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

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mtkmbc4
My young teen d was diagnosed with ARFID last year. It was a several month ordeal of hospital stays, tests, NG and IV nutrition and finally all food by mouth but we got her to gain 20 pounds (restore lost weight and then put her up to almost 50% BMI). 

All along she has has known her weights, percentiles and calorie goals since time after time, she denied any body image disturbance and genuinely seemed happy to reach new weight goals. She also had characteristics consistent with ARFID in the past (and still does to some degree—texture, taste selective and low volumes at times)

We’ve allowed her to participate in food choices to varying degrees along the way, but due to no net weight gain in the past few months (and therefore falling off her growth curve again) and a few other concerning things, we are rethinking our approach. 

Today begins a new approach: considering less frequent blind weights only (weigh more frequently only if her eating is not going well), parents take over all food prep and plating, and we won’t be discussing any more numerical goals (no interim weight goals, no daily calorie goals).

Has anyone else switched strategies along the way, especially those whose children don’t fit neatly into one category?


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tina72
Hi,
you have already done a great job, congratulations, and I think you are doing the right thing to go for blind weighing and parents in charge again.
To be honest, nearly no kid fits 100% into the ED categories and we all are switching strategies from plan A to B to C every day! My d for example was diagnosed atypical AN although I personally thought she was very typical AN...
How can we help besides encouragement?
Keep feeding. There is light at the end of the tunnel.
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mtkmbc4
I can’t think of any specific questions but curious how others who straddle diagnoses handle things. Good to know that we must move from plan A to B to C when needed. I fear too many changes will make us seem arbitrary and inconsistent to our child.
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tina72
Try and error. Try what works for your kid and leave what doesn´t. 😉
Keep feeding. There is light at the end of the tunnel.
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mimi321
Your new approach sounds like a good one. There may be a few bumps along the way but that is to be expected when changing things up, but it certainly seems better suited for what her needs are now. 

I've switched strategies out of necessity, things get better with practice and time. It sounds like you are really on top of this, so well done! 
Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think. - A. A. Milne
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debra18
My daughter also denied body image issues and didn't seem to have a problem when she needed to gain the weight back she had lost .I only found notes from her later saying she thought she was fat and lost weight on purpose. Is it possible she has body image issues and doesn't tell you?
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mtkmbc4
debra18 wrote:
My daughter also denied body image issues and didn't seem to have a problem when she needed to gain the weight back she had lost .I only found notes from her later saying she thought she was fat and lost weight on purpose. Is it possible she has body image issues and doesn't tell you?


Anything is possible, that’s why I’m not ruling it out as possible!
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Foodsupport_AUS
I think caring for a child with ED is constant changing thing. What we do at one stage we don't do later, sometimes it comes full circle. 

My D would have been described as typical restrictive AN for most of her illness, however at the very start she also didn't express any body dissatisfaction. There was no body checking. She was however very thin. As soon as she started gaining weight was when she started expressing the concern and fear of weight gain, then the checking started. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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mtkmbc4
Here’s what I could use help with:

does anyone have a quick link to ED treatment guidelines for pediatricians?

I have Dr. Peeble’s PowerPoint presentation. I also have found the most recent position statement on treatment which was co-authored by Dr. Lock.

I’ll keep looking but thought someone here would have a quick reference.

thanks!!
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scaredmom
I am not sure exactly what you are looking for but here are some links:
http://mh.providencehealthcare.org/sites/default/files/BC%20Eating%20Disorders%20Clinical%20Practice%20Guidelines.pdf

https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/level-care-guidelines-patients

https://www.aedweb.org/resources/publications/medical-care-standards

https://www.adolescenthealth.org/SAHM_Main/media/sahm2015/Speaker%20Handouts/Wednesday,%20March%2018/K-Katzman_Everything-You-Wanted-to-Know-About-ARFID.pdf

XXX
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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mtkmbc4
Thank you!! The purple brochure is one thing I was looking for. 
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Elibean1
Hi! We fit exactly this ‘straddling’ category.  My D was diagnosed as ‘having disordered eating’ after we saw her restricting and worried about having ‘fat thighs’ age nearly 11 - there had been girls teasing each other at school and she got scared. 

I read all I could and we started supervising meals and snacks and worked to empower her at school: she put on weight and felt happier and seemed fine. My gut feeling was that her ED stemmed from medical throat trauma as a baby and toddler - lots of her disordered behaviours reminded me of that, eg drinking milk but not wanting solids. 

She started resteicting again when secondary school school transition came last September, and this time felt sick and scared a lot. We took her to ED service and she was officially diagnosed with trauma based ARFID. She had no, or very few, body thoughts at that time. 

She’s weighed weekly and she eventually started reacting to her increased weight - we told the psychologist, who treated it like any other of her anxieties. But last week D herself said she thought her ARFID was better but now she was feeling fat and wanted to be thinner. I’d kept an eye as she has several AN traits (perfectionist, sensitive, anxious, bright). 

Weve asked for treatment to be reviewed this week and the nurse said it’s not uncommon for kids this age to morph between ARFID and AN....we’re already on 3 meals 3 snacks, so we just want help on the therapy side really. Her weight is good, she’s above her old weight curve.

sounds v much like you, minus the hospital admission - we never went below 92% weight for height, as far as I know. 

Hope all all goes well for your D, I’m sorry you have the same confusing mix tho it’s good to know we’re not alone too! Xx
Elibean
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