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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Wantherback
My 16 year old d with EDNOS has been hospitalised now for 3 weeks, the voice inside her head is so strong that I feel we will never get her back home. We have been trying some meals at home but just getting her to the table is such a battle. I feel like I am saying all the right things once she starts eating but then she stalls when it comes to eating all of her meal or even most of it. She tells us that she's scared if she starts eating she'll get fat so she never finishes anything. We seem to be on an endless cycle of one good day followed by several bad ones. Any magic solutions?
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Foodsupport_AUS
Welcome to the forum. This is a club that no one wants to join. Parenting a kid with ED is tough. It is also unfortunately a long and slow path to recovery, there is no magic wand.  Please feel free to read around the forum. In particular have a look at the Hall of Fame Posts at the top of the page. There will be lots of clues as to how to get things started. 

The most important thing for your D at the moment is that she eats and finishes her meals. I am sure that you know that. Getting that last bite in can be the toughest for some, getting them to start at all for others. 

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 She tells us that she's scared if she starts eating she'll get fat so she never finishes anything.


This is typical ED talk. One of the things that is so hard about parenting kids with ED is learning how to respond. Our natural response is often to reassure, let them know that they won't get fat. Weirdly reassuring the anxiety behind this statement may well increase the anxiety by giving it validity. This was tough for me to learn. These sorts of statements ideally should be acknowledged with something like "Hmmmm! You need to finish your meal. When you have finished we can do X. Did you see my new pair of socks?" You of course can use any other variant that does not acknowledge the scared of getting fat so don't eat. 

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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Charbonie
Our d found is reassuring that our dietitian (we were lucky to find an excellent one who specialised in EDs) set about a 4 lb range and reassured her that we would not let her go above this number. In fact she did go above it slightly but we only told her the trend was upward and she could start eating more according to her hunger cues which she is starting to do beautifully now and has told us twice over the past 2 days how hungry she is (once had a bowl of spaghetti in between meals!). It has taken hard work, thrown food, suicidality, depression, everything in the beginning but things continue to improve.

I am just trying to say that a top number (but don't tell them what it is) can really get some to trust that you are not going to just let them eat out of control and get bigger and bigger and bigger. This is a huge fear especially in the beginning and can reduce the anxiety enough for them to eat more. Is she being blind weighed weekly?

 

Best wishes,
Charbonie
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18 yr old d Dx Mar 25/14. WR June 2014. FBT/EFFT, Individual Therapy. In Phase III, eating intuitively, letting her plan ahead on her own re her nutritional needs for the day and how they fit into her schedule. Teaching her how to cook more for herself. Still watchful. Thankful every single day.

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Foodsupport_AUS
I guess the only thing about putting in a top number is that it is hard to know if they will need to go over this. Some kids need to gain more weight than we expect and even 16 and 17 year olds will still grow. Further there is the natural weight gain that occurs up till early twenties. D has always been told she needs to get back to a healthy weight range for her. Early on though as far as ED was concerned she was obese at any weight.
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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Torie
Charbonie wrote:
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I am just trying to say that a top number (but don't tell them what it is) can really get some to trust that you are not going to just let them eat out of control and get bigger and bigger and bigger. This is a huge fear especially in the beginning and can reduce the anxiety enough for them to eat more. Is she being blind weighed weekly?

I'm sure that is true, but please know there is also a danger in having a "top" number:  At this point, there is no way of knowing how much weight your d will need to drive plenty of nails into Ed's coffin.  And also, it needs to be made clear to her that she will need to continue to gain a little each year through the teen years and also early adult.  And as you may know, some here have found that a relatively high BMI is needed for solid health.

Many (most? all?) here have found that the initial "target weight" was set too low and have had to increase it more (and yet more and maybe yet again more).  That experience has left my d thinking we misled her.  So at this point I tell her, "Here's what I THINK will be enough.  But there is no way to know for sure until you get to that weight and stay there a while.  And then of course you will need to gain a little more each year through teen and YA years."

Charbonie is of course correct in noting that there are plusses of having a top number, and telling them you will watch out for her in that way - I just wanted to also note that there are dangers with that approach so you can have a little more to mull over as you decide what approach to take.

Hang in there - it does get better.
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Torie
Haha - Foodsupport, you beat me by one minute.  Kinda funny as I wrote this hours ago and just now found it sitting here, waiting to be posted.
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Charbonie
I do not use BMI and do not believe it is useful in the least.

I think when one has a very solid growth curve historically that is the best indicator of the natural zone for one's own body weight and one is generally quite safe in determining an accurate range and establishing a top number in that case. The top number does need to go up every year by at least a couple of pounds from 17/18 to early to mid twenties. 

50% of EDs morph into another type of ED, and I do want an indicator if my daughter is eating too much, as that indicates binging behaviour or a continued unhealthy relationship with food. In my opinion, for my daughter, that would be more than a few pounds above her historical growth curve.

I know all about the damage that the anti-obesity campaign has caused, however, being outside of one's healthy range for their own body at either end of that range is not healthy.

Best wishes,
Charbonie
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18 yr old d Dx Mar 25/14. WR June 2014. FBT/EFFT, Individual Therapy. In Phase III, eating intuitively, letting her plan ahead on her own re her nutritional needs for the day and how they fit into her schedule. Teaching her how to cook more for herself. Still watchful. Thankful every single day.

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galanick
My d wt goal was set at 95 lb. +/- 2 lb. if we stuck with that we would stayed Ill. She had little or no improve until 115-120 lb. be very careful setting upper number, many kids have remained sick for years because there team was unintentionally restricting their intake by setting goal too low
eeyore
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mamabear
Here is what we said :

" we will never give you too much and we will never give you too little. Only what your body needs."

We never ever talked numbers- ever.
Persistent, consistent vigilance!
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