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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KathLW
We need help with how to help our adult daughter with AN. We can't bring our daughter home to live with us... we live in a country with no resources. I could take a leave of absence or quit my job and move to the city where my daughter goes to college to try and help her.  She graduates from college this May.  Recently diagnosed and starting out-patient next week.  BMI is 16.  She is obsessed with exercise and runs long distances.  She is a vegan and environmental activist and won't touch food that she considers harmful to the planet. We have noticed her unhealthy relationship with food for years but when we approach the subject she always has a good argument ready.   She has been seeing a therapist for a few years for anxiety and some "food issues" but she says she was surprised when she recently received a diagnosis of anorexia.  I am going to take 2 weeks off and fly to see her at the end of March.  I want to speak to her face to face, give her comfort, and open a line of communication with her support team. 

When we offered to come to see her she said that was unnecessary, but I think I need to go.  We have not told her that I plan to come.  Our life is so complicated.  We don't really have a home-base in the USA anymore.  We live in central Asia but used to live in Japan where my D graduated from HS.  

Anyway - I know this is a lot of information.  I am seeing guidance on how parents of adult children can get involved in the AN recovery process.  I am also trying to find ANYONE else who has had to deal with an adult child with AN while also juggling a career overseas.   We are terrified.  

Thank you.
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Barberton
KathleenLW, so sorry to hear that you are having to deal with this. I don't have the answer you are seeking but can suggest that once your daughter is in the frame of mind to listen she could listen (and read) the work of Tabitha Farrar. Tabitha is a recovered AN who exercised compulsively. We have found Tabitha's no-nonsense approach really helpful for both us as carers and for my daughter, who understands that she is not alone. Good luck.
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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LaraB

Hi, welcome to the forum. I am so sorry you have had to find your way here. The forum has been a wonderful support to me. There are so many kind parents here. There are several parents with adult children here who I am  sure will be along soon to share their experience. My daughter is younger.

Just a note, the forum is public and it may be an idea to be cautious about sharing personal information. You can always edit messages if you want-pencil function top right of messages.
I felt really frightened too and overwhelmed and shocked when my D was diagnosed. The good news is that full recovery is possible. I appreciate with your family’s circumstances that support is tricky and will need some thinking through. We found plans needed to change to focus on recovery and you and your daughter’s plans may need to change too- so she can have the support she needs around her. 

it is so hard when you are far away. I am glad she has shared her diagnosis with you. Has she been checked out medically- to make sure her pulse rate and blood pressure are stable?

sending you a hug. 
 

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Foodsupport_AUS
Welcome to the forum, sorry that you have had to find your way here. 

It must be very hard to deal with having a daughter who is so very ill so far away. It is really common for those with AN to not recognise the degree of illness and indeed some of the behaviours including food restriction you have seen over the years may be her eating disorder. Unlike many illness those with eating disorders often struggle to be helped, they deny the severity of their illness and also tend to isolate themselves. It is an incredibly tough illness to recover from on one's own and recovery generally takes years rather than months. Close support is often essential so there may need to be some new plans made. Eating the foods that are needed to gain weight, having the support to eat through when they get terrified of what they  need, even though she will deny it is an issue. 

I think it is great that you are planning on arriving very soon. The sooner things get started on recovery the better. 
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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Kali

Hi KathLW,
Welcome, and I hope you will be able to get information and support from ATDT and from the FEAST website

http://www.feast-ed.org

My heart goes out to you in this difficult situation, but it sounds like you have some good options.
Visiting her is a great first step. You can see how things are and try to make some decisions about how to proceed with treatment and how best to support her. 

Becoming well educated about evidence based treatment and reading as much as you can about eating disorders can help prepare you. The FEAST family guides are a good place to start:

https://www.feast-ed.org/family-guide-series/

The first thing will be to figure out how your daughter can weight restore so that she is back on her historical growth curve. This is the first line of defense against anorexia: getting the weight up again, and often the most frustrating and difficult part of the process. The quicker the better. This can happen at home, it can happen at a treatment center, but typically someone who is ill cannot do this on their own and needs support at every meal and snack. And typically they may be very resistant to restoring weight so don't be surprised if this is the case, it is the illness. 

My daughter is the same age as yours and when she first became critically ill we took her out of college and she went into residential treatment. Then she was home for a year while we supported her eating and continued in outpatient therapy. She was at a similar bmi to your daughter when she entered residential. At a bmi of 16 your daughter ought to be seeing a medical dr. trained in eating disorders to have her electrolytes checked, and her heart and health monitored. If your daughter is not already doing this, perhaps you can ask some of the parents on the board if they can recommend a dr. in or near St. Paul who is knowledgeable about ED and make an appointment for her. The problem is that not all physicians are highly trained to work with people suffering from eating disorders, so it is best to seek out someone who has experience in that area.

So those are really the first places to start; with medical monitoring, a plan for weight restoration and figuring out how you can to best support her while she is ill. As with all mental illnesses, people with eating disorders who have solid family support tend to do better than those who do not.

Please ask all the questions you want. There is a wealth of knowledge from the parents here who have walked this lonely road before you and I hope we can be of assistance to you. We are all a little less lonely and frightened because we can support each other.

warmly,
Kali

Food=Love
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ValentinaGermania
KathLW wrote:
I could take a leave of absence or quit my job and move to the city where my daughter goes to college to try and help her. 


If you could do that, do it asap. This will be the first step to help her. She cannot get out of that alone.

KathLW wrote:
She is 22 and graduates this May.  Recently diagnosed and starting out-patient next week.  BMI is 16.  She is obsessed with exercise and runs long distances.  She is a vegan and environmental activist and won't touch food that she considers harmful to the planet. We have noticed her unhealthy relationship with food for years but when we approach the subject she always has a good argument ready.   She has been seeing a therapist for a few years for anxiety and some "food issues" but she says she was surprised when she recently received a diagnosis of anorexia.  I am going to take 2 weeks off and fly to St. Paul MN to see her in March.  I want to speak to her face to face, give her comfort, and open a line of communication with her support team. 


1) Graduation in May should be postponed. She is too sick to do any tests at the moment. She is too sick to be at University at all. She needs bed rest.
2) Exercise needs to stop ASAP. At that low BMI she has NO energy to spend for that. BED REST.
3) Vegetarian, vegan, that is the normal downspiral. Next step is no food at all. This is used as an excuse NOT to eat and this needs to stop. There are full fat vegetarian options that are not harming the environment at all and she needs to eat. She cannot save the planet by dieing.

KathLW wrote:
When we offered to come to see her she said that was unnecessary, but I think I need to go.  We have not told her that I plan to come.  Our life is so complicated.  We don't really have a home-base in the USA anymore.  We live in Kyrgystan now. Our daughter graduated from HS in Tokyo where we used to live.  She is planning on spending the summer there at a little cottage we own.  I am a teacher and have June-August off of work.  She is planning on going to graduate school in London in September.   


Go there, no matter what she says. She will not want you to come and stop AN for sure. She does not want to change anything. She will not recognise she is sick at all. That is a normal symptom of the disease and is called anosognosia.
Stop all plans until she is weight restorated and eats normal again. She cannot go to any school in September in that state. She is life threatening sick.

KathLW wrote:
Anyway - I know this is a lot of information.  I am seeing guidance on how parents of adult children can get involved in the AN recovery process.  I am also trying to find ANYONE else who has had to deal with an adult child with AN while also juggling a career overseas.   We are terrified.  

Thank you.


I can imagine that you are terrified but AN is a treatable disease and if you act now directly and with full power she can get recovered again.
My d was 17 when she was diagnosed and is 20 now and in a very good state. She still needs to eat regularly and we have a lot of rules for a safety net against relapses but she can do everything a normal young woman would do at her age.
You can get involved if you take over with food and cooking and feed her normal food 3 meals and 3 snacks.
Try to find an tay-FBT professional in that region she lives to support you. tay-FBT is for those age 17-23 years old. If you could tell us in what region she lives we can try to help you find a professional there.
Keep feeding. There is light at the end of the tunnel.
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mbs
Dear Kathleen,
 
I've only joined this forum recently but so far been too busy to post . . . until I read yours. I didn't think it was possible that someone else could be in our position.
 
We also live overseas. Our adult (21) daughter recently diagnosed with AN will graduate US college in May.  She was born & raised in Asia, never lived in US until 2016. Until about 2017 she was a classic gym rat, but this devolved over the last year or two into what we now realize was exercise addiction.
 
D​espite this, she was eating well. 
In Sept. 2019​, however,​ she began to​ experience depression and anxiety, and​ ​started to ​restrict food​. [BTW we were told by the school counselor at our international school that pre-college graduation anxiety is fairly common among "Third Culture Kids" . . . .! ]
 
I flew ​to the US end of October to eyeball the situation, ended up staying a month.
Steep learning curve. The girl was diagnosed with bradycardia but bloods OK. Contacted and followed advice from director of Children's Hospital of Philadelphia eating disorder clinic (who don't take patients over age 18). Long story short: she eats very little and becomes anxious after eating anything w/carbs, fats etc. Plant proteins only. Stable now but still underweight: 1st hurdle is getting her menses back on track.  After that, needs to remain stable+eating. For now she gets a physical and weigh-in check 1x weekly by campus clinic doctor; this info is conveyed directly to an FBT-orientated private therapist whom she sees 1-2x weekly (this therapist diagnosed her with OCD and clinical depression); the kid has also begun to see a psychiatrist for medication.
 
Carrie Arnold's book "Decoding Anorexia" is a layman's compilation of ED research, and has been an enormous help in understanding the chemistry and biological aspects of the illness. Also she accurately describes specific anorexic personality traits that mirror those of our daughter. 
 
Tabitha Farrar's books and blog seem to really resonate with our daughter. It's possible that she will do an online consult with Tabitha soon. 
 
As in your situation, our local ED resources are rather basic. Despite her ordeal, our daughter has been accepted into a US grad school and we're now researching & organizing local resources there, as it's unlikely she'll be able to feed herself adequately without oversight. My husband and I are keeping a very close eye on her.  We talk daily to her, and he and I will likely "tag-team" between the US and home in order to oversee her care.
 
I'm not sure where you are but sounds like we might be in the same or similar time zones.  Maybe we can connect/chat.
 
Marybeth
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