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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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Alwaysthere
Hi Everyone,

I haven't posted on here for a few months, but I find myself looking for help once again. My sister got back from residential treatment back in March. Her team didn't think she was ready to come back, (she's been there since October and is now weight restored) but she's married and was also told her job couldn't keep her employed any longer if she continued to be away. So she came home...

At first things seemed good. She was continuing with therapy and also seeing a nutritionist. She was trying to follow the prescribed meal plans and not exercise. She had her support contacts that she kept in communication with from residential as well. Now here we are in June and weight wise, I believe she is doing well. She definitely looks heavier. While that makes me happy, she has told me that she feels uncomfortable in her skin, changes her outfits a lot, and wants to cut back on the snacks with a little exercise. She is upset because her care team all think she needs to go back to in-patient treatment, which is across the country. So, naturally, she doesn't want to go and I can understand that. She has a new job that she likes and she's married, so going back would mean leaving all that again. She said she never wants to go back to how bad she was before and feels like she can do that on her own without treatment.

Her care team has told her they cannot continue to see and meet with her (the therapist and nutritionist) because it would be "un-ethical" if she doesn't want to follow the treatment they think she needs. I just don't understand that... isn't it worse to just leave her be rather then continue to meet with her, even if she isn't following their directions? And I know relapse happen all the time, but can I trust her when she says she will never go back to being that bad and support her decision to stay here and try it on her own?

I just don't know what to do... I want someone to be in her corner. I'm just so heartbroken to know she's still struggling.... Tears come to my eyes even now. ;(

Thank you
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Barberton
Dear Alwaysthere,

What a terrific and supportive sister you are. You are in your sister's corner and she is lucky to have you.

Perhaps it's not so bad that her care team wants to stop seeing her because their reasoning sounds like BS. I'm not a professional but as a carer of a child with AN, I have come to learn that there is no one clear/straight path to recovery. It takes a lot of effort and has to take each individual into account. So maybe it is a sign that your sister needs a new team?

I would recommend starting by listening to Tabitha Farrar's podcasts to bring yourself (and perhaps your sister's husband) up to speed on caring for an adult with an ED. These podcasts cover a lot of aspects of EDs and something there might ring true and help you help your sister.

Your sister probably doesn't want to go back to the way it used to be. But the ED is probably trying to get her as close to it as it can. Being in her corner might mean someone being there 24/7 to say, "No, you cannot go for a run but you can do some gentle stretching or yoga instead." 

I hope that helps a little. Others with some better insight will chime in soon. Best of luck!

Barberton
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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Foodsupport_AUS
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At first things seemed good. She was continuing with therapy and also seeing a nutritionist. She was trying to follow the prescribed meal plans and not exercise. She had her support contacts that she kept in communication with from residential as well. Now here we are in June and weight wise, I believe she is doing well. She definitely looks heavier. While that makes me happy, she has told me that she feels uncomfortable in her skin, changes her outfits a lot, and wants to cut back on the snacks with a little exercise. She is upset because her care team all think she needs to go back to in-patient treatment, which is across the country. So, naturally, she doesn't want to go and I can understand that. She has a new job that she likes and she's married, so going back would mean leaving all that again. She said she never wants to go back to how bad she was before and feels like she can do that on her own without treatment.


I am sorry that your sister is still struggling. It is great that they managed to get her weight up whilst inpatient and that she seems to be able to maintain this since discharge. It also sounds as though she is struggling from what you say with how she feels inside but is scared to give up those supports that she has around. I agree with Barberton that there are some concerns about the coercion that your sister's team seem to be offering. At the same time clearly we are not there and are not sure of what truly is happening. Since your D does feel that she doesn't want to do what is suggested, but also wishes to continue in treatment has she thought or anyone suggested perhaps bringing in yourself or her husband into the team and working as a group with the therapists to come up with a plan that will work more towards recovery but allow your sister to not feel so restricted?
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.
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Enn
I would agree with all the above. It is common for those when they are discharged to want to restrict again. It tells us that ED is still quite active and a good team would know that this  is a vulnerable time (discharge) for them and actually offer more support rather than less. 
I know how worried you must be, and your sister is an adult and hopefully with your help can make more sense of it. 
Does she involve you and her h in her treatments? If so, then I would ask that you and  her h join her with her therapy sessions so that you will "hear it from the horse's mouth" and you will be able to discuss your concerns as well. Unless you were there you don't know exactly what happened or what was actually said to her. 
Also with COVID, was her workplace not able to accommodate her medical issues, in order for her to continue her therapy? And if work required a note to stay off to be in residential, I would think the  team could do that quite readily.  That would be a valid reason to not go to work. 

Things sound very tenuous at the moment. Wishing that the path become clear so that you may all go forward.
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)
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Alwaysthere
Thank you to everyone who took a few minutes to reply, I really appreciate it. It sounds like my thoughts are similar to your responses, which makes me feel a little bit better. I have asked my sister if I can talk directly to her therapist here locally and she has agreed, so I plan to ask some of these questions. Does anyone have any advice on what to say to someone who is recovering from A when they say they don't like how they look? All I want to do is hurl a ton of compliments at her each day, but I don't want it to feel inauthentic. Sometimes I feel like I never say the right thing...

Thank you guys.... <3 
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PleaseEAT

Can you s do video appointments ?
my d did this for a period whilst the covid restrictions were in place and saw the local GP for bloods etc

it sounds like your s may benefit from more physiological help if she is still concerned about her size/body image issues
We tend not to comment on body shape/size 
but compliment d on her hair or if an outfit looks pretty or I like those shoes/top 
or that colour suits you
that sort of thing

 

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Foodsupport_AUS
What to say to someone when they don't like how they look?

I agree with pleaseeat if you do offer any compliments don't have them be appearance based. Rather compliment kindness, generosity, interest etc.. 
Showering with positive compliments about appearance may make her feel even worse, and make her feel that you are lying to make her happy and that she was right to worry. 

When she is making these comments I would take it as a sign that her eating disorder is making her feel uncomfortable - I would normalise it - it is normal for her to feel uncomfortable at this time, and it will take her time to get adjusted to her new and healthier body. Recognise that she is going to get these thoughts and she will need to learn to sit with them rather than act on them. 
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.
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MKR
Hi @Alwaysthere,

Compliments - tell her how she makes you feel. "I love talking to you", "I am so glad you are here", "Always a laugh". Those are the ones I like to hear best, in any case.

And come to think of if, the friends that always cheer me up, lighting up the room, the life and soul of the party, I don't even notice their outfit or hairstyle but sure can hear their giggles.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Barberton
Alwaysthere, I agree with the others about making the focus of compliments on kindness, thoughtfulness, etc. We went to the measure of covering up mirrors for the first few months of being back home after IP. My h thought I was crazy, but my d said it helped.
If you feel up to it, I would read, "Sick Enough" J. Gaudiani to get a full picture of the medical complications of EDs. It's actually pretty easy to read and helps a carer know what questions to ask the team (including the psychologists).'
Stay strong and be your sister's rock. When you fall into the trap set by the ED and react to comments about body shape etc, forgive yourself and move on. It took me a long time to learn to take a deep breath, wait a beat and then change the subject. My mantra with my d is "You are loved. You are safe." I just say this over and over again to her bc I think it is what she needs to hear.
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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