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

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Hi all, our college d was just diagnosed with AN.  She got a medical emergency release from her college so that she could finish her finals here at home.  She has been home for a week and we have a treatment plan in place.  She met with the dietitian yesterday and was completely overwhelmed by the meal plan.  Dairy upsets her stomach and she has never liked any meat except for chicken (believe me, I have been making LOTS of chicken).  The good news is that she is able to eat with us now (in October she could not sit down and eat with anyone).  She really wants to get better.  This past week she has been eating 3 meals a day, but she doesn't want to snack/supplement.  Does anyone have any suggestions?  Any great recipes for sneaking in fat or protein?  I know that recovery is a long process and we are just at the beginning of it. Thank you for any advice that you can give.
Mamacita, many / most here got in a lot more calories by adding canola (rapeseed in UK) oil to everything from smoothies and soups to yogurt and pasta.  One mom even added it to her d's orange juice!  I was amazed to find that it really does disappear without changing flavor or texture if you whisk it in vigorously and don't go too, too overboard.  (Best to practice beforehand to see how much you can add.)  You can add heavy whipping cream (double cream in UK) to her milk, butter both sides of bread when making grilled cheese, find the highest calorie versions of everything. etc.  THose things can make a huge difference.

It's not surprising that she "doesn't want to snack/supplement."  I can't think of any AN sufferers who do.  It is your job to REQUIRE her to complete them anyway and follow through with the 4 C's: Courage Compassion Consistency Calmness.

Hang in there.  It's tough going, but it's so worth it. xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Welcome to the forum. Sorry that you have had to find your way here. 

It is great that your D has expressed a desire for recovery. For many who have the illness though the desire for recovery is often at odds with what is required to do so. Recovery is anxiety provoking and difficult. If she is going to recovery firstly she is going to need to gain a significant amount of weight. It is probable the amount she is willing to gain falls far short of what will be needed. She will also need lots of fats and oils and a wide variety of foods to make up for her malnutrition. Long periods between meals often makes it much harder to overcome this disorder, hence the recommendation in general for three meals and three snacks, though some do three meals two snacks. Often early on, most foods seem to upset their stomach which has been shrinking and becoming inactive because of the reduced food intake. Considering liquid meals and or snacks can be a good option. If dairy is an issue then looking at thick soups may be an option. 

Encouraging her to follow through on her plan, which is likely to need to increase is essential. If things continue to deteriorate of course you will need to look at other options for treatment. She cannot control those fears so we as parents often have to learn many new skills to help them overcome them. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
Hi mamacita,
welcome here and great that you got her home and are able to make her eat SOMETHING. That is a good start.
"Dairy upsets her stomach" - is there really a medical problem with that? A lot of AN patients say that they can´t eat diary but it is only because they think it makes them fat. If there is no medical reason, diary is necessary. You won´t get all the proteins and fat in there without.

You will not get all the needed calories in there with only the 3 meals, so try to ask her to eat at least one snack and then if she is used to that start with a second one. We only had 3 meals and 2 snacks and it was o.k. It is very important to have not too much time between the meals/snacks. She should eat at least every 4-5 hours to keep her blood sugar constant.

Problems with the stomach are totally normal with refeeding. Her stomach is used to very small portions and needs to get bigger again. Give her a warm pillow or a litte massage after meals to calm her down.

What I can highly recommend are smoothies. We bought a blender and that was the turn. Put fruits and vegetable and juice into it and add up to 100 ml canola oil for 400-500 ml fruits (you need to try how much you can add, increase it slowly). That looks very healthy and light and it gives you a big progress if you can get her to drink two of them a day. Wake her up early in the morning and tell her "Here, drink your vitamins". Vitamins seem to have no calories for AN.

As Torie said, walk through the grocery and buy the yoghurt, the cheese and bread and everything with the highest calories you can get. It took me a week but now I now which are the best brands for that here. Add some canola to yoghurt, pudding and some cream to the milk, cacao etc. Be aware that she doesn´t see it! Lie if necessary.

Ask whatever is needed. We can tell you a lot of tricks...[wink]

Keep feeding. There is light at the end of the tunnel.