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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Hi, I have only just registered with Around the Dinner table and reading some of the stories has made me cry.  My 12 yr old daughter was diagnosed with anorexia in October 14.  Since then we have been seeing CAMHS weekly and doing FBT with them.  She has a meal plan but has never eaten everything on the plan each day. She has put on about 200gms since October, some weeks losing and some weeks gaining but obviously only small amounts of weight.  
I met up with a friend just before Xmas and she has suggested joining this forum and also, using the Maudsley approach, insisting that my daughter eats everything on the plan.  I came home inspired but my husband was worried and didn't want to to down this path.

I agreed that we would try backing off as sometimes she does eat when there seems to be less pressure from us, but made him promise that if it didn't work we would try the Maudsley approach.  

Over the last few days it has been very hit and miss, she didn't eat or drink for a day, then she ate the following day well, yesterday she didn't eat or drink anything till 2pm, then ate supper and snack, today she has eaten breakfast, snack and lunch but nothing since.  She is going to get weighed on Tuesday and CAMHS will make a decision as to whether she can go to school then as they feel she is getting to a stage where she is not well enough to go.  She says she is desperate to stay in school, she is doing well academically and wants to see her friends.

I need some advice from you.   Have you all done the 'eat everything' approach and does it work?  Do I need to take some time off work and keep her off school to do it?  What happens if she refuses to eat breakfast, do I then just move onto snack and forget about breakfast or bring breakfast back on the table at snack time along with her snack?  And do I do the same with lunch if she hasn't eaten anything by then?

She says she wants to get well and I believe her, she seems to have insight into the disease and what she calls her 'monster' in her head.  

I just want to help her get well but feel I don't really know what I am doing.
Please help!
Many thanks

Dear  Cal,

Can you have your H join in here on the forum either as his own membership or view through yours. I believe that your H needs to do heaps & heaps of learning about how eds impact on our offspring & how dads can learn how to fight the monster in a collaboration with you & the clinicians. Get your H to read all the dad/husband posts here to learn just how important it is to be a combined & same page effort against your d's ed monster

""Food is Medicine"" is an important thing to get to learn. The brain consumes huge amounts of the food energy we eat & when its starved of this energy its processes are disrupted & become distorted. And then when the rest of the body is starved there is a lot of catching up the body & brain have to do. The body catches up first & then the brain takes some further time to heal & food is the medicine to make this happen.

Its a balancing act to get the medicine in at the right amount & to do it with the least amount of anxiety & stress. However there needs to be an effort to get regular nutrition every day and at the times when her ed monster is ramping up inside her head she needs you as parents to ramp up externally the efforts to over rule the head noise & get the daily nutrition in.

Some here have found that time off work was needed to ensure every meal & snack was eaten. Time off school is sometimes required. If your D is eating all meals & snacks at school then school can be an incentive although if school meals & snacks are not being eaten or being discarded then some here do supervision of eating at school & being away from work allows school meal/snack supervision.

I hope some more experienced at re-feeding can post soon

ED Dad
Cal wrote:
I need some advice from you.   Have you all done the 'eat everything' approach and does it work?  Do I need to take some time off work and keep her off school to do it?  What happens if she refuses to eat breakfast, do I then just move onto snack and forget about breakfast or bring breakfast back on the table at snack time along with her snack?  And do I do the same with lunch if she hasn't eaten anything by then?

She says she wants to get well and I believe her, she seems to have insight into the disease and what she calls her 'monster' in her head.  

I just want to help her get well but feel I don't really know what I am doing.
Please help!
Many thanks

Hi Cx - Welcome!  So sorry you needed to find us, but glad you did.  Your friend gave you good advice to come here - many wise veterans of the Ed wars can give you the best advice you will find.

In the meantime, to answer a few of your questions:  Yes, the "eat everything" approach worked for my d.  Many here have needed to take time off work, and many have found that their d needed time off from school. Others, like my d, were able to keep attending school during re-feeding, but it can be complicated to arrange / provide the needed supervision during the school day.  Finally, some have arranged a modified school day to keep some of the anxiety under control while ensuring the needed nutrition goes in and at least some of the social and academic time is preserved.

I'll let others take crack at the rest of your questions, but I will post a link to a video by forum member Eva Musby that I have found to be tremendously helpful:

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
I would first recommend reading magic plate. That is what many of us have used. If she is not consistently gaining wt she is not eating enough. Different families find different methods work best.

make plate more calorie dense. Add heavy whipping cream to milk or sauces, add oil to rice, butter, cheese, whole fat milk. Do not be afraid of fats(lipids) that is what they need the most.

If she does not finish will she drink a supplement- ensure plus- not sure what they call in uk. Or a smoothly. You will find many recipes for high cal smoothies here. Some are 1000 a glass. Can you add a bedtime smoothy. Gaining 1-2 lb per week is usual goal.

My d was dx last October at 12 yr old. She does not respond well to force , punish or reward. However does well with natural consequences. Like she can't eat breakfast she can't go to school. Not really a reward or punishment. Just if can't eat too sick to do xyz.

We also do life stops until you eat. At meal time if d does not starting eating within 5 minutes we have her sit in a chair in another room until she calms down. No phone, no entertainment or interaction with her until she is ready to eat. After awhile ( 5-10 min) I bring her back to table. Provide a lot of distraction, play cards, phone, music. Anything that she enjoys that does not interfere with eating. As long as she is eating will provide lots of distraction. After meals also try to provide distraction as my d has a lot of guilt about eating.

I have had attitude that if d is not able to eat she is too sick to attend school. If d really wants to go to school this may help her eat more. I took d out of school one month early to go to a day treatment program, in May.

Many of our kids are too sick to eat without supervision. Do you have someone at lunch who can supervise. School counselor, or teacher. Many parents have gone to school and eaten lunch in parking lot with d. My d eat with school counselor, and if did not finish had to come home.

Refeeding is a full time job and very emotionally draining. I only work 8 hr a week and took a few months off in the early days. Basicly took all day everyday to feed d. Husband had to watched other kids as feeding took all day. After we got a little better at feeding I went back to work.

The early days are so hard, so scary to see your child so sick. But, it does get better. You can do this.
Hi Cal,
My daughter aged 14 yrs was diagnosed late oct 14 and we decided to use the maudsley approach, we sat her down and said you must eat breakfast, dinner and tea, we did no negotiations and no in the kitchen whilst cooking, this has so far worked but we did have a difficult time when we added snacks too at the advise of the dietitian as she resented this, but after a few issues, shouting and resisting she has had these and so far has continued to gain weight. We also asked school to monitor that she eats lunch, so far so good. We used the fact that she likes to dance as a hobby weekly x 2 as if she eats she can go, if not she cant.  I think my husband to found it hard as he has not read as much as me and is a less strict parent, but we decide and agree rules before away for our D and then we back each other up.  Its so sad and so hard and sometimes I have wanted to give in as shes so upset by us making her eat all this food. But I say its your medicine and you MUST eat it.  Good luck. its a horrible journey to be on and I am so worried that one day our D will say she's not eating but for now it is working for us.x
17 years old, well into recovery and taking full control of food herself and gaining weight, she's loving life at the minute, it does get better!!

I am sorry that you are here but it's good that you found us. My ED D is 11 yrs old and was 10 at diagnosis. We did / do the Maudsley approach.  She was medically unstable when we started treatment and stopped sports until the doc said she was ready to return.  Either H or I would go into school every day to have lunch with her. There were a few days we actually kept her home so we could refeed her.  You will learn - LSUYE (life stops until you eat). She must eat everything on her plate. Our goal was to get her to gain 2-3 lbs a week -- we probably average 2 lbs. What you have to remember -- and it's so hard (at least for me) -- is that it's very hard for your D to eat now. The ED in her is telling her not to eat.   D wanted to go to school - if she didn't eat breakfast, she couldn't go to school. We allowed her to watch movies on her ipod while eating -- anything to get her to eat. It's a hard long battle but you (and your H) can do it.  Read the old posts -- ask questions. We're here to help.  We learn from each other. Good luck!
Lisa NJ Mom to daughter dx AN (Nov. 2013) at age 10. WR April 2014. ~There is light at the end of the tunnel.~
We also did Maudsley with our then 16yr old. The game changer for me was realising that being firmer and allowing no choices in what our d ate resulted in a huge decrease in anxiety once she realised we were serious. She explained it later as though she had two sets of parents - us and the ED - and she could only say no to the ED when we were the stronger ones - and it was a relief to be able to say no to the ED. You have to make eating all that is presented non negotiable and your d will thank you for it! ED may jack up initially but try to just hear that as ED speak. Good luck - you can do this!
Belinda Caldwell FEAST Executive Director. D 21 now well into recovery after developing AN in 2011. Inpatient 5 weeks, FBT and then just lots of time, love and vigilance.
Cal,  writing as a Dad what I would say (and I think it is massively important in your battle!) is that both you and your husband have to be extremely strong and work together, and present a united front against the Anorexia.  It is so hard to do but we almost had to treat our d as two people, our d who was always there somewhere and we just wanted her back, and the anorexia which had taken over her!  If the anorexic side to your d sees, hears or senses any weakness in the way you both treat this terrible illness it will thrive and constantly play you and your husband off against each other!
A phrase I have used on here before is you have to be cruel to be kind!  Cruel to the anorexia, and fight it constantly - and kind to your daughter, it may not appear it at times but she is in there trying to get out and you will I am sure get her back!
It will slowly get better I am sure, and there is a huge amount of support here on this forum for you and your daughter, but you and your husband must work together, good luck and best wishes!!

You have found a great resource in this forum and have already gotten great advice.

What is your H afraid will happen if you don't insist that your d eat all the calories she needs to eat each day? You may anger the ED and it may react by screaming, crying or otherwise putting up a fuss, but you need to fight this with everything you've got. Your d has an illness that it making her slowly starve herself to death. She needs you to be strong and to give her what she needs-food and all of it. Food is medicine. Would you or your H be okay if your d had a prescription for a medication but she didn't take all the prescribed dose each day? This is the same thing. She needs all the food, not just some for her to get better.

The sooner she puts on the weight she needs, the sooner she can begin to heal. This illness takes a long time to recover and if you put off getting the weight on it only prolongs the misery and gives ED a stronger foothold.

I found that my d was actually relieved when we were making all the food choices. So, I concur, do magic plate, load up on fats, make her eat everything. If she can't I don't think she's ready for school.

Good luck and try to get H on the same page.
Hi Cal,
welcome! I know how hard it is to come onto this site  but let me tell you that I have found the most helpful advice on this site.  I dont know where I would be without it.
My Daughter was diagnosed with Anorexia at age 14.  We started with Maudsley right away.  We saw a therapist specializing in Maudsley once a week to help us thru the process. We are now transitioning from stage 1 to stage 2.  It was the hardest thing I have ever ever done in my life.  It was hell on wheels but I kept on telling myself "food is medicine, if my daughter had cancer I would never skip a chemo treatment and i would never reduce the dosage".  I said this in my head over and over.  I had her weight restored (14 pounds) in about 8 weeks.  She had all the classic symptoms. She cried, screamed, kicked, punched, cursed me out, begged me to just kill her over and over and over again. Her wrists were black and blue from hitting the wall, her thighs were black and blue from piching herself, her hands were all cut up from scratching  herself. I was in by myself.  My husband just couldnt get on board.  He didnt understand the illness well enough to help.  I learned everything there was to know.  I didnt leave a stone unturned.
Now as we started phase 2 things have really come around.  The food has really nourished her body and her mind.  All those aggressive behaviors disappeared and all the suicidal talk just went away.  I look back to just a few weeks ago and I cant even believe how far she has come.
My advise to you is just stick with Maudsley and believe it works.  Stick to every single thing.  Dont let the ED find loopholes.  Just keep on beating it up and you will be successful. It was so hard for me to go to sleep every night and think that this is really going to work.  But I promise you if you stick to it it will work. Please keep on believing in it!!!! Don't give up no matter how hard it gets.
Also, I actually spoon fed my daughter all her meals and snacks for about 2 weeks.  Some meals took hours.  She just couldn't feed herself.  It was less painful for me to put the food in her mouth. Whatever it takes..... just get the food in and have faith!