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My husband and I have been refeeding our 12 yr. old D for about 11 weeks now. She'said gained 14.5 lbs. so far. Yay!She has about 13 more to go.

Our daughter has unfortunately decided that since we (the parents) are "torturing" her by making her gain weight, she then will not do anything else we tell or ask her to do that she doesn't want to, like ride in the car with the family to go for a fun outing or do her homework, etc. She has grown to getting really angry with me for even bringing up the schoolwork subject just like she used to about food. She was a straight A student before the refeeding started. Now she just wants to give up.

Anyone else have an experience like this? We give consequences sometimes, but it's very hard to find much that she cares about besides tv. Yet tv is the only way we can consistently get her distracted enough to eat.

She does care about her special t-shirts and also her aquarium. She wants to be a marine biologist.

If we take away t-shirts, it helps for a little while, but she quickly goes back to her old ways after she's earned getting her shirts back. If we give the t-shirts to goodwill, she seems to get over it and continue to think we enjoy "torturing" her.

We've thought about taking away fish or live rock, etc.; but her fish keeping hobby seems to be one of the healthiest, most normal, educational, soothing things in her life right now.

What's a parent to do? Any ideas or things that worked for your similar situation?

Thanks for reading. Ever hopeful,

Great job on the weight gain!  Please don't take away her fish tank, you are right, it is a healthy distraction.  My D (now 14) does not do well with consequences, she is better with a goal.  Is there a way to put a positive spin on something?  If you finish your homework without fussing, we can go visit the fish store?

It will get better, and school work is the least of your worries right now...  Just keep swimming!

Maybe she is looking forward to the new Dory movie?
worried mom
Dear hopelove,

Firstly well done!  You've made a great start. 

I think mumto3 has given you a good response. If I were you I wouldn't take away the things she loves. 

When my d was refeeding, we let everything else go.  We decided she was under an enormous amount of distress, dealing with so much, and we didn't want to add to that. We did very few 'fun' things as a family because they usually ended up being not fun at all. 

We did not require her or her younger sister to contribute the the running of the household, chores, etc. It just seemed unfair to expect either of them to clean the kitchen if dinner had been an hour-long screaming match or (attempted) negotiation.

People with active RAN have a (scientifically quantifiable) negative filter.  In other words, a neutral comment or facial expression will be taken as insulting, disappointed, angry, etc.  It is very difficult for all involved.  Maybe the best thing we can do is parents is to keep coming from a place of love and support, rather than consequence and punishment, just like mumto3 says.

And do remember that this is temporary.  You are making amazing progress, and you should start to see improved cognition as her weight goes up.

We found it the most remarkable thing to see the 'attitude' and 'behaviour problems' flicker and die over time. 

You really are doing well. 

D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]

"Our daughter has unfortunately decided..."

Your d has a potentially fatal major mental illness. Her brain is starved and shrunken and its connections and wirings are messed up and she cannot think rationally nor make rational decisions.  In fact, if one can't think rationally, does one make 'decisions' at all? I'm pretty sure she didn't decide to get anorexia. Just as she's not deciding to starve herself, she's not deciding to behave badly. She absolutely cannot help it and treating her as if she can just increases her guilt.

Her wonky thought process may have something to do with self-loathing and depression, which are things that often ramp up during refeeding. She may be thinking something like "I'm so worthless I don't deserve to eat", or "if I'm so fat I don't deserve to go on a fun outing."

I don't know what she's thinking of course, but I'm pretty sure it's bad, that she IS being tortured (but not by you of course) and the best thing you can do for her is feed her well, watch her closely, treat her lovingly, explain that her behavior isn't good right now but that you know she can't help it; it's the illness, not her, get her more fish, be super THANKFUL that all she wants to do is watch TV (instead of doing pushups or something) and cut her hecka slack.

best wishes,

D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
Great advice already, just want to add our experience. D is also not motivated by consequences. She has lost so much already, what's another thing to lose but evidence to her that AN is her only friend? (her pov!)
When my d is compliant with her feeds she needs to feel control somewhere, she needs to say No to something. Often it is her shoes (she's in ip and they have a health and safety rule that shoes need to be worn at all times, so often when d is struggling with her feeds she refuses to wear shoes), sometimes it's school, recently it's been me visiting which has been painful but I know it's all part of the illness.

It is great that you've tried to find a way to motivate your d by imposing consequences, and that does work for some, but not all, and as it's not working it is pointless to continue with consequences. At least she's eating, which is amazing!

She's young, schoolwork can wait. My d has always been a high achiever but she lost her confidence when she realised she was not able to function at her usual high level. Concentration, focus, memory, understanding etc all diminish with starvation and malnutrition.

Gaining weight is the most important thing your d needs to do right now, everything else really doesn't matter!
15yr old d. June 2014 stomach pain. Medical investigations until Feb 2015, referred to CAMHs dx food anxiety. Kept restricting and losing weight until July 2015, medically unstable. Began intensive re-feeding at home. Re-evaluated by psychiatrist, dx Autism Spectrum Disorder and Atypical AN.
Found out it's actually Typical AN.
IP from Oct 15, ng tube Nov. Re-started eating food July 2016. Discharged from IP August 2016 97% weight for height.
Hi, I agree with everything people have said already. When we were refeeding, we let all behaviour go, ignored it.... it was hard, especially for my husband who likes things to be disciplined. My d cannot cope with negative consequences, even now that she is at a healthy weight and doing better. She repsonds much better to rewarding what is good. We recently used a bead jar, like a sticker chart to help her behaviour. This was her idea in fact! So when we caught her doing things we wanted or approved of then she got a bead. And we also had some concrete, measurable goals like- get to school on time 3 out of 5 days (she still struggles with anxiety and getting t school is tough) then she got a bead. When she had enough she could get the ukele she had been asking for [smile]

It is so difficult to parent when they are ill, sending you strength x
D officially diagnosed April 2014 at age 13 after being hospitalised on a medical ward due to severe restriction. Been refeeding at home, doing FBT through CAMHS. Living life moment by moment