned in the near future.

sending warm support,


Kali

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melstevUK

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Reply with quote  #5 
frazzledmum,

Welcome and sorry you had to find us.  This illnesss scares the hell out of us and suddenly we have a child who is no longer the one we knew.

You have a team which is willing to hospitalise your d - at this stage take up that offer and get her into hospital.  You are already trying to get to grips with fighting all the irrational behaviours of an illness which does not respond to reason.

Tell your d straight that she is seriously ill, she cannot comply with eating what she needs to eat at home and that she needs to go into hospital because you alone on your own can't take this illness on.  Let her know that you understand what you are dealing with, forget the guilt - just get her into a place where you have a whole team to deal with it.

While she is in hospital youcan get a rest and get your head around what you are dealing with.  Just get her somewhere where she will be safe, will start eating and putting on weight. Tell her you love her and that this needs to happen

She is actually likely to be reassured by your confident stance because right now she is fighting a voice in her head which will not let her eat.  Don't get involved with it - just let a team take her into hospital and start treating her.  These offers are often hard to come by - so take that opportunity.

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toothfairy

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Reply with quote  #6 
Hi Frazzledmum,
Welcome from Dublin.
I think its important to note that our kids cannot be given age appropriate independence with cooking and choosing food.
Allowing her shopping and choosing low fat etc is feeding into the anorexia. I advise you to throw anything out of your house that says , diet , low fat,etc
A 12kg loss in a short time like that is very serious and she could be medically unstable or become medically unstable very quickly.

As she is 17, there is a very short window until she is 18 and can refuse treatment. This illness takes a long time to deal with so I advise you to take immediate action.Do not wait.
The vegetarian thing has to be dealt with too, it is likely that that is part of this illness.
Honestly from what you have posted, given her huge weight loss and age, I would grab an IP bed with both arms....they are hard to come by and things will likely change dramatically as soon as she is 18.........
or if you are going to do this at home than here are some FBT guidelines....


Many of us (not all) here follow (or have followed and been successful with) the Maudsley approach (FBT), which follows these guidelines:

1. You prepare meals

2. Do not allow your child in the kitchen during meal prep

3. Your child should not go grocery shopping.

4. Toilet before meal and no toilet for at least an hour afterwards.

5. If purging is suspected, use an open door policy in the bathroom, or have them count or sing whilst in there. And no flushing

6. Do not negotiate - whatever you serve has to be eaten

7. Use whatever leverage you have - phone, Internet, tv - whatever they hold dear is to be removed if they refuse to eat, until they have eaten. If they're older and are not financially independent, this is your leverage

8. Separate the two - Your child is not the ED

9. Detach yourself from the situation during meals. Do not get drawn into emotional discussions. THIS IS NOT UP FOR NEGOTIATION

10. Remember that your child wants to recover - the ED is stopping them

11. Your child needs your permission to eat. They need you to stand up to ED as they do not have the strength to do so themselves

12. 3 meals and 3 snacks per day (supervised) - do not deviate from this. Add time limits to the meals (as a guide/goal!). Ours (and the hospitals) was 30 mins for meals and 15 mins for snacks. In the early days this could extend A LOT. I made my Ds meal times the same as they'd be at school so that when she transitioned back to full time it would be easier and less anxiety provoking.

13. High calories are needed throughout refeeding with lots of full fat dairy. Some need as much as 6,000 cals with hyper metabolism, but the norm would be minimum 3500-4000 cals (for you to track not your child)

14. When they know you will not negotiate, I promise you will see the weight lifted from their shoulders... If only for very short periods

15. BE THE CAGE that keeps ED away from your child

16. When food is eaten be mum / dad again and have cuddles if they'll let you

17. 24/7 supervision - I slept with my D for 4 months - this will protect against them purging through vomiting or exercise. Many patients will exercise alone at night for hours on end when nobody else is awake.

18. All sport may need to stop in the early stages, and
for those who compulsively exercised this could be long term.

19. Be consistent, consistent consistent!

20. Don't congratulate them after a meal or say 'well done' - just cheer inwardly! Likewise when (for girls) their period returns!

21. Learn from others. I found this website with stories of other parents journey through recovery to be extremely helpful - http://www.maudsleyparents.org/familystories.html

22. Recommended reading: 'Brave Girl Eating' by Harriet Brown

23. Be prepared for resistance, and lots of it! You will find your own way to manage this, but NEVER back down. Any compromise is a win for ED. Remember, you have to see the beast to slay beast!

24. Making decisions / choices is extremely difficult for them (painful to watch). This is true in areas outside of food too. If you've tried to hand over some control of a meal or snack and notice that they are struggling, that is an indication that it is too soon and that you need to be making those decisions for them.

25. Sometimes distraction helps during meal times. That can come in the form of games,TV, music. Whatever it is you control it and it only continues with eating.

26. Lean on us - you have 24/7 support here as FEAST/ATDT  is international

27. In some cases FBT isn't an option, generally if there are comorbids such as ASD and BPD (Borderline Personality Disorder) . It may just be that FBT needs to be tweaked, or that a different approach is needed. There are many here who have found ways to work around those comorbids or who can advise on an alternative approach which worked for them.

Hope this helps! Best of luck!
 



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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
frazzledmum

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Reply with quote  #7 
Thank you all for your answers, you have made me realise that an IP stay might not be the worst thing in the world and I am lucky to have the possibility. We'll see on Wednesday. I think what I'm wondering the most is, will she pick up any 'bad habits', she did say once that she tried to make herself sick after a meal but didn't know how to, is that something she might find out in hospital? Then we would have even more problems.

Thank you as well for the recipes and telling me to get her out of the kitchen as well. Sometimes you just need reassurance so you can pick your battles.

So glad I found you all.
Torie

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Reply with quote  #8 
Hi Frazzledmum - so sorry you needed to join us here.

You asked if there are risks in hospitalizing her and honestly there are always risks no matter what you do.  There is just no risk-free path in life, especially when dealing with this vile illness.

I agree with the others who have encouraged you to take a tougher stance regarding menu options.  First, the options she is insisting on will make her sicker and sicker so that has to stop.  Second, when she comes back home after hospital, you will need to keep feeding her enough so that she keeps gaining weight - that's not gonna happen with her rules.  She needs to see that her rules don't cut it at home; otherwise she will dig in her heels again as soon as she gets back.

This is a horrid, horrid illness.  But it does get better.  Hang in there. xx

-Torie

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toothfairy

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Reply with quote  #9 

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #10 

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
frazzledmum

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Reply with quote  #11 
Thank you for the videos, they really hit the nail on the head!
toothfairy

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Reply with quote  #12 
no prob 
here are a few more....

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #13 



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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
frazzledmum

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Reply with quote  #14 
The parent to parent video is brilliant. Thank you for linking it. We had our appointment today and she hasn't lost any more weight, which is a huge relief, though it did make her quite angry. There is a school trip in July next year which she wants to go on, so she'll have an incentive to gain weight. Came home and had an argument about the size of a potato....Though I suspect this was mainly because she's not lost more weight, I can see this becoming a big problem. Still struggling to get her out of the kitchen when I'm preparing food.
toothfairy

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Reply with quote  #15 
This might help


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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
Torie

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Reply with quote  #16 
So glad to hear she didn't lose weight this time.  Yay!

You said, "There is a school trip in July next year which she wants to go on, so she'll have an incentive to gain weight."  Incentives are good, but usually they need to be very short term.  Like, for example, every time she eats a new item, she gets $1 credit toward the trip.  Or 1/2 hour of Internet.  Or whatever.

Keep up the good work. xx

-Torie

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

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Reply with quote  #17 
Yes, that's a good idea, the Drs said the same. There are other things in the meantime for her to take part in if she's well enough. At the same time though, I don't want to end up constantly bribing her to eat.
Husband is now being a bit awkward, saying if she doesn't eat what the drs say, it doesn't matter, she'll be the one to suffer the consequences. I do think this is partly because he wants her to be friendly with him, but also he doesn't have my tenacity, so now I feel I'm battling them both.....
toothfairy

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Reply with quote  #18 
Hi,
I am guessing that your H has no idea how vile ans potentially deadly this illness is.
Your Daughter has a severe brain illness,and food is her medicine.. 
There is a very high death rate with this very serious illness, the same as childhood cancer,,,
If she does not eat, its because she cant eat, its not a choice..her disorder has control of her and is bulllying her not to eat, and is trying to kill her.
Many of us were forced to take major action and our kids hated us, but really its the illness...not the kid...and when the kids are better many thanked us for   fighting for them against the ED, WHEN THEY COULDNT....
Very aggressive intervention is required now, and I cannot stress strongly enough to act now as she is 17. I have seen so much heartache over the years when peoples kids turned 18 and refused any more treatment, it is devastating to say the least....

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Reply with quote  #19 
http://www.nytimes.com/2006/11/26/magazine/26anorexia.html?mcubz=3
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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
NellyMac_UK

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Reply with quote  #20 
Just want to say, our D was diagnosed at 16 and we were told she would be admitted for ng feeding the next week if she continued to loose weight, I took her home and spoon fed her. I really felt desperate to keep her out of IP, but with hindsight I wish I had let her go as she would have got intensive therapy.

I would find out about the facility they are considering and what they offer.

If you are in UK getting a bed in these facilities is very difficult so I would grab it.


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Torie

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Reply with quote  #21 
Quote:
Originally Posted by frazzledmum
At the same time though, I don't want to end up constantly bribing her to eat.


I'm sorry, but this confuses me.  Would't constantly bribing her to eat be the least of your troubles?  When she is well again, she will not want or need the bribes any more.  While she is sick ... well, if it helps, why not? xx

-Torie

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

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Reply with quote  #22 
Yes, Torie, you're right, I am overlooking common sense here, of course she will not need to be bribed to eat when she's well, I guess I am too bogged down at the moment to have any common sense left!


frazzledmum

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Reply with quote  #23 
I strongly suspect that is the reason they haven't hospitalised her, there are no beds. D did mention that when she came home from one appointment that I wasn't able to get to. Maybe she is not ill enough. I have now come to the conclusion that if there is a place for her, then it is better for her to go now rather than wait until she is 18 and we have no say in the matter.
toothfairy

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Reply with quote  #24 
You may need to fight tooth and nail to get what you need, I advise you to contact them immediately..

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
frazzledmum

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Reply with quote  #25 
Yes, maybe, I am trying to persuade him that he needs to back me up rather than wander off. I think he's having trouble dealing with it (having said that, don't we all?), but all I'm asking for is back up, not 'I'll tell the Dr.', it's too late then.
He should have an idea of how awful this is, as his sister was anorexic, back in the late 70s, the only help they got was an understanding GP not used to dealing with ED.
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