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

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toomanyquestions
I'll give a bit of background.  We are totally new to this forum and really to the disease itself.

Daughter is in college, she has been struggling with ED for about 4 years (2 of which were in HS living at home).  We had no idea of it until about 18 months ago.  I knew but "listened" to everyone telling me there wasn't an issue.

She's been officially diagnosed for about 9 months.  She stayed in school and has gained weight since her diagnosis.  She was thin but never dangerously so.  

She is probably now close to the weight she was when she came to college if I had to guess.  She goes to her therapists at school on a regular basis and is motivated to heal.  She has never missed a session and she's 100% accountable to no one but herself with these appointments.  She's made remarkable progress this school year.  She's learning to make good decisions in regards to stress etc for her health.  

She told me right after spring break she was really struggling and could I come to stay with her at college.  I've been here off and on for about a month.  I've been to the therapist with her a few times so I understand what's going on.  

She has been struggling with eating fear foods.  She started with a "healthy" diet for about the first two years.  Didn't lose any weight but was slowly taking anything she deemed unhealthy out of her diet.  No sodas, desserts, bread, cheese etc.  (although she eats full fat plain yoghurt like it's going out of style...I know it is not a logical disease)  Ate a lot of calories a day, so no weight loss.  Truthfully you have to eat a lot more volume of food if it is all healthy to maintain weight with an active lifestyle.  So she was eating a lot. 

Went vegetarian last summer.  That was bad.  She lost weight.  That's when she was diagnosed.  Since then meat is back into her meals on a regular basis and she's ok eating it.  She just decided to one day start eating meat and that was it.  It's weird, she can turn things on and off like that.  

When I came, she was struggling to eat bread but if I plan and prepare the meals she will eat everything in front of her.  Even had pizza a few days ago, and has sandwiches every day for lunch.  She wants me to plan and prepare the meals.  Asked me to do so. 

I feel like she needs to be in a program this summer to learn some coping skills.  I'm hoping with the three month summer break that she can go back to school in the fall and be safe.  

All of her bloodwork, heart tests etc are all completely normal.  She struggles with the voices in her head and is feeling pretty miserable about herself.  But she will eat without a fight (I know it is an internal struggle) anything I put in front of her.  She's asking for me to help which I know is a blessing. 

What I'm wondering is if I'm being delusional that ED is doing this or is she just fighting ED well right now?  It's incredibly difficult.  She's one of the most mentally tough people I know.  I want to do what is best, just not sure what to do.  Do I have her go to a facility for a month or two and get treatment (we don't have any good facilities in our state, so we would have to send her out of state) or do I simply being her home and refeed and have her see a therapist where we live.  I'm not 100% sold on the pysch doc she's seen at home.  She was basically telling me to let her make her own decisions as she's an adult.  She is not financially secure on her own, so I feel like we need to get this done now before she graduates and has a job.  

I've seen no throwing things at me, a tiny bit of yelling but mostly what I see is just general fatigue from fighting this disease so hard.  If I had to guess, I'd say she is probably at her appropriate weight or close to it.  It's really difficult to determine what her weight restoration should be as her body has changed greatly over the course of her college experience.  She's much more muscular now due to the exercising she does.  And muscle weighs more than fat...so she might be at the exact same weight but her fat percentage I'm sure is lower than when she came to college.  She's in the healthy range for body fat percentage.  Her BMI is right around 21-22.  

Any suggestions would be helpful.  Thank you. 
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Francie
Hi TooManyQuestions (there never are too many), Welcome, sorry you have to be here.

Can you give some clarity to this question: What I'm wondering is if I'm being delusional that ED is doing this or is she just fighting ED well right now? What exactly do you mean by you being delusional that ED is doing this? ED is doing what? It sounds like your daughter is fighting ED and she needs help, and she's asking for it. What I hear is your daughter asking you for help and willing to have you help her. Are you able to do what she is asking of you: live on or near campus for the remainder of the semester? FBT (family helping their loved on recover) is the best way for an ED sufferer to move forward and to recover. It seems like your d is asking for just that, and it sounds like she is willing to have your help, which is most important and is in your favor.

I want to do what is best, just not sure what to do.  Do I have her go to a facility for a month or two and get treatment (we don't have any good facilities in our state, so we would have to send her out of state) or do I simply being her home and refeed and have her see a therapist where we live.

I think in recovery it is most helpful if we can include our loved ones (when they are rational, in relatively good health, and older) in weighing in on what they think is most helpful. She is asking for you to help her. Why are you wondering about having her go away for a month or two for treatment? Maybe you can assess that need if your help for her, or her own efforts, are not enough to move her toward recovery.

Do you think you can do what your d is asking? Then have her take some time off this summer and then see how it goes? If you help her and things start going south then you can plan to have her go to a facility.

I hope this is helpful, I don't mean to add to your confusion. I just want to help.

Francie

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toomanyquestions
Well right now, she's asking for help and I've heard so many people saying their kids were so opposed to help and that if your child is happy then ED is happy.  My daughter isn't happy and is asking for help but she's not angry.  She's just exhausted.  I would be too if I had those voices in my head all the time.  Her asking me to meal plan I think is the recovery voice and not ED.  

Between my husband and I we can pretty much get her covered for the rest of the semester.  She may be by herself for a week or so.  Maybe less, we are working it out right now.  He's got an extended trip planned and I have a couple of committments back home that I need to get back to.  I will cancel is she doesn't seem like she's stable.

As far as doing the right thing, I can feed her.  I can have her come back home for the summer.  I just don't feel like she will get the best therapy.  As I said, I'm not in love with the psych doc and I really don't have another good rec.  She came highly recommended but some of her advice has just been flat out wrong.  You know your child and if you see them choosing self destruction things then you don't let them go down that path.  I had a HUGE issue with her saying just let her go and if she ends up in the hospital she ends up there. Absolutely not OK with me.  It would be much easier for my husband and I if she came home but I don't think that is the best place for her.  I think she needs to go to a facility and get treatment.  Let her be with people who know the disease and who have treated it successfully.  I think this could jump start her down a very positive recovery road.  She can't stay at school by herself.  That's not healthy.  No one will hold her accountable and truthfully I think she knows it is not in her best interest.

Have any of you sent your children to places?  I don't think she will qualify for in patient.  I think she will qualify for intensive out patient and if that is the case, either my husband or I will live with her all summer or however long she is there.  We are committed to her recovery.  

My daughter knows she needs help.  She obviously doesn't want to go to a facility (who does) but I think she's realizing she needs it.  We are working on the admissions process now.  and then will make a decision.

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toomanyquestions
I guess that I just haven't seen many on here whose children have asked for help and accept it.  I'm worried it is an ED manipulation.  I don't think it is but maybe that's the part of me hoping she's walking toward recovery.
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Elibean1
It don’t think asking for help ‘is ED’ but I do get a real sense of confusion from you, which I’m guessing may well be a reflection of your daughter’s own confusion. 

Is there anywhere/one you would trust to carry out a thorough assessment with her? Someone who knows about EDs? 
Elibean
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toomanyquestions
She did an admissions screening for a facility.  We need her doctor to send in some records before the team there can come back with a recommendation on what treatment they recommend.  Her therapist at school thinks she needs to go to a facility for at least a little bit to get a better handle on things...I am of the same thought.  
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deenl
Hi toomanyquestions and welcome,

My son is younger so I don't have many specific tips for you. 

One thing that might help you is more information. I would recommend Decoding Anorexia by Carrie Arnold. Carrie had AN for many years and recovered when she was college age with meal support from her parents. I wonder could your daughter come home for the summer but Skype her current team who she seems to work well with. 

I would also recommend https://tabithafarrar.com. Tabitha also recovered as an adult and now provides Skype support.

From my years on the forum, my gut says that your support for your daughter is exactly what she needs. And to look at creative ways tofill the gaps you feel exist in her treatment. Please remember that there are downsides to residential care too and the cons may not outweigh the pros in your case. 

You and your husband are playing a blinder with all the great support and your daughter is AMAZING. Keep up the good work. 

Warm wishes 

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, no progress. Medical hosp to kick start recovery Feb 2016. Slowly gaining at home, seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. 2018 growing so fast hard to keep pace with weight. 2020 Off to university, healthy and happy.
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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toomanyquestions
I'm asking in all seriousness because I don't know the answer.  If I take my daughter home and refeed does she need outside therapy?  Can her brain heal itself with good nutrition?  I'm reading Tabitha's book and it 100% resonates with my daughter's situation.  She didn't have a bad childhood, she didn't have a traumatic experience much like Tabitha, she just started restricting and it went down a bad path...

I'm wondering if all of this "therapy" is helping when what she really needs is food.  (which I know she does need) but if you get the food part back, do you still need to do therapy?  I get you may need coping mechanisms so that you stay in recovery but I guess my question is that with FBT, if the parent is managing meals, does the child still need to go to therapy or can we just focus on eating for now?  I feel like I would need a nutritionist to help make sure she has enough calories and nutrition.  She doesn't need to gain a lot of weight, (or at least I don't think she does...)
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Kali

Hi Too Many questions,

Welcome to ATDT. I hope you will get good support here and some ideas which can help you decide how to proceed. 

There also may be some parents who can recommend providers near where you live if you are comfortable sharing that.

Some of the reasons to seek out a higher level of care might be:

food refusal
dangerously low weight
purging and the need to interrupt that behavior.
excessive compulsive exercise
depression
self harm 
suicidal ideation

There are also some outpatient therapies which my d. tried at the same time as being refed. CBT and DBT. You can look into them and see if it is something your daughter might benefit from. 

 

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I'm wondering if all of this "therapy" is helping when what she really needs is food.  

It really is very individual, what helps or not. It always requires enough food and being weight restored for a long period of time for the state of someone suffering from an eating disorder to improve. Sometimes adjunct therapies can also be helpful and sometimes individuals can benefit from higher levels of care. It is really up to you and your daughter and what her providers are recommending at the moment for her to consider.

Here are a couple of books many parents have found helpful in case you want to take a look:

Anorexia and other Eating Disorders: How to Help your Child Eat Well and Be Well

 

When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating

 
 

 

Food=Love
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atdt31_US
A couple thoughts reading your posts:

1.  Can you access her growth charts from maybe Seventh Grade forward?  If you can, you might see trends that verify your thought she has been struggling for four years (or it might show something else).  It likely will show that at some point she had a normal growth arc that at some point dipped or plateaued .... you want to get her back to at least the highest part of that pre-dip/pre-plateau arc and THEN assess "state" to see if that is high enough.  Just knowing her current BMI is not a great indicator of whether she is "weight restored."  Her "state" seems good in some respects, but the fact the pros you trust (and you yourself) think she needs a higher level of care is telling.  You can go to a free program online, MyGrowthCharts.com and input any data you have ... any height or weight you trust from her childhood would be helpful to try to assess whether she is in fact near a weigh that seems to make sense when looking at her own personal history at least a year or two before you believe the restriction started. 

2.  From reading on this forum for years, it seems many families are able to refeed at home and SOMETIMES the weight restoration (and MAINTENANCE of healthy-for-her weight) for a substantial period of time, is enough to deal with the issues that therapy may in other circumstances address.  Depending on the patient, however, many patients do get to a good weight and enjoy some reduction of the co-morbid psychological issues, but still need some sort of therapy to separately address the co-morbids.  Generally speaking, unless there are crisis type issues at play (suicidal, etc), a sustained time at a proper weight is step one; then assess what's left and with the well-nourished patient, start proper treatment of the co-morbids.

3.  I like the idea of skypeing with the current team if that is something you can work out, since it seems you prefer them to the local team if she moves back with you for the summer.  That said, this advice that she be independent "because she is an adult" is, I think, premature and perhaps a red-flag for the team that made that suggestion.  Keep in mind, however, my kid is way younger, so maybe with a college kid hitting this reality head-on is done more quickly.

4.  You pointed out you still have some financial leverage .... many here have found that even with older patients the parents can use this to see that proper treatment and nutrition are sought.  It sounds like she is saying some very comforting things, and I'd take full advantage of that and feed her as long as she'll let you pick the "what" and "how much" of eating.  BUT I would be on alert for this being less than genuine ... and I'd keep an eye on the exercise since you mentioned she has become more muscular while away.  Some kids purge by way of exercise (not vomit).  
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth.  UPDATE:  July 2019 diagnosed with PANS. Dr. said likely started first PANS episode at less than 1 or 2 years of age.  On long-term daily prophylactic antibiotics. BMI now about 16 after period of intense refeeding prior to PANS dx,  followed by stagnation as we sort out what is next. FWIW ED-D is a fraternal twin and we have no other kids.
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ACL
It is fantastic that she is asking for help and can let you feed her. I think if I were you I would read lots, try to be creative in figuring out a team with enough knowledge of EDs to really help and try to support her at school \ home.
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Mamaroo
Welcome from me as well and sorry you need to find us.

I'm asking in all seriousness because I don't know the answer.  If I take my daughter home and refeed does she need outside therapy?  Can her brain heal itself with good nutrition?  I'm reading Tabitha's book and it 100% resonates with my daughter's situation.  She didn't have a bad childhood, she didn't have a traumatic experience much like Tabitha, she just started restricting and it went down a bad path...

I'm wondering if all of this "therapy" is helping when what she really needs is food.  (which I know she does need) but if you get the food part back, do you still need to do therapy?  I get you may need coping mechanisms so that you stay in recovery but I guess my question is that with FBT, if the parent is managing meals, does the child still need to go to therapy or can we just focus on eating for now?  I feel like I would need a nutritionist to help make sure she has enough calories and nutrition.  She doesn't need to gain a lot of weight, (or at least I don't think she does...)


Food needs to come first, the brain can't heal or benefit from therapy when it is malnourished. The brain consists of 60% fat, so include a lot of fat in her meals. I gave my d an omega 3 capsule as well as a good multi vitamin, calcium and zinc. So getting her back to her historical weight curve (and even over) is the first step. The second step is to continue refeeding at the higher level since metabolism goes up when refeeding. This higher metabolism can last for several months to even years. Brain healing takes a long time, my d's ED thoughts were just as bad at her lowest weight than at her WR weight. In general it takes between 6 - 12 months BEFORE you will start to see a change. Our treatment team allowed for 6 months before sending her to the psychologist for a couple of sessions, after which the psychologist told me that there really is nothing for her to do and that the sessions (maybe 3 in total) could be stopped. I know of a lot of people here who did not use therapy to get their children well. It seems that your d is able to separate the illness from herself and is thus able to ask for help. As for getting a nutritionist, here is a good recent thread, pros and cons explained, so that you can make up your own mind;
https://www.aroundthedinnertable.org/post/dietician-harm-vs-help-10097176?pid=1308198735
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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toomanyquestions
Thank you for all of your replies.  I wish this was more black and white.  How do you know what is best for your child?  There are so many different viewpoints and options.  I know she needs to eat.  It seems like there has been about nine months of therapy when in reality she needed to eat more and doing it slowly has just drug this long process out even longer...

I'm frustrated.  My husband is frustrated with me for pushing and my daughter is digging in her heels at coming home or going to therapy this summer.  ED is not happy being told ED can't stay at college all summer.  We had a blowout last night and I'm the bad person.  
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ValentinaGermania
Hi and a very warm welcome from Germany. I am sorry that you need to be here but glad that you found us.
I am a bit late into this discussion but want to throw in my 2 cents as I have a daughter at university too. I do not remember if you wrote how old your d is but mines is 19 now, She was diagnosed with AN 2 years and 4 months ago at age 17. We refed her at home and she had no additional psychotherapy as it was not necessary at all here.
I will try to answer the questions I have missed through your last posts:

"Do I have her go to a facility for a month or two and get treatment (we don't have any good facilities in our state, so we would have to send her out of state) or do I simply being her home and refeed and have her see a therapist where we live.  I'm not 100% sold on the pysch doc she's seen at home.  She was basically telling me to let her make her own decisions as she's an adult."

What she needs is to regain the lost weight and get to a healthy weight for her body and size (which can mean she needs more than she had before AN moved in) and she needs to learn to be relaxed with all sorts of food again and to eat with pleasure and to know what good portions are. This is learning by exposure therapy and that is what FBT is about. FBT works with young adults too and is called FBT-tay then.
So to make it short, she does not need to go anywhere when you are able to serve her food at home and she eats it without compliant. She can learn all that with you. In most cases there are no underlying issues with AN and AN is a metabolism disease which is genetic and you would not call a psychologist if she had diabetes. That is the same. She needs to be well nurished and keep her blood sugar level constant by eating very regularly and all sorts of food without restriction and then she will get better when her brain recovers. It took about 6 months to get my d weight restored and about 4 months later brain recovery started and about 1 year later she was about 90% in recovery. She is in a very good state now although I would not say totally recovered.

"I guess that I just haven't seen many on here whose children have asked for help and accept it.  I'm worried it is an ED manipulation.  I don't think it is but maybe that's the part of me hoping she's walking toward recovery."

"I wish this was more black and white.  How do you know what is best for your child?  There are so many different viewpoints and options.  I know she needs to eat.  It seems like there has been about nine months of therapy when in reality she needed to eat more and doing it slowly has just drug this long process out even longer..."

Sorry, it is not. All families and patients are different but some things are the same. You are right, it is about food. She needs to eat enough and she needs to eat a great variety. Did you already see the FEAST family guides about nutrition? You can find it on FEAST homepage.
It is totally correct that slowing down the refeeding process lengthens the pain and the risk for getting chronic. Fast weight gain is best, that is evidence based.

When my d was at her lowest she also asked for help. Maybe it is a bit different when they are nearly adult, maybe we saw the "light" cases. We had not much throwing and screaming, too, but a lt of melt downs and shut downs. My d was relativly fast in accepting that we plate and is compliant up to now.

" If I take my daughter home and refeed does she need outside therapy?  Can her brain heal itself with good nutrition? "
YES. Here it was the case too and we did nothing but refeed her. Much fat and sugar in the diet and working through all fear food and she is back at her old self and in some cases even better than before (with food range and OCD).

" I feel like I would need a nutritionist to help make sure she has enough calories and nutrition.  She doesn't need to gain a lot of weight, (or at least I don't think she does...) "
This can help if you find a good one but we can also help with that. All I know about refeeding and all tricks with making them gain I learned HERE.

"My husband is frustrated with me for pushing and my daughter is digging in her heels at coming home or going to therapy this summer.  ED is not happy being told ED can't stay at college all summer.  We had a blowout last night and I'm the bad person."

You are totally right with pushing, if you do not push ED will stay forever and she could live an ED free life about next year if you step in now. Take your d home, probably not only for this summer but for an additional health care semester (I am not sure how long "summer" is there 🙂). No college with ED. Back to college only with in a good mental state and with weight restoration at least for 6 months. Make a contract what you will do for her and what she needs to do.
You are not the bad person, you seem to e very good informed and I think you know by heart what is right to do. Go with your gut, you are a good mum and your maternal instincts seem to work quite well.

To give you some time line, my d was weight restorated for 1 year and 3 months when she started University last October (she graduated from school in June). We have a contract and she had to chose a university near home so she can live with us at the moment and go there by public transport. She started on half schedule in first semster being 3 days at University and 4 days at home and that worked well. She learned to eat at the cafeteria there. Now she is in second semster and goes 4 days at University and is 3 days at home and we hope to increase that till winter.
We have a contract: we pay for living, university, car, insurances, holidays, all that is needed and she needs to maintain her weight, eat 3 meals 2 snacks every day, go to GP to get weighed and for blood check regularly and stay in contact with us and the meds. Works very good up to now.
Recovery from AN is possible but it is a long and bumpy road.

Keep feeding. There is light at the end of the tunnel.
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sk8r31
Hi & welcome toomanyquestions.  You've been given some great resources to check out, and I might just add that you should check out the 5 Day program for young adults at the Center for Balanced Living in Ohio.  It's gotten some great reviews from those who have been.  A good way to get everyone 'on the same page' and to give all of you skills and tools to move forward.  We did a very similar 5 Day program for adolescents at UCSD with our then-17-year-old, and it was a game-changer.
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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toomanyquestions
Thank you.  Has anyone done the FBT-tay program in Ohio?  Wondering if this could help jump start things.  It would get everyone on the same page.  The UCSD program doesn't have any adult sessions scheduled.  
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sk8r31
Colleen has done it with her d.  You can search for her posts on ATDT.  I know her personally and have spoken to her at length about their experience at CBL, which was positive.  I know there are others on the forum who have also done the program; hopefully they will share their thoughts.  I'm sure Colleen would be willing to connect with you to discuss her experience if you'd like.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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toomanyquestions
I'm going to get her growth charts today.  
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ValentinaGermania
Yes to the 5 day family programs, no matter where. It is a great start and you get into all you need to know very fast and that is very important in your situation. DO THAT IF POSSIBLE!
If I could have done that (I live in Germany) I would have brought my d on the first flight available.
Keep feeding. There is light at the end of the tunnel.
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toomanyquestions
Actually can't get the growth charts.  She's in archives as she is over 18 and records are in storage elsewhere.  They only do the records once a month at the end of the month, so that's not going to happen for a couple more weeks and then it take a week to process.  They only digitized the records of the younger patients,,.
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ValentinaGermania
We did not have any growth charts too so that is not a big problem. My d just was not sick between 5 and AN moving in at 17 and had not seen any doctor and we did not even use a scale at home.
I just fed her until I saw a change in state (which was about 2 kg more than the professionals suggested). And I got out some pictures of her from about 2 years before AN moved in to see how her face and body looked like then. And then I tried to see the same look today (still working on that part).
You cannot feed her too much in that state. They have a super metabolism, my d eats same as hubby for more than 2 years now and just maintains her weight...
Keep feeding. There is light at the end of the tunnel.
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Torie
If I take my daughter home and refeed does she need outside therapy?  Can her brain heal itself with good nutrition? 


You are correct that what is essential is regaining the weight she has lost (all of it).  And wiping out other ED behaviors (compulsive exercise, fear foods, excessive weighing/measuring of portions, etc.).  That is the key - she cannot get well without that.

Once she has been weight restored for a while, you will know if she needs therapy for comorbids like depression or anxiety.  It is unlikely that therapy will work now, with her brain in a malnourished state.  Many, like my d, have underlying anxiety / depression that will need work later, but that is a problem for another day.  For now, feed her.

I think one of the 5 day family intensive programs sounds like a great starting point.  Many here have said that kickstarted recovery.

Keep swimming. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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toomanyquestions
So, here we are many months later.  Daughter seems great.  State of mind is great. She's my old daughter, happy and enjoying life.  She's eating adequately to maintain her restored weight (assuming it is so since her moods have been so good for months now).  My question is if she's happy and in a good mental state and eating enough to maintain that, should I still worry about fear foods etc?  She's not eating them on a totally regular basis but our family in general eats fairly clean (not a lot of sweets, takeout etc).  If she is with people and pasta is what is served she will eat it.  Will go out with friends for ice cream, but I wouldn't say she would do this alone.  She will go out for drinks with college friends now where before it was a "fear food" issue.  Is exercising on a regular basis but I wouldn't say excessively at the moment.  She did have that issue but seems to be ok with it now.  So, where do I go from here to support her?  
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ValentinaGermania
To be honest, that all sounds very great! So where is your question?
I think you answered it mostly yourself already. If she CAN do it easily when her friends go out she does not NEED to do it daily (sweets, fast food, takeouts).
I would simply watch her and make clear she maintains her weight when she is a grown out and make sure her mood is good and no ED behaviour visible. Take her out regularly to see that she CAN eat in restaurants and have normal takeouts and try to keep that good state! I have no idea what you can do more!
Keep feeding. There is light at the end of the tunnel.
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toomanyquestions
My question is right now do I just watch her state of mind?  If it is good and she's maintaining weight do I sit back and enjoy her and not worry?  So hard to do that as a parent.  
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