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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Lexi123
Hi,

I’ve been reading this forum for a while now and have decided to make an account as some of the advice I’ve found on here has been immensely helpful. My d is 23 and has had an eating disorder since she was around 13. She was diagnosed with anorexia (binge and purge subtype) and had some success with recovery at home and with an outpatient team, however she never fully was weight restored and was always engaging in some “milder” behaviors (only eating foods she deemed as healthy for example). When she graduated from college and started her job, she began to lose weight rapidly and was nearly hospitalized. Since then, she has been in IOP two times and has been seeing a therapist and dietician as well as a doctor. Since she is an adult, it seems like there is much more of an emphasis on her making recovery her choice, and there is less of an emphasis on WR. I don’t know her weight but my guess is she is around 10-15 pounds underweight (which would put her at around 19 BMI; she has always been on the smaller side). Obviously, she is an adult so she makes her own decisions, but she is not getting any better and I worry about the lack of changes. She lives with her boyfriend who is supportive and very aware of the situation. She says she is purging but her labs are okay and her doctor specializes in EDs and monitors her. My question is, how can I support her when she has been sick for so long and hasn’t been able to make a lot of progress with her current team?
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Foodsupport_AUS
Welcome to the forum, sorry that you have had to find your way here. 

My D is also 23, and I understand how hard it is to keep on supporting changes as they become more independent. It sounds as though your D is managing a lot of her day to day things but struggling to do what she needs to do truly recover. 
I have found that although my D's boyfriend is supportive of her need to eat and has pushed her to eat more variety etc., he has struggled to understand the really large amounts of food she needs to gain weight. When he says her eating average amounts of course he accepts this as normal. I have also had to encourage him with the permissive eating - saying it is OK to have seconds or whatever. 
Some ideas that have been used before for adults - sending food bundles, regular meals at home. I try to use a lot of motivational interviewing - helping her to see how she is better off continuing to work at things. Not accepting ED behaviours in the house. 
Given she has been ill for a long time, it would be expected that any changes would be very slow. Have you considered something such as the UCSD young adult program where the person goes with their close carers so all can learn to support them together? 
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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Lexi123
Thank you so much Foodsupport_AUS! I already feel less alone after making this post and reading your reply. We try to encourage her to come home on weekends, as she has said she feels as it is easier to eat at home with our support, but she is very rigid about what she will eat, and usually cooks her own meals. My h is an amazing cook, and will try to cook for her, and she is always appreciative, but won’t eat what he makes. Sometimes she will pretend to eat it (and thinks we don’t notice). It’s really hard for her to abstain from all ED behaviors in the house. Do I call her out on them when I see them? You’re so right her boyfriend might not realize just how much she needs to eat to gain weight. As I’ve grown to learn from my D, she usually wakes up before him and misses breakfast, and then works through her lunch break... by the time she gets home, she usually hasn’t eaten anything. Her dietician is working with her and her boyfriend on having him take over some of her meals, make and plate them, etc, but she is pretty resistant. I know she wants to get better, but she seems terrified to take the steps necessary to kick this once and for all. I’ve talked to him about the permission with eating, as I know she won’t eat more on her own but is more likely to if he encourages her to. I’ll look into the UCSD program- I’ve heard it mentioned on the forum quite a bit. I’ll also look into the motivational interviewing you spoke about. Thank you! How is your D doing now? 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Enn
hello and welcome! 
I too am sorry you needed to find us. I do hope you get the support and information you need. 

I do not have an adult with ED, but I wanted to let you know that you are not alone.
Many will be here soon who have adult kids and share their stories with you. 
Here is the link to UCSD Program
I am sending a big hug!
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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Lexi123
Thank you so much for this advice and the helpful link. That program looks fantastic. Thank you for all the support. Xxx
Enn wrote:
hello and welcome! 
I too am sorry you needed to find us. I do hope you get the support and information you need. 

I do not have an adult with ED, but I wanted to let you know that you are not alone.
Many will be here soon who have adult kids and share their stories with you. 
Here is the link to UCSD Program
I am sending a big hug!
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Foodsupport_AUS
Lexi it sounds like there are a lot of areas where your D's boyfriend could step in and support her more. Her resistance to this is of course expected. It is the old line that she can recover on her own, but she can't. What it really means is she avoids the challenge of having those meals three times per day and snacks, part of which is as important to her recovery as the weight gain. 

As for my D, we are also coming up to 10 years soon. Mine is around 90% recovered, each year brings some small improvements. This year it is the introduction of meat back into her diet after 9 years of being pescetarian. For Christmas, she is making some ice cream and for the first time including pure cream (also called double cream). She eats widely in general, and few people know there is any issues at all. 
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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ValentinaGermania
You could support her with inviting her for meals (and YOU cook). What about going out in restaurants?
You could support her boyfriend with information why it is so important that she eats regular und gains a bit. And with ideas how he could make purging impossible.
Does your d know that she could get better with gaining a bit? Many patients did lose hope for recovery totally and cannot imagine that maybe 2-3 kilos more could change their whole life...
Keep feeding. There is light at the end of the tunnel.
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Lexi123

It sounds like your d is doing really well and that gives me hope for mine. This illness really is so awful. Do you have any advice on what to say to her boyfriend? I’ve talked to her before about him helping her more and she got upset saying that she didn’t want him to feel like a caregiver. I told her that he loves her and wants her to get better and that he probably would be open to helping her in any way. That is great your d introduced meat back into her diet!! Wow! Huge, huge step, AND making homemade ice cream! 

My d told me that she did an assessment for a treatment place by her that has IOP and PHP. The IOP she is in now is not that helpful and this one is 5-6 days per week and works with her work schedule. However, she told me they recommended PHP and she was really upset and says she won’t do it. 

Lexi it sounds like there are a lot of areas where your D's boyfriend could step in and support her more. Her resistance to this is of course expected. It is the old line that she can recover on her own, but she can't. What it really means is she avoids the challenge of having those meals three times per day and snacks, part of which is as important to her recovery as the weight gain. 

As for my D, we are also coming up to 10 years soon. Mine is around 90% recovered, each year brings some small improvements. This year it is the introduction of meat back into her diet after 9 years of being pescetarian. For Christmas, she is making some ice cream and for the first time including pure cream (also called double cream). She eats widely in general, and few people know there is any issues at all. 

D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Lexi123

these are really helpful! Usually when we have meals together I let her cook because I have the mindset of “at least she’s eating”, but I think I need to try just serving her what I cook and saying, “this is what we are having”. Great idea with how to talk to her boyfriend. I think he gets she needs to recovery and gain weight, but doesn’t really understand the “why”. She says that because she isn’t at her lowest weight anymore, she’s fine and doesn’t need to gain anymore weight, even though she is not weight restored. I also don’t really know what her WR would be since she developed her ED before she was finished growing in height. I’ve talked to her about how the weight gain will help her brain and that the weight and nourishment will help decrease the thoughts and urges. She seems to think this applies for everyone except for her. 

You could support her with inviting her for meals (and YOU cook). What about going out in restaurants?
You could support her boyfriend with information why it is so important that she eats regular und gains a bit. And with ideas how he could make purging impossible.
Does your d know that she could get better with gaining a bit? Many patients did lose hope for recovery totally and cannot imagine that maybe 2-3 kilos more could change their whole life...

D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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ValentinaGermania
I wonder if you could make her boyfriend read "Decoding Anorexia" by Carrie Arnold. That is a scientific book which explains all the biochemical processes in her brain and what is important to do and to say. It also explains why she cannot get better without eating.

"Usually when we have meals together I let her cook because I have the mindset of “at least she’s eating”, but I think I need to try just serving her what I cook and saying, “this is what we are having”."

This would be an important step if you can do that. She cannot cook healthy meals at the moment. And it is not better to eat anything than nothing until that anything is nearly nothing. She needs to eat normal full fat family meals like your grandma would have cooked with a lot of butter, cream and oil and she cannot cook that herself. For the next time, think about preparing all food before she arrives and just put her in front of a plated meal like in a restaurant.

"She seems to think this applies for everyone except for her. "

They all think that. They all have 1000 excuses why they cannot get better. You can only tell her that you talked to a lot of experts (us 🙂) and that they all said the same, that brain recovery is going along with a good personal body weight and that recovery from ED is possible at any age and after any years of sickness.
Keep feeding. There is light at the end of the tunnel.
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