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

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TouchandGo
I'm sad to report that I was right, our D has been water loading to hide her weight loss.

She's nearly 6 kilos lower than we thought she was and has gone from a BMI of 21 to underweight in 4 and a bit months. She's also about two weeks out from being 18 which is adding to my terror. She doesn't believe she's sick again because she isn't vomiting or binging and keeps on insisting that people don't need to eat all the time, that you can take a break and etc. I don't think she is purging this time and the psychologist has said that it is common to go from one ED diagnosis to another. She was previously AN B/P.

Because of the drop we're now back to seeing the GP for fortnightly medical checks and our psych gave us a sheet to give him outlining hospital criteria and etc.

Her blood pressure was pretty good (sitting 116/83 - standing 123/83) but her heart went from 100 to 121 bpm. She also has a prolonged QTC interval on her ECG, something she had last time when she was at this weight. The psychologist is very concerned with the results, but the GP didn't seem at all concerned. She only just reached the hospitalisation criteria but he didn't even mention it, it was the psych who told me. I'm scared that she isn't emaciated yet but already having medical complications and that our doc isn't taking this seriously enough. But I don't want to repeat what happened last time she was ill, in which her last GP would send her off to hospital and they would keep her that day + night (and not bother to feed her!!) until they finally got a good vital reading and then send her home.
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Foodsupport_AUS
I am sorry that things seem to have gone backwards so fast.I see that you have been a member for a few years. That ongoing denial/anosognosia is common even this far in. Her medical instability is of concern. My own D seemed to become stable more rapidly at higher weights for some years after re-feeding. That is she had the same degree of medical instability at 48kg as she did at 38kg. My theory was it made a difference as to the speed of weight loss, as well as the rapidity. 

Either way your D sounds like she needs very close watching. You don't mention where you are? Are there local guidelines to help arrange for close monitoring / admission as needed?  Are you able to take over meal supervision again? 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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tina72
Is it possible to see another doctor for a second opinion? Is your GP acknowledged with EDs? Many GPs do not know much about EDs...

It is good that you realised that she is water loading and you can help her now.
Try to ignore that magical date 18. You do not lose all power then until she is financial depended from you. Have a contract with her and tell her what you will do for her (pay for living, phone, insurances, food, car, university, whatever) and what you expect from her (weight gain, eat what you serve, see a GP when needed and compliance and talking to you).
Keep feeding. There is light at the end of the tunnel.
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TouchandGo
I am sorry that things seem to have gone backwards so fast.I see that you have been a member for a few years. That ongoing denial/anosognosia is common even this far in. Her medical instability is of concern. My own D seemed to become stable more rapidly at higher weights for some years after re-feeding. That is she had the same degree of medical instability at 48kg as she did at 38kg. My theory was it made a difference as to the speed of weight loss, as well as the rapidity. 

Either way your D sounds like she needs very close watching. You don't mention where you are? Are there local guidelines to help arrange for close monitoring / admission as needed?  Are you able to take over meal supervision again? 


Yes, it's quite shocking how quickly things can spiral. I knew something was off, I could see she was losing weight but everyone else said she was fine and her weight was good. I don't know if she's really in proper denial or is just good at putting the wool over our eyes. She can talk so logically one moment and then you catch her saying something so disordered, it's not funny. Her work is having a weight loss competition with $100 prize that thank god she hasn't signed up for, but she was telling me all about it and asking me if it was technically cheating if she entered  because wouldn't an ED be an advantage and technically by percentage lost she's beating those that signed up and isn't that hilarious. Doesn't at all see the problem there. 

But yes, she's now back down to the weight she started having medical complications with previously. As far as I've seen, she hasn't been fainting (although I think she's been getting head rushes when she stands up, she denies it but occasionally she braces herself against the table/wall when she jumps up too quickly.) or anything else just yet. Fainting and tachycardia (although all the literature/guidelines talk about bradycardia) was a huge issue last relapse. We've been been dealing with her ED on and off since she was 11/12, so a good 7ish years of this hell and she still keeps crawling back into that hole. I don't know what to do with her anymore. Psych thinks she's been losing about 1 - 1.5 kgs a week since the end of march.

We're located north of Brisbane (QLD). I've been doing some meal monitoring again but it's so hard because I'm a single parent and I have to work. We've been getting some more food into her and stopping the skipped meals but it still isn't great. I don't know of really any support other than the GP/Psychologist where I live. The hospital likes to keep her overnight and then kick her out because she doesn't come across depressed/anxious. She's very polite + affable and will eat/pick at the food given to her so they don't pay attention to the fact that she's only taken a few bites and mushed up the rest. They only tubed her after she started having seizures from low blood sugar (and that hospital stay only lasted a week because she was bubbley and ate what they put in front of her. D told us later on that she knows if she eats and doesn't put up a fight they kick her out faster without making her put on any real weight.)
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tina72
Can you get anybody to help you? Grandparents, a friend, a relative? Someone who could supervise meals when you need to work?
Can you get some time off work to care for her? Here there is a legal right to get some time off work and still payed (but lower income) for some time x to care for a sick family member - something like that?
Keep feeding. There is light at the end of the tunnel.
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scaredmom
At this time I am concerned about her orthostatic heart rate and her prolonged QTC, I suggest that you get her assessed today and I would take the admission criteria hat you have as well as other guidelines  to the hospital.
Your GP and psychologist need to have a heart to heart discussion about the care your d is receiving or not. They with you need to be on the same page and line and have plans in place for all different scenarios for your d. So that all can act timely. 
I am sorry this is happening.  Please get her assessed today. 
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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TouchandGo
tina72 wrote:
Is it possible to see another doctor for a second opinion? Is your GP acknowledged with EDs? Many GPs do not know much about EDs...

It is good that you realised that she is water loading and you can help her now.
Try to ignore that magical date 18. You do not lose all power then until she is financial depended from you. Have a contract with her and tell her what you will do for her (pay for living, phone, insurances, food, car, university, whatever) and what you expect from her (weight gain, eat what you serve, see a GP when needed and compliance and talking to you).

Yes, most GP's know bugger all about EDs. The one we're seeing now isn't the one who was originally following her, but he has a good bedside manner and seems quite willing to listen to the psych and learn what he needs to do. With her turning 18 I'm mostly worried about her being able to refuse medical treatment. The hospital nearly let her refuse the NG tube when she was having seizures and we had to convince them that it was in her best interest to ignore her, so I'm worried how much more difficult that could be once she's a proper 'adult'.

So far she has been pretty compliant in regards to going to all her appointments and talking to her therapist so I'm not pressing the issue there quite yet. Don't want to rock the boat. The weight thing is obviously an issue, but I worry by taking away her distractions, uni, etc. she'll just have more time to focus on ED and greater motivation to fake the weigh ins.  She told the psych one of the reasons she hid her weightloss was because she didn't want to get in trouble or worry/upset me.
tina72 wrote:
Can you get anybody to help you? Grandparents, a friend, a relative? Someone who could supervise meals when you need to work?
Can you get some time off work to care for her? Here there is a legal right to get some time off work and still payed (but lower income) for some time x to care for a sick family member - something like that?


My parents are quite sick at the minute and I don't really have any friends/family that really could understand or step in for me, sadly. The only people who could supervise meals I think would be more harmful than helpful. At least when she's back at Uni next week I can see her card balance to check if she's bought food or not from the cafe. I run my own business (hairdresser), so I can't get any time off like that. If I took more than a week off I wouldn't be able to keep up with the bills.
scaredmom wrote:
At this time I am concerned about her orthostatic heart rate and her prolonged QTC, I suggest that you get her assessed today and I would take the admission criteria hat you have as well as other guidelines  to the hospital.
Your GP and psychologist need to have a heart to heart discussion about the care your d is receiving or not. They with you need to be on the same page and line and have plans in place for all different scenarios for your d. So that all can act timely. 
I am sorry this is happening.  Please get her assessed today. 


It's very late at night here and she has been eating more the last couple of days. We talked to the psych about it, and she's only in the cusp of the admission criteria so as long as she isn't experiencing any symptoms they're just going to keep on monitoring her. We'll be seeing the psych again on Friday and the GP early next week so hopefully we'll be able to get on the same page then. Both the psych and GP want her to stay in control of her meals however and I'm worried about that. I feel like they're acting as if she's only lost a couple of kilos, not 10 in such a short span of time.
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tina72
"So far she has been pretty compliant in regards to going to all her appointments and talking to her therapist so I'm not pressing the issue there quite yet. Don't want to rock the boat. The weight thing is obviously an issue, but I worry by taking away her distractions, uni, etc. she'll just have more time to focus on ED and greater motivation to fake the weigh ins.  She told the psych one of the reasons she hid her weightloss was because she didn't want to get in trouble or worry/upset me."

If necessary she must get treatment against her will if she refuses treatment. These laws exist in many countries and sometimes parents needed to go to court to get their kids treated. It is sad but sometimes necessary.

RE rock the boat: it is needed. We have a say here: you cannot wash her without making her wet. I think it is quite dangerous to let her continue going to Uni in that bad state (if I got that right). It is really scaring that she was able to fake the weight, the psych should have known about their tricks. Is it possible to convince her to do blind weighings? My d fought that about 4 months and then once she was convinced to try it she never wanted to do open weighings again. She is now 19,5 years old and does not even want to know her weight any more.

RE 18: Is it possible that she signs legal papers that you can continue to talk to the doctors and therapists? We have something like that here.
Keep feeding. There is light at the end of the tunnel.
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Foodsupport_AUS
Things are definitely difficult in Australia at this stage of life. At 17 she does have the ability to both consent  to and refuse treatment. There is actually no minimum age as we use Gillick competency as they do in the UK. Your D however sounds very ill, and getting her more specific treatment than just getting her to eat more is an emergency. This post on the NEDC website should hopefully help you out. https://nedc.com.au/research-and-resources/show/issue-7-hospital-emergency-rooms-for-eating-disorders-treatment  It provides links to access pathways of care in Queensland along with links to the current Eating disorder care guidelines from RANZCP. 

If you cannot stay home to care for your D it may be that the only way forward for her is to be in some form of intensive treatment, I would think it would be extremely difficult for her to remain at school during this time and she is probably not fit for work either. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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TouchandGo
Things here have taken a turn for the worst. My mother has had a heart attack and is in hospital, I need to go up there to take care of her and the rest of the family. D is staying home by herself till Sunday because she has work, uni and an exam on Monday. I'm really not happy about this but she's seeing her psych on Friday and then the GP and Mon/Tue. Psych is going to talk to her about possibly staying at an inpatient facility but I don't expect it will go well and she'll be focused on how her Uni is starting again next week and not wanting to miss out/waste money. I've already left but I've talked to her and made sure the freezer is full of frozen, easy meals. I hope she'll eat at least some of it (and if she doesn't we'll see it on the scales at the GP. Maybe the psych can motivate her to eat while we're away to avoid inpatient?).  We're also going to talk to the psychiatrist soon to see about restarting her on antidepressents.

I'm worried about her staying inpatient as well, she's only been at inpatient mental health facility once before and that was a horror show. She ate pretty much nothing for three days (except for two cups of milk) and they didn't monitor her or anything. In fact, she was the one who told us they weren't watching or making her eat and when we confronted them about it they said they didn't have the time/manpower and she needs to make her own decisions (even though they had her on a constant 1:1??). We won't be trying there again, but I have no idea where else she could go that's close and how other people have found it.

Things are definitely difficult in Australia at this stage of life. At 17 she does have the ability to both consent  to and refuse treatment. There is actually no minimum age as we use Gillick competency as they do in the UK. Your D however sounds very ill, and getting her more specific treatment than just getting her to eat more is an emergency. This post on the NEDC website should hopefully help you out. https://nedc.com.au/research-and-resources/show/issue-7-hospital-emergency-rooms-for-eating-disorders-treatment  It provides links to access pathways of care in Queensland along with links to the current Eating disorder care guidelines from RANZCP. 

If you cannot stay home to care for your D it may be that the only way forward for her is to be in some form of intensive treatment, I would think it would be extremely difficult for her to remain at school during this time and she is probably not fit for work either. 


Yes, I believe that's what they used when she was 16 and was refusing the NG tube.  Thank you for the link, I really appreciate that. We're talking about going into an inpatient setting but I don't know much yet. The psych is planning on talking about that with her tomorrow. She's been on holidays for the last month and a bit (and her work is only giving her 1-2 shifts a week because of her age/expense) but she will have a slightly lighter load when Uni starts again next week. Obviously, if she does end up going inpatient Uni and work isn't going to be happening.

tina72 wrote:

If necessary she must get treatment against her will if she refuses treatment. These laws exist in many countries and sometimes parents needed to go to court to get their kids treated. It is sad but sometimes necessary.

RE rock the boat: it is needed. We have a say here: you cannot wash her without making her wet. I think it is quite dangerous to let her continue going to Uni in that bad state (if I got that right). It is really scaring that she was able to fake the weight, the psych should have known about their tricks. Is it possible to convince her to do blind weighings? My d fought that about 4 months and then once she was convinced to try it she never wanted to do open weighings again. She is now 19,5 years old and does not even want to know her weight any more.

RE 18: Is it possible that she signs legal papers that you can continue to talk to the doctors and therapists? We have something like that here.


Yes, it took a woefully long time for them to catch on that she's faking her weight (and especially so that she was managing to fake 6 kilos!!!). We did do blind weighing when she was younger, but it caused her to be a lot more obsessive and resistant so we eventually went back to this. When she is well she doesn't seem to care about her weight (as long as it's no greater than the target range) but as soon as she isn't well she has to check it all the time. We found out that when we did blind weighings she would walk to a pet store nearby and weigh herself on the dog-scale there (and of course the highschool gym let her weigh herself at the start + end of the day without ever bothering to think that maybe that wasn't normal).

I did mention to her about giving us the power of attorney for if she becomes unwell. She didn't say no which is a good sign and was curious about what exactly that would allow me to do and when/how it would end/start. So when she turns 18 we might go see a lawyer to talk to her about it and try and get her to sign it.
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Foodsupport_AUS
Power of attorney in Australia gives you the power to make decisions if she loses the capacity to do so. There are different types and each state has its own rules. This is the Queensland government site with information. https://www.pt.qld.gov.au/enduring-powers-of-attorney/about-enduring-powers-of-attorney/ It does not entitle you to access to her medical records, she can offer a written release. Consent and or power of attorney can be withdrawn. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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Foodsupport_AUS
There is also an Advanced Health Directive which functions similarly and is particularly about how health care should be managed. https://www.qld.gov.au/law/legal-mediation-and-justice-of-the-peace/power-of-attorney-and-making-decisions-for-others/advance-health-directive
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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TouchandGo
Thanks @Foodsupport_AUS , the advanced health directive sounds more focused on what we want but I'm a little bit worried by it stating she can specify that she doesn't want to receive tube feedings. She fought like hell last time to avoid the NG tube (got a 2nd opinion, invoked 'ryan's rule', etc.) so doubtlessly she'll want to put down that she won't want to receive that. Hopefully when we get round to talking to a lawyer he'll point us to which one is best for our situation and make sure her current ill health doesn't effect it. So far she's still allowing her GP/Psych to talk to us outside of her appointments and lets me come sit in with her so that hasn't been an issue so far.

"In your AHD, you can give specific instructions about certain medical treatments, such as whether you want to receive life-sustaining measures—such as tube feeding or resuscitation—to prolong your life."
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Mamaroo
Sorry to hear about your mum, I  hope she's able to recover quickly. Sending you lots of hugs 🤗🤗🤗🤗🤗
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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tina72
Sorry that your mum is so bad. I hope she gets better soon.

RE uni: Who is paying for that? If you do, I would simply refuse to pay for the next semester until she is better. We have a rule here, - 2kg means a gap semester and we will not pay again for uni before she is not WR again.
Keep feeding. There is light at the end of the tunnel.
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deenl
So sorry to hear about your mum. I hope she recovers well.

And so sorry for you trying to juggle two loved ones with medical needs. I hope some issues resolve themselves soon.

Sending you strength and courage,

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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TouchandGo
My mum is recovering well, thank god. Thank you all for your well wishes. She should be released on Sunday and I'll be back home late Sunday arvo.

Just had a call from the therapist this afternoon and it isn't great news. D has somehow 2.1kgs in a single week, but she's claiming it just must be water weight because it's impossible to lose that much that quickly and she'll bounce back up next time we check and etc. I don't know how she's managed to lose that much in only week because she has been eating - not a lot, but much more than before. We're pretty damn certain she isn't vomiting either.

From Psychs session with D she thinks D has very little insight that this is a problem (D thinks it isn't bad because she isn't doing anything like purging or binging, just not eating so much. Even with pointing out her not great vitals at GP D seems to have lost the insight she had). She's changed D's diagnosis from previously AN-BP to purely AN-R. Psych is worried that D is now a chronic case because while we jump between periods of wellness and sickness (She gets very ill, gets better for 6 months to a year and then relapses for the next 6 months/year) this has been going on for nearly 7 years. They talked a little bit about her options as she's turning 18 in two weeks time. Psych is someone D has really clicked with and she has her own private adult practice so D can continue seeing her. But at the minute, with things so bad Psych has recommended D do this 20 session course of CBT-E. It's done by an eating disorder specialist service that opened up only last year, and while our current psych is certified/trained in the CBT-E they do she says it's their bread and butter. So we've got to decide whether or not she does this course with our current psych or with an expert at that clinic (and afterwards we can go back with current psych if need be). I'm not sure which way to jump and if any y'all have experience with CBT-E that would be much appreciated.

We have a med review with the psychiatrist in 2 weeks time in which we might see about starting back again on anti-depressents.

@tina72 Sadly, we're not paying for her Uni. It's going on her HEX debt so we can't use that as leverage. She is paying for pretty much everything in that regard, although she's still living at home with us for free.
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Foodsupport_AUS
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Psych is worried that D is now a chronic case because while we jump between periods of wellness and sickness (She gets very ill, gets better for 6 months to a year and then relapses for the next 6 months/year) this has been going on for nearly 7 years


7 years is often a time frame used to define longstanding eating disorders. The recovery rates seem to go down after this time. It is important to remember though that recovery can still occur after any length of illness. With young people sometimes what they really need is maturity, and frontal lobe development. 
If they are suggesting CBT -E it will take a lot of work from your D to do this. Did the psychiatrist talk about withdrawing from school too? It would seem most appropriate. This is becoming medically urgent. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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TouchandGo


7 years is often a time frame used to define longstanding eating disorders. The recovery rates seem to go down after this time. It is important to remember though that recovery can still occur after any length of illness. With young people sometimes what they really need is maturity, and frontal lobe development. 
If they are suggesting CBT -E it will take a lot of work from your D to do this. Did the psychiatrist talk about withdrawing from school too? It would seem most appropriate. This is becoming medically urgent. 

Yes, I'm hoping that growing older gives her what she needs to get over this awful illness. It's odd, she's so mature and intelligent in every other way that I can't wrap my head around it. Even when she is very ill she is very rarely overtly defiant or rude to anyone. It's so different from what I've seen some of y'all describe or another mum I knew who's D also went through this. I just couldn't believe the cruel outbursts she would describe and the way her kid would throw plates. I feel like I'm falling apart as it is, I wouldn't survive it if my D did and said half of the things hers or some of y'alls do. And yet, her D was only ill for 2 years and has been recovered for 3 now. Jokes on me, I guess.

And yes, from what I've said CBT -E requires a lot of motivation and engagement from the sufferer and I'm worried my D is too in denial to properly engage with it all.She can sound very reflective and motivated at times but I think she's just saying what will make me/the psych happy atm. I don't know. We haven't talked about her schooling just yet, but she is doing only 3 classes this semester instead of the 4 she was doing last semester. If she ends up hospitalised or needs to go inpatient we'll withdraw her but at the minute I don't think we can convince her to defer for the semester. And hopefully it will give her something to focus or motivate her to gain a little weight.
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tina72
Losing 2 kg in a single week is possible. I have seen that too.

Isn´t there a possibility to do FBT with her? I do not see how CBT could work at this malnurished point with no insight...
Keep feeding. There is light at the end of the tunnel.
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TouchandGo
tina72 wrote:
Losing 2 kg in a single week is possible. I have seen that too.

Isn´t there a possibility to do FBT with her? I do not see how CBT could work at this malnurished point with no insight...

We've been doing more FBT/Talk therapy with her for the last couple of years, and while it's helped on quite a lot of facets (especially in regards to her anxiety, expressing distress, being assertive and asking for help) I think the psych sees the CBT -E as the next level up in care. Medically, if her vitals get worse she might need to get medical stabilisation at hospital but at the minute they don't think she's severe enough or a low enough weight to benefit from proper inpatient care. Doc said inpatient is more helpful when BMI >15.5 which she isn't yet.

And that's the problem with how non-combative and polite she is. They don't realise how severely ill or little awareness she has because she isn't acting out. It's awful how much they ignore because she isn't as vocal as other kids are.
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tina72
"Doc said inpatient is more helpful when BMI >15.5 which she isn't yet."

So this seems to be another doc that wants to see patients hit the bottom and nearly die before they get help? Sad.
Keep feeding. There is light at the end of the tunnel.
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deenl
Hi TouchandGo

Tabitha Farrar has a post on the various treatments for EDs. I do love this summary at the end.

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If it works: keep it — if it doesn’t work: trash it

You are an individual, and what works for one person may not work for you. To that point, some aspects of therapy may work for you, and others not so. You can pick and choose. You can pick and mix also. There is no straight path to recovery; it is a ton of learning, tweaking, trying. If you are picking and choosing, your intention has to be solid, and by that I mean you have to understand that if your resistance to someone or something is because you are scared that they will get you to gain weight, then you may have to dig deep into the healthy brain in order to keep yourself there. Tap into that motivation and grit your teeth.
If something is helping; use it. Anorexia recovery is a long and exhausting process and you should take all the help that you can get.
If something is not helping; stop it. Anorexia is a long and exhausting process and you cannot waste time or energy on things that are not working.

I have known people who have been in therapy for Anorexia for years and not progressed, but been told that they are being resistant to treatment if the express that said therapy is not helping them. I strongly disagree. An individual approach has to be taken in order to find what is right for the person. An agile approach has to be taken in order to make changes needed so time is not wasted for that person. We have to be responsive and learn from experiences so we can sift out what works for us to get us where we want to be.

This also means treating the individual even if doing so means you have to drop your own preconceptions or beliefs. To this end, I vow that if someone comes to me and tells me that psychotherapy helped them weight restore and reach full remission I will accept that worked for them. (gulp)

This goes for evidence-based practices too. For example, for some families it is impossible for them to succeed with FBT due to the dangerous level of resistance and/or other psychological problems and therefore additional help has to be given. We have to be able to think outside the box more and get realistic not idealistic. 

There is no right or wrong answer here. But it should not be assumed that seeing a therapist is essential to recovery. The only essential ingredients are food and determination, but that is not to say that additional ingredients won’t make the process more palatable.



I wish you all the luck in the world in finding a path forward. 

Warm wishes,

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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debra18
My daughter was almost always compliant and polite. She had the more passive behaviors like hiding food. It has helped her to express her feelings in other ways (playing piano and journal/poem writing). 
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TouchandGo
As everyone expected, I don't think D made some magical turnaround while I was away. I don't know if it's just me being overly anxious, but she does look she's lost some more weight. We've had to reschedule the app. with the GP so we'll find out if I'm right on Friday.

We had difficulties yesterday, she didn't want to eat breakfast because she was planning on having lunch at her Uni and we eventually compromised (although, she put a quarter of what she was supposed to eat in the bin...). First day back wasn't horrific, she had an important exam that she thinks was okay but cried when she got home because instead of just having what she planned she had seconds(!!). She only had three quarters of dinner, but she was legitimately sick afterwards. Too much at once after no/minimal eating.

She's been insisting as well lately that the only breakfast she wants or will have is oats with water. The sachets themselves don't have a lot of calories (~150 I think?) and I do believe it's the ED talking, but if she doesn't have that she won't have anything in the mornings. Rock and a hard place.

tina72 wrote:
So this seems to be another doc that wants to see patients hit the bottom and nearly die before they get help? Sad.

All the help is like that around here, sadly. Places have BMI requirements to qualify for their service, but they won't see you if D is having medical complications and D seems to get heart + blood pressure problems very quickly. Hospital will only begrudgingly take you in if medical stuff is very out of whack and soon as she gets a single okay reading on their machines they kick her out regardless if she's been eating in there or not. It's a revolving door of stabilisation but not proper treatment.

debra18 wrote:
My daughter was almost always compliant and polite. She had the more passive behaviors like hiding food. It has helped her to express her feelings in other ways (playing piano and journal/poem writing). 


Yes, we've been trying to get her to have other activities that she can express herself with or use to relax. She has always read a lot, played video games and now she's getting into oil painting. I honestly do think the reason she keeps relapsing is because of her comorbid anxiety disorder because when that flares up she always goes back to her ED. The ED behaviours seem to numb her anxiety.
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