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

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salmy
I've been listening to Tabitha Ferrar's podcast, which though it is many directly towards adult with ED I think there is a lot of interesting information. I am wondering about a few things though...

1. Ferrar talks about motivation for recovery. So far, in our experience D16 is not really motivated to recover. Yes, she is compliant with meals, but any time she is stressed or gets upset, or the body dysmorphia is too much, she reverts back to all ED thinking. At what point does motivation kick in with an adolescent? Will she ever get motivated? She is within WR, but we are still adding weight - looking for that sweet spot where her brain begins to recover too.

2. There is also a lot of talk about energy deficit, brain hunger (brain telling you to eat or a constant thinking of food) and then ravenous hunger where you just eat and eat and eat when feelings of hunger return. We haven't seen any of these behaviors except maybe energy deficit - and I wonder if that still occurs during refeeding even while eating 4000 cal per day? D doesn't talk about food at all (except when she is wanting to refuse to eat what is in front of her) and has just twice in the past 3 months said she felt hungry.

 3. Our FBT therapist was explaining to D how brain recovery happens after a long time of refeeding and solid WR. I am wondering if anyone has a blurb that is short, easy to understand, (maybe even something that includes pictures!) that they have seen or used with their children. D knows that her brain has not recovered. She needs hope that this is going to happen at some point down the road, and wants to understand HOW it happens in the brain. I've explained the neuroplasticity of the brain and what happens to the brain during starvation and how after refeeding and eating enough for a long time that the brain undoes those grooves that were made during starvation and goes back to the correct path.... but maybe someone else has a succinct and understandable blurb that does a better job than either mom or therapist talk?🙂
D16 diagnosed AN October 2019 -25% of body weight, but still "healthy weight" per Dr.
Started FBT Dec 2019
July 2020 Fully WR + 10%
2 Months in to Phase 2
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Enn
Isn't Tabitha Farrar great!
I will address each question in turn and remember this is just my opinions/feelings.

1: Your d is still not well and she does not have to be motivated to become well. It think it is different for adults with ED as they tend to be more autonomous.
It takes at least 6 months AFTER WR to START to see some brain changes. That is what we found here. It happens very slowly and it is not like a light bulb that turns on. It is very subtle like less body dysmorphia, wearing appropriate clothing, eating a bit more, or with less agitation, less exercise, happier moods and that is not alway consistent and can vary by the hour. It is just a little bit better very very slowly. It is sometimes in retrospect that we look back and say " Oh since October she hasn't thrown food" things like that are your guide. Some write a diary of good and bad days and then look at it to see the progress. 

2: My d has never had excessive hunger. I only knew she was hungry when she asked when her dinner was coming. Some kids do go through this stage and others many not. We are three years in and only in the last 4 months has she verbalized that she was hungry.- still does not eat ravenously. And yes it is hard to feel hungry with all the food at this time. Either way, she needs to eat hungry or not. 

3: I agree with your therapist. Although you may wish her to see the light about recovery etc.. she may not understand or want to understand it. My d still cannot talk about ED but does admit she is better now.  
Without being technical maybe just saying "the brain takes a long time to recover and it will take good nutrition for as long as it takes". You could just let her now that parents here noted that  it takes  long time but the brain can/does heal with time and nutrition. She is still so early into this, I am not sure what you could tell her so that her brain gets it. Her brain still needs to catch up a lot before she may really understand this concept - maybe?
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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PurpleRain
I found Tabitha really helpful for ME, I don't think my daughter (14) would benefit from reading or watching her videos yet, but I think it would be helpful later, to understand the risk of relapse and the importance of self care and full nutrición for her.
Brain healing for my D happened slowly, we are not out of the woods yet,but definitely after 6 months WR (we are 8 months WR+ now), we could see many positive changes and we now see weekly improvement. Almost since we started refeeding I made a calendar with red, yellow and green days (thanks Valentina Germania for the suggestion), to be able to see improvement when it was almost imperceptible at the begining. 
I told my D about Shan guisenguer's evolution explanation for anorexia right from the beginning because it makes perfect sense to me (I studied biology) and I felt comfortable with that explanation,  I always talk to her about AN in those terms. We don't talk much but when we do is always in terms of genes, energy deficit, etc. She is used to me talking like that (in evolutionary terms) about other things previous to ED so it makes sense to her I think, and it comes naturally to me. 
We don'talk too much about it though. We talk about anxiety a bit (she has been anxious all her live although not terribly, so I taught her to breath through it and other helpful tools since she was quite little). Our talks are very casual and usually related to something that happened or that needs to happen, if I tell her something out of the blue she shots down. I hope that with more brain healing, more talking will be possible especially about relapse prevention.
13 yo d started to eat "healthy" September 2018, she had a growth spurt a bit later, followed by tummy bug. She started restricting breakfast and school lunch in January 2019 (that we know). We succesfully refed at home.
I have found inner strenght, patience and compassion that I did not know I had.
Never retreat, never surrender
keep feeding
 
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teecee

I never allowed my D to watch videos/blogs/read recovery stories etc however she was similar in that she wanted to understand the brain and body and why, why, why all the time. Her favourite subjects are science. She read one book....Deciding Anorexia by Carrie Arnold (I also read it) and she told me that helped her understand the science bit that she needed to satisfy in her own mind. Something in her eyes that was ‘credible.’  If a therapist or professional loses credibility in her eyes she is not interested. Even though we said the same things as the professionals in CAMHS she needed to hear it from a professional she respected. 

After reading the book she wax satisfied. 

I agree she doesn’t need to be motivated to get better. It helps us with refeeding if we can find a motivation to eat. 

My D hunger cues are there or thereabouts now but it’s taken 2 years. 

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Foodsupport_AUS
It can take a long time for them to "want to recover" or more to the point I found my D did want to recover in that she didn't want to feel as bad as she did, she was truly miserable, she didn't want her thoughts dominated all day every day by the negative thoughts nor did she want to keep on having to think about food. What she didn't want to do is gain weight. The problem for most is that they need to eat regularly and reliably against the negative thoughts, and gain weight and for most for some time they struggle with this. So want to recover can be really difficult to define, and even harder to follow through with. My D also read Carrie Arnold's Decoding Anorexia. She is also a science type person and found it very interesting and certainly from this recognised more of why I was saying what I was saying. Like teecee she would not believe me for most things, she had to hear it from "the professionals". One reason why finding the right professionals is so important. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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