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

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Hello all you brave people,

Needing some advice or hopeful comments to get me through a difficult period please. Miss 13 years has had anorexia since start of 2016, diagnosed in July, many many hospital admissions since then. Several treatment paths tried and failed, and we recently started with a private psychiatrist who is highly regarded and seems very good. But he is on Christmas leave for a few weeks and a new issue has cropped up.

Miss 10 years has on and off for awhile said she thinks she is fat (she isn't) because her one of her schoolfriends is very thin. And very recently she has started talking about dieting and skipping a meal here and there. I have spoken to her about all the issues - what ordered versus disordered eating looks like, what she should be focussing on instead, etc, but I think Big Miss' presence at meals without eating at all has sort of normalised this disordered eating in Little Miss' mind. Obviously we are all very nervous about all this but to complicate things, Big Miss has become absolutely hysterical that her little sister may follow in her path. She has not even begun the path to recovery, not really. So I strongly feel that she is not equipped to help anyone else, despite her arguments that she knows how Little Miss feels and can empathise. But she pushes and pushes to get involved in Little Miss' care. She is really getting involved in every meal, trying to force food into Little Miss, undermining my and their Dad's efforts (which as the oldest of three kids, she's done on many topics for many years anyway). I have told her again and again to trust us as the parents and focus on herself and leave it alone. But I can't seem to stop the girls getting together talking about it constantly.

We are in Australia so we are one week into the six week summer holidays. Which at least means we can monitor Little Miss' meals and she can't just bin her lunch like she could at school. But also means the kids are together all the time.

Does anyone else have experience with multiple eating-disordered children and their influence on each other? Really hating the idea of physically separating my girls but at my wits' end.

Thanks so much.

Dear ausmum,

Where in Australia are you?

There is a person in Victoria I know of who had an elder daughter with AN & now younger D with AFRID.

The mum & her family were actually on channel nine about the Feed Your Instinct website. I will ask here to look on this forum to see if she can help you.
ED Dad
Hi AUSSIEedfamily, I am in Melbourne.

I will be honest right from the start-although I am refeeding smallboy,my 9 year old,it is because of a reaction to Ritalin.HOWEVER, yes, I am experiencing some of the same behaviour from my oldest one who is/was also my an sufferer.
And like you we are dealing with attempts to tell us what to do and how to do it-which a lot of oldest kids are like anyway.
We deal with it two ways.because smallboy keeps a different time schedule,I often get to feed him on his own.i have found that in the morning,feeding him before d gets up works best and .we disallow any talk of refeeding skills with him.that means that she can give him the chocolate milk out of the fridge for morning tea, but she doesn't get to say anything about it,or she has to leave the room.
We as the parents can talk to him about why we are doing what we are doing, but that is not her job, responsibility or right.
9-10 year olds need a different approach in a few ways from older sufferers.they are used to you as parents controlling their diet.so I can plate up French toast for my s that I expect him to eat,and as his breakfast is always made for him anyway, he will.thats his normal.
This was very different from my at the time 15year old who had been making her own breakfast from the time she was 9.i learned from that.
In the end if I get pressure from my oldest an one I point out that I have kept her alive against the odds, I absolutely can manage this,because my s is completely compliant as he has obviously inherited the gene for rapid weight loss, but isn't suffering the same compulsive behaviour.
It's ok to own whose in control of the family-we are as the parents, because when the sh$t hits the fan-the buck stops with us.so try feeding at different times, use family and friends to help distract as needed and be ok with telling the oldest one no and sending her away if needed.just out to the garden to cool down.
Hope this helps,
Thanks for all your replies so far. Regarding the suggestion of separating them via sending Big Miss to residential, this level of care does not exist anywhere in Australia for under 16s and she is only 13. Regarding the comment about her being not ready to return to school, I agree, and was just trying to point out that the kids are necessarily all home all the time right now because it's summer holidays here (I am assuming a lot of people on this forum are in the Northern Hemisphere so not on holidays). She really has attended extremely little school for the past six months.

Refeeding, Yes, agreed this is primary and crucial focus no matter the treatment plan, and has been attempted since day 1. Has been established that this hasn't worked under previous treatment plans we've tried. She does not eat outside of the hospital. 12 admissions in the past six months. Our new psych has ideas but as he is on leave he said before he went on Xmas leave that we would have to "limp along" for now. The issue with Little Miss came to light after he left, hence the fact that we have sort of been left alone with this issue. Big Miss is still getting medical checkups weekly and becomes readmitted to hospital as required.

Husband has severe disabilities and is limited in the extent to which he can assist and support/supervise meals.

I guess my question is how do I separate them given that NOTHING I have said to Big Miss is getting through to her in terms of getting her to leave me and Little Miss alone to manage this. But this is really only something I can work out so I am mostly having a vent!!

Sorry hon, I was unclear.i know that residential i s not an option for everyone-though if NZ has two places I know there must be places in Australia-because up until 2010, NZ had nowhere and the worst cases were sent to residential in Australia.however they sound like they are in Sydney maybe?and given how large Australia is I understand if you don't have local care.here we also have the child and family unit where the under 15s go.its not ideal but they can be moved to the hospital upstairs if they refuse to eat.
What I meant was sending your oldest d into the garden,or in her room-or with dad as even a wheelchair bound person can supervise.it won't be perfect of course but what in this illness is?we do the best we can,with the resources we have.so if you have a friend who can take the oldest for morning tea maybe do that.
Then in the limited time you have get a calorie laden meal in.i am doing waffles with butter,golden syrup and icecream and a milo.french toast with icing sugar and cinnamon.gingerbread men and a juice. Milkshakes with three scoops of icecream and fullfat milk.nothing that looks overwhelming,but stuff that packs a calorific punch.y'know 'bang for your buck'.
Today I reheated a waffle in a normal frypan so I could use butter.keeps it crispy and adds more calories.so you can make a batch and reheat it that way-means you don't have to make them every day.
I hope that this makes more sense to you.its tricky but I think there's ways round it, even if it means one eats with dad and one eats with you or you get little miss up and feed her first.
These long holidays are lovely when you live a normal life but when you don't they can be hell on earth.if nothing else have a cyber hug ( )from me

Yow, you've got your hands full. I'd say, this is the time to call in all your favors. Ask for help. Don't be shy, you can't afford it. Be specific, and you may find that any, many people in your life are willing and able to and happy to help. You have a disabled spouse and two severely ill children. Perhaps a neighbor can shop for groceries once a week, perhaps someone at church can week your yard once a month, perhaps a coworker can do something....

All this will provide you more time to feed your two ill daughters separately, which sounds like the best solution at the moment. (At least, you need to tryh it and see how it works.) Because no, your older d with anorexia can't listen to reason now. Her brain is starved and broken and she's just. not. rational.
And yet the extreme concern and guilt about the effect of her illness on another of her family is a typical symptom of ed. 

Even if you served them the same meal at the same time, but put them in different rooms and shuttled between them....perhaps that could work. At least it would work better than having them at the same table.

In any case, hugs and sympathy to you, and please keep posting here, vents are welcome!

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
Ausmum13 I really feel for you. It sounds as though you are really stuck in the middle and trying to just keep your head above water. Given you are currently being seen via the public hospital could you talk to them about what is happening at home with younger D? I know she is not their patient, however they seem to be the people offering care at this time. I am sure your D is not given a role in refeeding the others when she is in hospital, so this is definitely an ED thing, so could you offer a consequence for her interference in feeding younger D?This is a limit that she will need to accept, you are after all in charge even though for her ED is. 

There is definitely no residential care for under 16's in Australia including in Sydney. In fact the only involuntary inpatient treatment is in public hospitals as either acute medical care (short term) which is what ausmum13's daughter is receiving or via inpatient psychiatric services which may be non eating disorder. Over 16's do have voluntary care in private hospitals, however due to a quirk in the health insurance act, admissions are for 28 days at a time.
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.
I've got two... wouldn't wish this in anyone. Might have three... things that have worked for me, no talking about other child, repeat "that's my job, not yours" about 10 billion times and bring focus back to child in front of you. As much as possible I staggered feeding them so they weren't in same room while eating. It worked for breakfast since they had different school times and if I had to feed them snack together then they got different but equivalent snacks. That avoided the "hers is smaller than mine discussion."
We eat dinner together as a family and it's not always pleasant but it is finally manageable.

Both are currently under their target weights and as always if one starts doing better, the other starts sliding.

Time to put on your big girl panties, I know I had to remind myself to step up support this holiday season when I really wanted to relax.
worried mom
You might point out to Big Miss that the best thing she can do for Little Miss is to eat when they are together.  My brother has two daughters.  One of the conversations I've had often with my daughter is that they look up to her as their aunt and she needs to set a good example by making sure she eats when she is around them.  She has always managed to do that and says it is much easier because she is eating for them.  I don't care why she eats but whatever works!!!