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.

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MamaBearAnne
Hello all,

I just found this forum today.  I don't quite know where to start with my daughter's story and how it has affected our family (husband, daughter and three sons), but I'm thankful to have found a community that can empathize with what we have been walking through with her.  She began to deal with the ED (anorexia--along with anxiety, depression and likely OCD) in college, but she was going to school far away.  (We live overseas and she went to school in the U.S.  We only saw her on breaks during college and during her second year when we lived in the U.S. for a year.)  She's very private and even though she sought help from the school counselor and health professionals, it wasn't until her final year at university that we realized this was the cause of her mysterious health ailments.  I dropped everything to go be with her that semester for a couple of weeks, secure the support she needed and help her get back on track. For a while, she did very well.

She began to work and moved into an apartment with friends, but a bit over a year later she was doing so poorly (threat to herself) that she had to be hospitalized.  She entered her first stint of residential inpatient treatment last fall/winter, and stepped down to outpatient (just in time to go to her oldest brother's wedding) and then part-time early last spring.  Thankfully, we were back in the U.S. for the wedding and holidays and were able to be there for her.  She seemed to be doing better and making good progress.  She had a counselor, psychiatrist and dietician she met with regularly, and her work was very understanding about allowing her to work 80% time in order to fit in doctor's appointments.  

We made plans to come again in the summer, and had a wonderful time together, but after we left, she went downhill again very quickly.  I extended my stay to help her until she could enter full-time residential treatment again in September. She is currently stepped down into part-time treatment, but staying at apartments the treatment center rents out.  She's nearly 25 now and very independent, but my husband and I (and our 16 year-old son) are now making the move back to the U.S. for the remainder of the school year so that we can provide closer support. (Our 16 year-old is handling it all very maturely but my heart breaks to put him through this transition right now.)

I would love to know if there are other parents whose adult children have come to live with them after full-time treatment, and to hear any advice you may be able to give us.  She did not have to think long about our offer (to move in with us once we arrived), and we were surprised and thankful that she was willing to let us in on her path to health.  It's tricky because she is an adult, and does not have to include us in on any of her treatment, but navigating meals and times together as a family can be tense.  I want to encourage and empower her to take good care of herself, but she has to be the one doing it at this point for it to stick.

I have not been able to read a lot of posts yet, so if there are some that address this, please feel free to point me in the right direction.  I appreciate any guidance you can give.

I'm very sorry that all of you on this forum are in the midst of this difficult battle.  My heart goes out to you.  I'm grateful that my daughter is able to recognize that she needs help and is seeking treatment.  I know that is not a given.  My heart and prayers go out to all of you tonight, and your children are blessed to have you there caring for them.

Thanks for listening,
Anne


MamaBearAnne
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Enn

Hi MamaBearAnne,
I welcome you to the club that no one wants to join. It sounds like you have had a long journey with ED. I don't have an adult child, mine is 13 so I cannot advise you much.

 But,there are many here with adult children who have had to have the child live with them, have contracts in place and have had to provide significant parental support. I must say I am pleased that she is willing to take your help! I think that is the first big step in the right direction. You will get a lot of support and advice from others here who really,really,really have been where you are. 
I am glad you are here. 
Please ask all the questions you have. We are all ears!

XXX

food+more food+time+love+good professional help+ATDT+ no exercise+ state not just weight +/- the "right" medicine= healing---> recovery(--->Life without ED)

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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sk8r31
Another warm welcome to you & hope that you'll find good peer support and evidence-based treatment info here to help in your family's journey.

It's a great, positive sign that your d is willing to move in with you and accept your support.  I can recommend Carrie Arnold's book Decoding Anorexia if you haven't read it yet, both for yourself and your d.  It is quite helpful in being able to understand the biology and science around eating disorders.  In addition, Carrie herself had her parents' support as a young adult dealing with an eating disorder.  So that might also be of interest to your family and your particular situation. 

Might I also suggest that you have a look at two programs that work with families/support persons and young adults 18-35?  One is at UCSD and the other at the Center for Balanced Living in Ohio.  Both are excellent, and there are a number of families on the forum who have found them beneficial.

Our family went to UCSD for their 5 Day Multi-Family Intensive program for adolescents with our 17-year-old.  They now also offer the same programs for young adults.  You'll gain a lot of skills and tools that can help your d, while also dealing with the particular strengths and challenges of managing with a young adult.

Sending warm support,
sk8r31

It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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MamaBearAnne
Thanks to all of you for the welcome and words of encouragement and hope.  I'm finding I just don't have friends I can talk to about this, and I've been looking for people who understand.  I know you do and that helps.

Scaredmom (boy, can I relate to that username), thank you for the kind words of encouragement.

Mimi321, thanks for the UCSD program recommendation as well as the website.  I'm grateful for the help.

Thank you sk8r31 for the book recommendation as well as the programs to look into.  Our home state is North Carolina and she has taken part in a program there that includes family therapy, but not the type of intensive that it looks like the other programs offer.  I'll check those out.

We are two weeks away from move-in day with our girl, so I welcome any more bits of advice you can offer.  I took a screen shot from a video posted on another thread of things to do during/after eating to lessen anxiety and distract from feelings of shame.  My daughter has said doing something immediately following a meal really helps.  Any suggestions for activities?

Thanks again,
Anne


MamaBearAnne
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Torie
Hello and welcome.  It's great that your d will have her family here to offer support on this difficult journey.  And it is really super extra gold star awesome that she welcomes your help.

My d was a teen during the AN battle; she is now in her second year of university and considered (by law; not my me!) to be an adult.  We are lucky to have a lot of financial leverage, although we have not had to use that as she is in strong recovery.  As this is a relapsing illness, I remain alert and aware that things could go pear shaped at any moment.

In my mind, the biggest difference (by far) between helping a teen vs adult sufferer is their status as "adults,"  I wonder if you are providing financial support to your d as that can give you more leverage.

You said, "I want to encourage and empower her to take good care of herself, but she has to be the one doing it at this point for it to stick."  I'm not sure if I'm understanding this correctly.   She may "have to be the one doing it" in a few different senses, but recovery will "stick" regardless of how you get there.  Recovery is what happens when they regain all the weight they need (including eating plenty of dietary fats for brain healing) and maintain that weight for an extended period of time.  To me, that's what makes it stick - getting to and staying at a proper weight.

I would suggest you contact the Center for Balanced Living in Ohio and see if they think your family is a good fit for their one-week intensive program.  If not, I bet they could offer some helpful suggestions.

Please feel free to ask all the questions you like. xx

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

Thanks for your response.  Our daughter has been financially independent of us since shortly after she graduated from university in 2016. While that is generally good, it gives us no financial leverage in terms of creating contracts.  There may be other ways, though, and I'm glad you have brought it up.  She has made contracts with her counselor, and those have been helpful.  We've had one skype call with her family counselor at the treatment center, and I hope that once we're there, we can talk in person with her counselor and dietician about the best way for us to help her meet her goals and keep her on track.

I can so relate to things going "pear shaped" at any moment.  

I hear what you are saying about recovery being gaining the weight and keeping it on. Her brain definitely does need healing, and we can see how out of whack her thinking is at present.  We are absolutely on board to help facilitate this process of healing, which is why we are moving to be there.  I think the social/relational support is the most critical help we can provide as she knows (and has proven capable of doing) what she needs to do to gain and maintain a healthy weight if that social support is present. I know ultimately, she wants to be independent again, and I think that's what I was getting at with my comment.  But, she needs her family right now, and I'm relieved we can be there.

Thanks for the tip about the center in Ohio.  It's good to be hearing about so many resources that I didn't know existed.  

Thanks again,
Anne
MamaBearAnne
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Torie
Well, there seem to be both pluses and minuses to her independence.

The programs at UCSD and Center for Balanced Living are very similar and both have excellent reputation as one-week intensive programs.  I'm not sure if UCSD still includes adult sufferers or if they do but only occasionally or what.  I think CBL has more availability for adults but I could be wrong.  Of course one week is not enough to perform major miracles, but they do seem to manage the minor ones - families report coming back with a very useful contract and all family members reading from the same page.  And a lot of useful information and experiences, from what I hear.  So I would definitely give one or both a call.  I think they might be the only programs of that type in the world - certainly the only ones I am aware of.

Do you know when you will be coming? xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Nicstar4
Hello and welcome. This is the best place to find support, the group has been invaluable to my wellbeing.
Have you had a discussion with your d about the rules of living together again? This would be a difficult change even without AN. Maybe ground rules on eating and cooking. Setting some expectations and making the framework together with a slant on you deciding s few more guidelines as her thinking is “out of whack”
The treatment centers the others have mentioned, sound good.
I have listened to some of tabitha Farrar’s podcasts, and I like her approach.
I can’t offer more my d is 16, and we are still in early stages of treatment, even though we have been treating for 9m, AN was sneakily creeping up for over a year before that.
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LaurieW
Hi MamaBearAnne -

I am sorry you had to find your way here, but I am sure you will find a lot of great info as I have. I am sure it will be a relief to you to be near your daughter so you have a real sense of how she is doing.

Although your daughter is an adult, you do have at least some leverage.  She is living in your home.  It seems harsh, but you could make her living with you conditional on her adhering to certain conditions like waiving medical confidentiality so her team can talk to you, eating her meal plan, etc.  Her disorder needs to know you are serious.  

My daughter is 21. In order for us to continue paying for her university, cell phone and so on, we have a contract with her that allows her care team to talk to us (which I do not abuse) and to contact us directly if she loses weight two weeks in a row or loses a more than trivial amount in a week.  There are other provisions and intermediate steps, but it is serious and we are sticking to it.

Best of luck to you, your daughter and the rest of your family
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Kali
Hi MamabearAnne,

You have gotten some very good advice and I am hopeful that your daughter will recover since she went into treatment willingly and is open to you helping her. However you will most likely need to arm yourself with all of your patience, compassion, unconditional love for your daughter, and practical knowledge about eating disorders and meal support. Remission from an eating disorder is not a straight line and there may be steps forward and backwards along the way.

To learn how to be an effective meal support, I read Eva Musby's book; she has very practical advice.

https://anorexiafamily.com/

And I thought I'd describe for you what we did before and when my daughter came home from residential treatment. She was a young adult at the time. First she had a meeting with the dietician and they asked her to create a list of 7 breakfasts, 7 lunches and 7 dinners that she would be able to eat, as well as some snacks. The requirements were that they have enough calories and nutrition. So she couldn't for example decide she wanted to eat 3 carrot sticks and drink a glass of water for dinner. Then I went in and met with her and the dietician and we discussed the meals. That set up an expectation that she would eat those things when she came home. 

You might want to try and figure out a guesstimate about how many calories a day you will need to feed your daughter based on her weight and height, and her historic growth chart and whether she needs to gain more weight or maintain because she has been weight restored while in treatment. But there is no need to speak with her about calories. Or maybe you can ask the treatment center how much they needed to feed her in order for her to gain weight.

At first I exclusively made meals from the list. As time went on I introduced some new meals each week. I did all the cooking and she stayed out of the kitchen while I did so. Each Sunday we sat down and planned the weeks meals together, I made a shopping list, and went out and got what we needed. And then I posted the week's menu on the fridge so she could know what to expect, it seemed to help. She had been given a menu each week while in treatment and was able to circle the foods she was ordering as long as they were enough calories, so we continued something like that when she came home.

We also kept to a similar meal time schedule like she had had in the treatment center. I let her know that I expected her to be eating all her meals at home with us. There were 3 meals and 2 snacks a day in our house, only full fat milk products, only caloric drinks with mealtimes and I slowly reintroduced desserts again over a period of time.

I tried to make mealtimes as calm as possible. I used nice china, had flowers on the table, music playing that she liked, and tried never to discuss anything unpleasant while we ate. I upped my food game and tried to use fresh herbs and just generally tried to make everything taste as good as I could. 

Also you should know that it may be a very long time before your daughter can feed herself enough to maintain a healthy weight, and the more meal support she gets the better for her. That even though she is an adult, in this one area, she needs others to step in and encourage her.

We found it also helpful to discuss my daughter's goals and some things she would like to do when she was better. Things to look forward to in life.

After meals we often binge watched netflix or walked the dog. We did some crafty projects from time to time.

So I would say the things that were most important were:
Regular mealtimes. !!!!!
Staying in treatment for as long as necessary.
Encouraging her to create a life worth living (as they say in DBT)

We did not have a contract for her homecoming, we set up expectations instead. But when she went back to college I did give her a list of things we would need for her to be able to do in order to be able to be in college. Maintain her weight, etc.

Also, if your daughter was purging you will want to be on the lookout and perhaps ask her to go to the bathroom before meals and not go afterwards, but sit and do some activities with you instead.

Hoping for all the best for your daughter,

Kali


Food=Love
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MamaBearAnne
Kali, LaurieW and Nicstar4, thank you.  It's been really helpful to read your advice and extremely practical ideas.  I'm doing all the reading I can right now and trying to formulate some ideas into plans and an agreement or at least a set of expectations that we can go over with her and her team of nutritionist/counselor/psychiatrist.  

Torie, I'm definitely looking into the two programs.  We will arrive in a little less than two weeks.  One issue is her work and whether she has any leave left at all.  The other is our 16 year-old.  With him changing schools mid-semester it would be difficult to take him out and I need to see how he is doing when we land before we can determine if we can leave him for the week with others. It does sound so helpful, though.

Does anyone know the cost of either of those programs?  I'm wondering about insurance, etc.  Until I have more answers, I will just do all I can within what we can provide now.

I spent the night and this morning reading Brave Girl Eating.  It was extremely helpful. Although the author's daughter was much younger, it was easy to see the universal principle of feeding her and restoring weight as priority #1.

Thanks again


MamaBearAnne
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Kali

Hi MamaBearAnne,

I had looked into the two programs at one point and asked about insurance and costs. They both took our insurance and are contracted with most of the other major insurance companies. The Ohio program insurance would cover our daughter because she was ill with a small copay, but not the support people accompanying her, because we are not ill, and that would cost us an out of pocket $2000.

For San Diego program, our insurance covered everyone with a small copay. 
But you can speak with them if you are interested because the costs really depends on your insurance status and/or that of your daughter. If your daughter is 25 she can still be on your health insurance but only until she turns 26, so that is something to consider if you decide you think it would be beneficial to attend. 

There is also a web series running right now, which is called Helping Hands Summit which you might want to look into, for caregivers. 

https://helpinghandssummit.com/

There are videos from different practitioners about eating disorders and how to help someone who is ill, and there is a $99 fee but there is also a 50% off coupon code if you type in summit2018. You can watch the videos at your leisure, they send you a link to them and a downloadable ebook. It started last weekend but is continuing this weekend and there is an option to ask questions of the professionals participating. Might this be helpful to get you started?

warmly,

Kali

 

Food=Love
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ValentinaGermania
Hi MamabearAnne,

a very warm welcome from Germany from another mom with a now adult d. Mine is going to be 19 in a few months.

First I want to say that it is great that you found us here, this forum is a lifesaver. You will get a lot of help here.

As the others said, you are not without power even if they are adult. It is your house, so you set the rules. And RULES are the most important thing to avoid relapses. Thanks to biology most AN sufferers LOVE rules.
It might be intersting for you to read "Decoding Anorexia" by Carrie Arnold before you meet your d. She is a biochemist and a former patient and she describes very good the insight of an AN patient and how the biochemistry in their brains work. That helped me a lot to understand why she is doing this or that.

We are trying to fight the disease as a team now. That is easier with an adult. But we have a contract. We wrote down what we do for her (paying for living, food, university, car, cellphone etc.) and what she needs to do for that (eat regularly, maintain weight, go to GP and let us know all results and let us speak to doctors).
Your d is used to a more independent life. Maybe you need to find other incentives as a tour to a city she dreams of or a pop concert she would love to go.

What helped us with transition from IP:

Taking same meal times and the meal plan from IP for the start.
Eating regularly (3 meals 2-3 snacks) and together. You cook, she eats.
No scales in the house, no weighing at home.
No low fat / low sugar products in our house.
Distraction, distraction, distraction. Watch TV while eating. Play cards. Do all the things that were a no go in your former life.
Keep her busy and keep her out of the kitchen.
Be on the same page with hubby. Keep your younger son out of the line as much as possible.
Do as much normal life stuff as possible. Show her there is a life beside AN. Get her socialised again.

Come here and ask your 1 million questions, we will try to help you.
Tina72


Keep feeding. There is light at the end of the tunnel.
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