F.E.A.S.T's Around The Dinner Table forum

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

lovingmommy
Hello all,

I have been lurking recently on this forum, but our situation is getting worse and I desperately need advice. 

My d is 21 and a sophomore in college (USA). She was diagnosed with AN at age 17. She took a gap year before college for treatment and was weight restored and seemed to be in a better headspace. However, after seeing her during spring break, it is clear that she has relapsed. She won't tell me her weight, but she looks similar to how she did when her BMI was in the 16's. I have been unable to sleep as I am so worried that she will decline further. She denies having a problem, but obviously that is her ED talking. 

I am not sure what to do. She only has a month left of the semester, and she would be devastated if I pulled her out of school now. But, I am very worried that she will decline further which will make weight restoration even harder. She struggled with severe anxiety and her ED in high school, but she worked so hard and managed to get into an Ivy League university! I don't want to force her to transfer to a school closer to home because it will make her feel like a failure. (She has very low self-esteem.) I also am unsure about what to do about treatment. Since she is an adult, I can't force her to go to residential. When she weight-restored years ago, she ended up bingeing a fair amount. I am worried that if I re-feed her at home this summer, she will end up binge eating, setting her up for another relapse. 

I would be extremely grateful for any advice and/or personal experiences with a college-aged d. Thanks in advance for sharing your wisdom!
Quote
tina72
Hi from a mom of an also adult d (19) with AN and being in her first year at University. Sorry that you have to be here but I am sure you will get great advice from other parents with young adults soon.
First questions:
Who pays for college? If you do, you have some power left to set the rules for that. No matter if she is adult or not. You do not pay a senseless year for a sick person. We have a contract with our d what we do for her and what she needs to do to make us do that. She is 2 years in recovery now and doing great but we still have some alarm system alert.
Can you probably go and live with her for that next months to make sure she eats for that time and take her home when the semester is finished? She will need at least a sick leave semester or year. And you are right that it will get harder the longer you wait.
Keep feeding. There is light at the end of the tunnel.
Quote
US_Mom
My D was in college in US when diagnosed. She entered an IP program. The program informed her instructors. All of her instructors allowed her to finish her classes online. I think colleges are, unfortunately, used to dealing with health issues of students, particularly mental health issues. If your D doesn't enter a program, possibly a therapist, psychiatrist, or family doctor could provide a letter that would allow her to finish classes at home.  She might be more willing to accept the help if she knows this is possible. It eased my D's mind as school was all she felt she had at the time. Hope this helps! Thinking of you and your D and praying.
Quote
lovingmommy
tina72 wrote:
Hi from a mom of an also adult d (19) with AN and being in her first year at University. Sorry that you have to be here but I am sure you will get great advice from other parents with young adults soon.
First questions:
Who pays for college? If you do, you have some power left to set the rules for that. No matter if she is adult or not. You do not pay a senseless year for a sick person. We have a contract with our d what we do for her and what she needs to do to make us do that. She is 2 years in recovery now and doing great but we still have some alarm system alert.
Can you probably go and live with her for that next months to make sure she eats for that time and take her home when the semester is finished? She will need at least a sick leave semester or year. And you are right that it will get harder the longer you wait.


Thank you for your advice Tina! Yes, we do pay for college, so I will certainly refuse to continue paying if she does not weight restore. A contract is a great idea. If you don't mind me asking, what does your contract entail? Unfortunately, my husband is currently on an extended business trip in England, and I have a 15 year old at home and cannot leave her alone. We are only a 3 hour train ride from d's school, so I think I may insist she comes home on weekends so I can keep an eye on things for now. 
Quote
needhelp
Hi lovingmommy,

Our ds are very close in age - my d is also in her second year of college.  I learned a lot of safeguards from this site to put in place before sending her back to school (she had to come home second semester last year - but was able to continue with three of her classes from home - we drove her out (about 4 hours) for tests, and worked toward letting her stay 2 nights (that was tough) -- and she did go back for finals.  There are only a few weeks left of school - so maybe you could go on the weekends?  I don't know your situation - but having my d home was very difficult for my younger daughter (also a teen) - since it was not the sister she knew.  
Over the summer she was WR, she worked, and took a class - but had a very intense private therapy program (about 4-6 hours/wk).  Before she could go back to school we made it clear that she must eat a breakfast, carry snacks (we didn't want her to feel hungry - not be able to eat, and start getting into that denying the hunger pattern), and she had to see a counselor weekly.  This was key because we needed a knowing set of eyes on her weekly.  Because she was already eating breakfast (she was not allowed to drive if she didn't eat -- Tina's strategy of if you're paying - you can make the rules is vital!!) - we thought we were OK.  Unfortunately, that dwindled to an apple.  She was eating throughout the day - but that wasn't a good way to start because she was hungry.  That has finally changed.  She lives in an apartment - and having a kitchen has made a huge difference.  If possible - having that counselor set of eyes on her has been very helpful.  It doesn't mean everything has been perfect - but it does mean she was given guidance, and when needed, we were notified.  
The other suggestion I would share is to make sure she has a schedule over the summer - work, class at a community college (sometimes non major classes can transfer in a pass/fail way - like a PE class, or something not required- so not stressful).  It's much easier to have an eating schedule when you actually have a schedule.  Not a crazy every minute schedule - but something to do each day for an amount of time.
Finally - I watch my d's social media - and really look closely at her pix.  I am friends with many of her friends - so I can see her in pix that she doesn't post -- just another way to keep on eye on her.
I learned on here to sit down with her before going back to school and really explain in no uncertain terms what the expectations were - especially as far as the counselor.  I must receive a receipt from the counselor after each visit - she must go every week. Also, because she performs - we have had the opportunity to go see her several times a semester - but don't forget things like parents' weekend, football games, and anything else that lets you get an actual glimpse and hug - and of course a real feel for how things are.  
I am really hoping the next month goes well for you and your D. Believe me when I say I understand much of how you feel - it's scary when they are away.  Does your D call you?  If so, I also understand what those crying calls are like.  Fortunately, if you feel she can finish the semester - she only has about a month left.
Wishing you only the best.
Quote
sk8r31
This sounds like a pretty stressful situation for all of you.  Unfortunately, medical leave may be necessary.  The added stress of final exams, coupled with trying to get the ED situation under control could mean a disastrous and medically dangerous situation to come in the next month.  I would do everything possible to get a handle on things quickly.  Get in touch with school counselors, treatment providers asap. 

I know all too well how quickly a situation can turn dangerous.  While on a month's vacation overseas, our d reduced her intake substantially....still eating & drinking, but not enough.  She didn't look unhealthy, still within what would be considered a 'normal' weight range for her height, but the rapid weight loss over the month meant that I returned home with her, and she was immediately hospitalized for medical stabilization for a week.  Things can go rapidly downhill with continued weight loss... 1-2 lbs a week can create orthostatic blood pressure, and reduced heart rate among other dangers. 
 
School work may be able to be completed online or within an extended period; school is not the most important thing at this point.  Your d's health is the priority.  When she is ready to return, a strong safety net should be in place.  We had a contract, spelling out exactly what would happen with a certain weight loss.  For example, with a 5 lb loss, there would be 2 weeks to self-correct, or mom arrived for meal support.  More than 5 lb loss, or failure to turn things around within 2-3 weeks, and d would return home.  We had an 'eyes on' visit once a month, and later on, an RD who worked with our d's medical provider & who had a lot of experience with ED clients, with whom she checked in every couple of weeks for a few months.  RD created a 'pinterest' account with meals my d could cook and so on.  She basically said everything that we had done as parents, but coming from a 'professional' it was more easily accepted.  

Wishing you all the best as you navigate this challenging situation.

Warmly,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Quote
Kali

Dear Lovingmommy,

I'm sorry your daughter is struggling. I also have a college age daughter the same age as yours.
Here are some of the things I tried when she was not doing well and had a bmi similar to what you describe. We also found ourselves near the end of the semester and I had hoped she could finish, however I was really concerned because she was going downhill very rapidly and had suicidal ideations.

I offered to take time off from work and stay near her so that she could finish the semester; my stipulation being that she would need to eat her meals with me. (When she was unable to do that—and I realized how little she was eating, I did end up bringing her home). Are you able to go up and eat with her? Could your other child stay with friends while you spend time with for your daughter? 

If you are with her and can see first hand how her eating is, it will become clear to you what choices she has.
Whether to finish up the semester, or whether to come home and resume treatment.

There is also a group called eating disorder recovery specialists who will do meal support and they do work with college students. So basically they would send someone to eat with her and she could meet them wherever she wanted to and they would be discreet. I believe that they do have some arrangements with insurance companies. I had considered them at one point and I think it is a great idea. 

http://eatingdisorderspecialists.com/programs/campus-companion-program-college-students/

Is your daughter seeing a therapist or an ED team? It sounds as though perhaps she could benefit from an evaluation.

And basically since you are helping to pay her college expenses, you can insist that she maintain a weight restored weight for her and that she remains in treatment as long as she needs to. 

Another very helpful organization is Project Heal. They offer groups and mentorship and are located in a number of different cities. 

Understand also that universities will allow students to take a medical leave of absence and then come back when they are able. So if she does need to leave, if you make sure the proper paperwork is filed with the school and then go through the procedure for re-entry when she is able, she can resume her education. At the school my d. attends they were actually great; upon her return they REQUIRED that she be seeing an eating disorder team on a regular basis, and that she stay in treatment and that she have her doctors sign off that she was well enough to return. That, along with me insisting that she maintain her weight in order to be able to be there, meant that she had a firm framework in place to keep her somewhat on a recovery path. So even when she faltered—and she did—there were safeguards in place and she has been able to be successful.

warmly,

Kali


 

 

Food=Love
Quote
tina72
lovingmommy wrote:

Thank you for your advice Tina! Yes, we do pay for college, so I will certainly refuse to continue paying if she does not weight restore. A contract is a great idea. If you don't mind me asking, what does your contract entail? Unfortunately, my husband is currently on an extended business trip in England, and I have a 15 year old at home and cannot leave her alone. We are only a 3 hour train ride from d's school, so I think I may insist she comes home on weekends so I can keep an eye on things for now. 


Yes: Tell her that you will not pay for the next semester if she is not WR and a GP documents that she is in a healthy state (weight, blood, heart and bones).
Yes: Do ask her to come home for the weekend. If needed fake that you need help with anything because hubby is not around at the moment.

Our contract:
WE pay for living, university, insurances, her own car, phone and everything (including holidays, poket money, what ever is needed)
SHE must maintain her weight, go to GP regularly (when WE say it is needed), go to weighings regularly (we do blind weighing so she is not stressed about it), eat 3 meals 2 snacks every day, keep in contact with us and share ALL medical information (we have a legal paper for that that she signed at age 18)
If she loses weight (more than 2 kg) she gets 4 weeks to correct that or she must come home all days for the next semester and stay with us until it is corrected.
She is on half schedule and still living at home and not allowed to move out in the next 2 years. She goes to an university 50 km away by public transport 4 days a week now.
Keep feeding. There is light at the end of the tunnel.
Quote
Foodsupport_AUS
Sorry that your D seems to have taken some steps backwards. She may be an adult but of course it sounds as though you a supporting her and therefore have a significant say into how things go from here. 

It sounds as though initially one thing to do is to raise your concerns with her - you can mention that you are concerned she is relapsing - in particular comment on behaviours actions you have noticed
You can insist that she get further assessed - going to see doctor for assessment - weight, bloods, orthostatics and require her to share results with you 
Once you know where things are at the next thing is to make sure that things are not deteriorating - gaining weight, moving forward. You may be able to manage this from afar but it is also important that if she she is medically safe. 

As for her self-esteem - it is very common for kids with ED , particularly with AN to have low self -esteem. It is important not to let this trap you into not acting. 
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.
Quote

        

WTadmin