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

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My D was 16 when diagnosed 17 months ago.  Our journey has been up and down and currently she has relapsed.  She lost 30% of her body weight but has never been 'underweight'.  This makes it difficult as this is her mantra 'but I am not underweight'!! We are doing FBT.  The anorexic thinking is very strong as are her behaviors, even though she is not underweight, this is where I struggle.  I understand state not weight, so guessing she is still not at an ideal weight where her brain and body are recovered.  I'm feeling almost 'scared' of anorexia at the moment and get a knot in my stomach when D says 'I'm not having a milkshake' etc, I fight through this and getting 3 snacks and 3 meals a day into her. 
The first 6 months after diagnoses seemed easier as she was almost compliant with food?  I kept checking this out with therapist as it didn't seem right.  I was told she would be relieved someone had taken over the food for her as she didn't have to keep fighting AN.  D has since told me this was right and that she hadn't eaten much for so long it was almost a relief? 
However, now with this relapse, it is quite different.  Even though i am managing to feed her, she is fighting and the anorexic thinking and behaviors are much worse than before?
We are under CAHMS in NZ and have restarted back at stage 1 of FBT.
Any help or advice greatly appreciated
If you are going through hell, keep going. 
           Winston Churchill

I am sorry for the issues going on right now with your d. Ed's are such a bear. I would agree with you that she likely needs more weight even is she is not "underweight" for the population, she may be for her own body.
I understand and know intimately, that horrible feeling in your stomach. Finding that inner calm is not easy and many of us had to fake it before it really came. 

Although you say you are fighting to get the food into her, is it happening? Is she eating and gaining?It does get harder, I feel when they relapse, as they are older and know how other "ed tricks".  And there is peer pressure and body image stuff too that is hard to navigate for them and us. But YOU know how to deal with ED, you have done this and you know what is needed. Keep feeding get the weight up. 
Does she have co-morbid mental health issues?  My D has anxiety and is on meds that have been helpful. And we do need to work on the high school stuff now with girls and competition etc. (She is 14 going to high school in Sept). Has there been a trigger recently? Just throwing out some random thoughts.

You have the strength and love to get you through this and you have US. We are here to support you every step of the way. I found when things were bad, I would post more often just to "get it out of my head" on to the computer page. I let the others help me problem solve and it helped so much that I was not alone. You are not alone. We want to help. 
Please ask all the questions you have. Or just come here for a hug! Whatever you need, just say it. We really do care!

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)
Welcome. You are pretty new to this journey and recovery takes a long time. So I wouldn't see it as a relapse because most likely she wasn't recovered yet. It is complicated with Atypical Anorexia. Most people say they need to go back to their original weight. Go for state, not weight, and keep feeding after that to maintain that state.
I also had a d who was never 'underweight' for her height, and never had a BMI below 19 at her sickest, but who lost a substantial amount within 4 months, and ended up needing to be hospitalized for medical stabilization.  It really is a question of state not weight, and what is right for your d. 
It can be more challenging with an older teen, but we were able to turn things around for our then 17-year-old, who had been ill for 3 years.  For us, we needed a contract and leverage & incentives to start to make progress.  And as my confidence grew (from reading & peer support and finally good professional support) it became easier.  Never easy, but easier.
Are you under the same CAMHS team as you had before?  Have you been able to get on the ground peer support from EDANZ?
Please ask any questions you have & we will support you as best we can.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Thank you all so much! Yes I realise it is early days for us and we have a very long way to go!
D has anxiety and depression, anxiety prior to AN. She is on Fluoxetine (Prozac) and we have just had a dose increase to 30mg.
We are under the same CAHMS team but did start off under a private eating disorder clinic.
I have contacted the EDANZ and I am attempting to set up a support group as there is nothing in our area.
I like the idea of a contract for leverage and will attempt this once we see if she is going to be well enough to attend university next year. 
Currently she is at high school in NZ, in her last year. I am very grateful that I work at the school so I am able to supervise meals.
it feels like we have really pulled the plaster off and are hopefully at Rock bottom! the only way has to be up from here!
If you are going through hell, keep going. 
           Winston Churchill
When you are 17 months since diagnose I think this is not a real relapse but she was maybe never really recovered and on a good weight and maybe it has just happened what happens to thousands of families every year: professionals had set target weights too low, freedom and control was given back too early and the supervision was stopped too early. Normally it takes years before you get into phase 2 and 3 of FBT.

When she is 17 now please notice that her being 18 and "adult" is not far away. My d was 17 at diagnose and I was lucky that some old rabbits here told me that it is very important to get her back to a good weight and to start brain recovery before she turns 18 whatever needs to be done. My d was WR 4 months before her birthday and brain recovery started 2 months before and we were glad that she was compliant with FBT and with our help and everything when she turned "adult".

Can we help you with anything? I think you know what to do but maybe there are more questions?
About 25 % off all patients have never been underweight due to standards but underweight due to their former weight. They need to go back where they were before AN started (what percentile was she on until about 2 years before AN moved in?). And some need to overshoot even that for sme time x to get brain recovery started.
You will know when she is on a good weight. Her behaviour will change.
Keep feeding. There is light at the end of the tunnel.
A contract can be useful at this stage, even if your d is not in school.  For our family, we had a contract with incentives during refeeding and then another, different contract when d went away to university.
Finding out what motivates your d, and using that knowledge to leverage desired behaviour (nutritional rehabilitation) is key.  Contracts will be different for every kid & every family.  
Sending warm support.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou