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

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K63
So I haven’t been on here for a long time my daughter had anoxeria we as a family and she as a sufferer went through some hellish years . She is now binging she is aware and really wants to stop how can I support her. She is 22 and just about to start her 4 th year of college. I am just recovered from the last illness and am exhausted at the thoughts of another ED taking over.
Daughter started restricting in February 2014, tried re feeding at home hospital admission 4 1/2 months weight restored started restricting post discharge, back on meal plan full supervision weight restored april 2016. Starting to hand back responsibility for meals it's scary. 
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deenl
Hi K63,

Good to hear from you but I do wish life had not landed you all with yet another challenge. It's so unfair. I imagine it's a touch easier that your daughter is fighting beside you this time rather than against you? It must be very daunting to have to go looking for a way forward again but I am just wondering if you have had the chance to look around and see what help is available. I dread to think and fear it is probably even less than for RAN but it would be good to know one way or the other. What sorts of things are you and your daughter trying? Do you have any outside help at all?

Hang in there,

D


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

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • 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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Mamaroo
Hi K63, sorry you need to go through this again. I would suggest that you d eats regularly (every couple of hours) and that all meals and snacks contain plenty of fats and protein. If she binges on certain foods, then it would be best not to buy them. Hyper palatable food such as sweets and chips are ussually triggers for a binge. My favourite snack to stop a binge in its tracks is full fat cream cheese. Let your d carry nut or protein bars with her when she is attending class so that she can have snacks on the run.
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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K63
Hi all Thanks for advice, my daughter is still seeing the same dietician and that’s exactly the advice that she needs structure and needs to eat regularly and balanced meals no long breaks. She absolutely wants to stop binging and doesn’t do it every day but it is an issue as she is upset that she has gained weight .I try not to bring  sweet foods into the house as definately they are triggers. It’s a complete turn around after battling anoxeria I was so delighted that she was eating everything again and now it’s diffucult to stop but of course it’s better not to have them readily available . 
Daughter started restricting in February 2014, tried re feeding at home hospital admission 4 1/2 months weight restored started restricting post discharge, back on meal plan full supervision weight restored april 2016. Starting to hand back responsibility for meals it's scary. 
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tina72
Binge eating at the end of AN recovery happens quite often and I am sure if you insist on the structure of regular full nurished meals and make binging impossible (lock way food if needed) she will get over that too.
Keep feeding. There is light at the end of the tunnel.
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deenl
Hi K63,

My understanding of binging during recovery is that it happens more at the beginning, when a structure of regular meals has been started and the patient's system believes that the famine is over, tries to reduce vitamin and mineral deficiencies and they become hypermetabolic. Tabitha Farrar's blog post on binge eating in recovery describe this phonomena.

I get the impression that both you and your daughter are pretty sure that it is not a series of recovery binges but diagnostic crossover. You have been in the ED world long enough to have read about it. Carrie Arnold's Decoding Anorexia says on page 156
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Scientists know that relapse is exceedingly common, and that people don't always relapse into the same behaviors with which they were initially diagnosed. It's known formally as "diagnostic migration" or "diagnostic crossover," and it happens when someone with the restricting type of anorexia develops binge eating and purging behaviors. Or when someone with bulimia starts losing weight but still binge eats and purges regularly, changing their diagnosis from bulimia to binge/purse anorexia. And so on.


And on page 157
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What sometimes happens, Woodside said, is that the switch from primarily restricting behaviors to binge eating and purging behaviors happens during a relapse when a person's weight is slamming downwards. Every person he told me, has a genetic threshold for starvation and for binge eating, as well as a genetic tendency towards behaviors like vomiting, other forms of purging, and excessive exercise (Devlin et al.,2002). Someone with normal-weight bulimia has a low threshold for binge eating and a high tendency towards purging. Someone with binge/purge anorexia has a higher tolerance for starvation but a lower resistance to binge eating. The restricting type of anorexia has a high tolerance for starvation and a high resistance to binge eating. But if you starve someone enough almost everyone's threshold for binge eating will be crossed. The downward spiral of a relapse can often be when that threshold is crossed, which activates the switch from restricting anorexia to binge/purge anorexia or bulimia.

You say that your is upset that she has gained weight. I wonder if this is causing her to sometimes restrict or to eat meals that are too low in carbs or fats for example. Perhaps exploring some of the Health at Every Size resources may also be helpful.

There seem to be a number of positives in your case, namely that your daughter is working with the dietician to structure meals and that she is motivated to recover. I found this nice article with ideas that she may like to choose to help ride out a binge urge. 

CBT is evidence based for the treatment of BED and DBT seems to be an up-and-coming option for skills to deal with distress tolerance and interpersonal skills. As your daughter's binges are not everyday and she is well motivated I wonder if one of the CBT or DBT self help books, perhaps with the support of a therapist, might be enough for her.

I believe that some anti-depressants have been shown to help and the medication Vyvanse is FDA approved in the US for the treatment of BED. Does she have contact with a psychiatrist to explore some meds to support her recovery work?

On a personal note, I am really glad that you posted. Binge Eating is the most common form of eating disorder and causes huge distress to the person and family and yet gets so little attention. I hope that you and any other parents in similar situations can find help and support with us here on the forum.

You have had such a long journey already that I am sure you will have to dig deep to continue. Your history has shown how strong you are. Wishing you continued strength,

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

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • 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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K63
Hi all  so thanks for all the advice and support , structure and regular eating appears to be key factors. As my daughter has started back in college on work placement she has made out a structured plan with the dietician and so far it appears to be working . I am calling to see her tomorrow and will check in that she is managing. For sure it’s a huge bonus that she is aware and wants support around this new issue. 
Daughter started restricting in February 2014, tried re feeding at home hospital admission 4 1/2 months weight restored started restricting post discharge, back on meal plan full supervision weight restored april 2016. Starting to hand back responsibility for meals it's scary. 
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deenl
Thanks for the update. So glad to hear that something is working well. 

Warm wishes 

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

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • 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.
Quote

        

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