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.

Rose321
Good morning wonderful community.  I have two questions this morning.  D is almost 17.  Struggling with ED since she was 11, but managed to stay at healthy weight with FBT until last summer when she had significant weight loss.  Eventually put her in a PHP program, where she was highly motivated to recover and get out, ate 100%, etc.  She made and sustained weight recovery during and after the program.

Now, she has been out of the program for eight weeks and believes she is ready for more control over her food (basically this means plating her own meals using the guidelines from the PHP program).  She is tired of us monitoring her food, believes that her dedication to recovery should give her more freedom, and knows she has to develop skills to be independent.  We have a good support team, but she is somewhat resistant to their input.  We tried having less oversight for 10 days, and she lost a significant amount of weight.  Her nutritionist wants us to go back to monitoring all her food.  Our daughter wants to keep trying to do it mostly on her own (with the PHP guidance around meals).  Her point is that if she doesn't have a chance to learn from the setbacks, and try to re-jigger her eating on her own, she will never be independent.  Her logic sounds rationale and right and true to me, but I've been fooled by her ED voice showing up as rational before.  I have no idea what to believe -- is it her real voice, or ED?

Also, I'm wondering if anyone uses texting to communicate with their child to avoid fights.  "Remember, you need to work on two challenge foods this week,"  "I noticed you've had the same thing for breakfast the last three days, maybe some flexibility tomorrow?" "That was not a sufficient snack, please have XX in the next hour."  On the one hand I hate giving into this technology and not having real communication.  On the other hand, it seems like it will reduce the fighting, which is just hateful and exhausting and not productive (I know you all know....)

Sending gratitude to al of you.
Rose
Quote
Ronson
Hi - I use texting if I want to introduce something which I’m scared will cause confrontation.  So we went out for a three course meal and I introduced that idea by text.  To give d time to get used to it. 
Quote
scaredmom

Rose321 wrote:
  We tried having less oversight for 10 days, and she lost a significant amount of weight.  Her nutritionist wants us to go back to monitoring all her food.  Our daughter wants to keep trying to do it mostly on her own (with the PHP guidance around meals).  Her point is that if she doesn't have a chance to learn from the setbacks, and try to re-jigger her eating on her own, she will never be independent.  Her logic sounds rationale and right and true to me, but I've been fooled by her ED voice showing up as rational before.  I have no idea what to believe -- is it her real voice, or ED?
.

This piece is very telling. You DID give her control and she was not able to to keep up her weight. Since the weight loss is she eating more to gain it back? If so, it seems that is a good teaching moment and she learned.
Otherwise I feel you may have to step in soon.

Many people have texted their kids. You can try it and see what happens. That is the thing with ED we are learning how to manage each of our kid's needs and only through trial and error do we figure it out.

I understand you don't feel it is communicating properly. That is how I feel, but it IS the way our kids are more comfortable communicating and I think it would be worthwhile to try. 

My elder D, when I text her I love her, she can "say it back" but face to face, she doesn't. I can be effusive with my emotions via texting to her and she does not feel embarrassed when we see each other in person. I hope I expressed that properly.

No harm in trying and it may be a way to support her without being "in her face".

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)
Quote
mid73
I use text all the time with my nearly 17 year old. It is less confrontational and I find it easier to express what I want to say without getting drawn into nasty arguments with her or ED.   I have found it useful as she will barely hold a conversation with me face to face. And I think it lets her ED know that I’m aware it’s still there  as she flatly denies it if I broach the subject in a normal conversation. Her behaviour makes me know otherwise! 
Quote
tina72
Rose321 wrote:

Now, she has been out of the program for eight weeks and believes she is ready for more control over her food (basically this means plating her own meals using the guidelines from the PHP program).  She is tired of us monitoring her food, believes that her dedication to recovery should give her more freedom, and knows she has to develop skills to be independent.  We have a good support team, but she is somewhat resistant to their input.  We tried having less oversight for 10 days, and she lost a significant amount of weight.  Her nutritionist wants us to go back to monitoring all her food.  Our daughter wants to keep trying to do it mostly on her own (with the PHP guidance around meals).  Her point is that if she doesn't have a chance to learn from the setbacks, and try to re-jigger her eating on her own, she will never be independent.  Her logic sounds rationale and right and true to me, but I've been fooled by her ED voice showing up as rational before.  I have no idea what to believe -- is it her real voice, or ED?


Hi Rose,
8 weeks is very early days to give back control and to do that too early is one of the most seen causes for a setback or relapse here. It is right, she must learn how to do that and how to eat enough but this takes a lot of time and a laddering process. So first step could be that she plates herself under supervision and you tell her to add more if needed. If she is not compliant to do that and it leads into a discussion that shows you it was too early.
Did she skip meals or snacks or did she just not plate herself enough? Did she restrict again? What is a "significant amount of weight"? If she lost more than 2 kg in 10 days that is serious.

So in your case she has tried and she has lost weight and the nutritionist is right to go back to monitor her food intake until she has regained the lost weight and then you could give it a new try with more help and more boundaries. Was she truely WR before starting to give back control? No fear food any more?

My d (19) is 2 years in recovery now and 1,5 years WR and she must still eat 3 meals and 2 snacks (we never had 3) and she still needs to eat a lot. We did it that way (laddering): First she was allowed to chose between 2 or 3 options. Then she was allowed to plate 1 snack. Then another snack. Then breakfast, then dinner. Very slow, it took us about 6 months. Lunch is the biggest meal here and is still plated when she eats at home and she has to eat at home at least 3 days in the week (she is at University now but still living at home and having a reduced schedule). We eat breakfast and dinner together nearly every day and when I see that she eats not enough I can tell her that very calm and she will be compliant and add more. That is the state you need to get to, that she does not fight your help but takes it and learns from it. My d had totally lost the feeling for amounts and portion sizes and needed to learn that again. We gave her different "crutches", so for example to take 2 "fists" of each noodles, vegetables and meat. To have a drink that is not water with every meal or snack. To have a pudding after lunch and dinner. She uses that very reliable now and did not lose more than a kg up to now in more than 1,5 years.

I can understand that your d wants more freedom. And it is hard to not give it to them at that age. But if she cannot make sure that she can maintain her weight on her own you need to go back one step and give it another try later. Recovery from ED takes years. And to learn to eat alone takes a lot of time too.

We have a contract here: If she loses 1 kg she is allowed to gain that back within 2 weeks. If she loses more than 2 kg she needs to cut back university and eat at home at least one more day per week or have a gap semester and eat all at home again if that does not work. Same if she cannot manage to regain it within 2 weeks. No negotiation. If it does not work we are back in control. If she skips meals or snacks ED thoughts come back very fast here still after that time. She is afraid of that happening again now so she does not skip meals or snacks (and she knows we will take the car keys if she does it so that helps too 🙂).

So maybe you can offer your d to plate herself the snacks (and you help when it is not enough) and you are in charge for meals again until she has regained the lost weight. And then you can work on what is a good meal size slowly for each meal. You could set a limit of weight that can be lost before you step in again and you can set a time line for her to try to regain it alone. They need boundaries and a vey tight construction to be able to do that and stick to these rules for a very long time or ED will walk into that wide open door again.

RE the texting: Does it help? Does she eat XX if you text her that her snack was too small? Then why not? What ever works to get the food in...
But if it hits a wall (you wrote she is resistant to input of her team), then better have some open words...if that starts a fight that is another BIG sign that giving back control is too early...still need to fight for getting food in is a sign for phase 1.
Keep feeding. There is light at the end of the tunnel.
Quote
sk8r31
I most definitely used texting and emails to help with communication during our darkest days.  It did allow d to get 'used to the idea' of what was coming ahead, and it did avoid some of the blow out that could happen when challenging ED.

It seems to me that you might consider a contract with your d, as tina has suggested.  Spelling out exactly what will happen with a certain weight loss, and what support or 'scaffolding' will be put in place if needed.  It is a bit of a dance when giving back some control, but you definitely want to avoid uncontrolled and sustained weight loss.  

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Quote
debra18
My daughter just turned 13 and doesn't have a phone. I write her notes when I want her to work on things. But I saw that she kept the notes and didn't want her to only have negative ones. So I started writing positive notes too not related to ED. I wrote her about strengths and things she did not related to food and weight. So if you write about things to work on maybe write other things to so it's balance and doesn't seem like an attack. I suggest going back to plating her meals and give her control slowly. 
Quote
Rose321
Thank you all!  This is so helpful.  It did seem early to me to go back to our daughter having this much control, but she is very persuasive and uses the fact that she has made progress and been compliant to advocate for more control.  But her weight loss was 2 kg, so that is very concerning.  I really like the idea of doing a short-term contract with her -- she regains the weight with XX time and then maintains it or we come in with more oversight.  We have not ever done a contract with her and I think this will appeal to her.  I also appreciate the insight about how long recovery takes. I know this, but I think because we had a period of continuous progress, I got complacent/hopeful.  And yes, we will introduce texting into our communication -- I'm glad to hear it's been a good tool.  We just need to reduce the confrontation and a contract and texting may help. Thank you all.
Rose
Quote
Rose321
Tina -- Thanks for the detailed information about your plan and structure.  My D has a lot of anger right now.  Part of this is about the ED, and part of it is normal teen-age emotion that she is starting to feel now that she is WR. She's been keeping her anger suppressed for years and has just been the good girl.  So we are balancing how to allow her to express normal and healthy levels of anger without that anger getting in the way of us helping with her recovery (by plating food, monitoring it when she does it on her own, etc.).  So ways of keeping that help "neutral" are key.

Thank you 🙂 
Rose
Quote

        

WTadmin