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martican

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I just listened to the podcast which is by the way very informational and sums up what this forum is about as well. My question is, how do I assess whether my D is at her healthy weight when, in her case, she has ASD and her rigid thinking, distorted perspective and cold relationship to food has always been there? Even as a small child she never had hunger cues, eating was a nuisance to her, and was mostly a temperament-gifted child. She was developing fine physically wise, always on 50%-ile, then at age 6 dropped to 40%. Now at 15, wr for over a month she is a bit over 60%-ile but she is still not a fan of eating most of the time and wishes to exist without it, or just eat less.  Despite that thinking she knows the drill, and eats much better than in her entire life - with my supervision and plating. She desperately needs to work on her coping skills which we are doing through DBT - being a teen magnifies all the skills she lacked, in retrospective. 
I thought we are on a good track, and with patience and therapy we will reach the cognitive goal. The podcast made me wonder: what is that mental state goal in such case? I'd love your input.
mjkz

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I thought we are on a good track, and with patience and therapy we will reach the cognitive goal. The podcast made me wonder: what is that mental state goal in such case? I'd love your input.


This is often why I say the definition of recovery isn't the same for all kids.  My daughter never regained hunger cues.  If we kept trying intuitive eating, she would stay sick all the time because she just never gets hungry.  At least with my daughter, she will always have to give eating more thought than the "normal" person.  She has a meal plan and knows what a meal and snack should look like. She is able to be flexible with that and pick the things that sound good to her in the moment to fit that overall meal plan but she knows exactly how many servings of fruit, dairy, starches, fats, proteins, etc. that she has to get everyday as a minimum.  That having been said, she also knows that she can go over if she wants too so let's say she finds something she likes and wants more of.  She will take more of it and go over the minimums but she knows there is minimum.  Times of stress and chaos, she relies more heavily on making sure she gets all the minimums and may have to make up something at the end of the day.  She too would rather just eat one big meal and get it over with but knows she can't be healthy doing that.

We have been able to build in variety and get rid of the rigid rules she used to have-she used to eat the same thing everyday with no varying at all.  She has taken over the responsibility now of making sure she meets the minimums and keeps her weight at a healthy historical curve for her.  It has been so much easier now that she isn't growing anymore.  My daughter while still growing couldn't eat enough so I had to be there to keep pushing bigger portion sizes, etc.  I would love to say she never has thoughts of restricting but I don't think that is realistic for my daughter.  Food has always been an issue and a struggle that she would rather like your daughter just not have to deal with.  She eats in spite of the feelings she has and now knows to look at what she is avoiding in her life when she starts having trouble with eating.

My daughter doesn't have ASD but has OCD, depression and struggles with BPD issues although the BPD issues have lessened so much since she has been in a healthy weight range and her depression has been well controlled.  I'm pretty darn happy with where we are now and I know she is too.  Dealing with comorbids may have changed our personal definition of recovery but it hasn't prevented us from achieving it.
martican

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Thanks mjkz. Sharing how you achieved your D's recovery gives me a more clear direction as to what I should be looking for - her full rational understanding what her body needs and following through whether she enjoys it or not. Luckily, she doesn't mind variety in her nutrition - her rigidity is transparent more in her outlook at life, her values in general - which, many moms claim, disappears in recovery.
I have to customize our picture of recovery to our own scenario. Thank you for inspiration! 
hopefulmama

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Martican - 

I always LOVE Dr Ravin's blogs.  I think this one is so good at addressing some of the issues you are dealing with:

http://www.blog.drsarahravin.com/eating-disorders/after-weight-restoration-envisioning-recovery/

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martican

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Hopefulmama - THANK YOU! I needed to read this. Very very helpful. This article has answers all my questions. 
sandytoes

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Originally Posted by hopefulmama
Martican - 

I always LOVE Dr Ravin's blogs.  I think this one is so good at addressing some of the issues you are dealing with:

http://www.blog.drsarahravin.com/eating-disorders/after-weight-restoration-envisioning-recovery/


I am really surprised by one part of this article. I have never heard anyone (professional or caregiver) say that a person could still be considered ‘recovered’ from AN if they never ate sweets or junk food again. I thought that was just another form of disordered eating? Orthorexia?

Thoughts?
mjkz

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I am really surprised by one part of this article. I have never heard anyone (professional or caregiver) say that a person could still be considered ‘recovered’ from AN if they never ate sweets or junk food again. I thought that was just another form of disordered eating? Orthorexia?


I think the degree has to be taken into account.  For example I know a lot of people who don't eat sweets or junk food but they are not eating disordered or have orthorexia.  My daughter is one who doesn't eat sweets or junk food naturally.  I think the difference is that if she is at a party for a birthday, she is flexible enough to have some cake (can't do ice cream due to lactose intolerance) and be okay with it.  Left to her own devices, she wouldn't eat sweets and has always been like that.
melstevUK

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Martican,

This for me is a key statement in Dr. Ravin's blog:

"What is most important, in my opinion, is for a person in recovery to do whatever it takes to live a rich, happy, healthy, fulfilling and productive life. This is what recovery means to me."

One of the difficulties for us as parents of children with an eating disorder is that we focus so much on getting weight restored or stopping b/p behaviours that we imagine that if we can get this bit of the picture sorted, eveything would be fine.

But for any child moving through adolescence to adulthood there are all kinds of obstacles to overcome, social settings to negotiate and decisions to make about the future.  And as loving and responsible parents we do our best to support our children through that transition period.  If there are other conditions or comorbids, then these also need attention and if your d has been diagnosed as having ASD then this clearly has a bearing on the situation. You are doing all the right things in getting her support with coping skills - but ultimately her brain has to go through huge development and the 'cognitive goals' are shifting all the time.  How she feels and thinks about things will be different in ten years time.  

For me, you seem to be doing everything right in terms of ensuring that your child will become a capable and functioning adult, all while maintaining support around the eating disorder issues and weight gain, which is still a moving goal as she moves through the teenage years. 

I think you need to congratulate yourself on how far you have come and everything that you are doing to ensure your d keeps moving along that recovery path.

We had a wonderful parent on here who, very sadly we lost, called Charlotte.  But she had a great expression when parents were either in a state of crisis or overthinking, which was:

'Breathe!'

I think you need to cut yourself some slack and do that.  You're doing great!


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martican

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Reply with quote  #9 
Hello m.e.l.s.t.e.v. (I had to put your name this way, writing from my d's device and the autocorrect keeps changing it to Meister. I don't have time to figure where to switch it). 
Thank you for your encouraging words. Your outlook makes perfect sense. We have great support in place for her, not only ED related, and I am coming to realization that the only two factors I just have to let work on their own is patience and time at this point. She is so different from last year, and imagine the difference in maturity next year ... and next... just like you are saying. She is only 15. I can only compare her to herself, not anyone else.
With that said, I am off to cut myself some slack ... and a piece of cake and breathe [smile]
martican

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Reply with quote  #10 
Sandy toes (lol another autocorrect issue)
Your question - my thought is this: people's taste changes over time, and since AN takes so long to recover from, it is possible that whatever was your favorite food when you were 15 might not be anymore when you are 20. I avoid sodas( due to their sweetness), heavy fried food, or candy. They were my fave  foods when I was a teen. I am not AN, nor Ortho. 
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