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

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We are refeeding our 14 yr old D, and so far, have her doing 2-3 shakes per day for her snacks with the other snack being a high calorie muffin that we made.
As for the other 3 meals, she only likes to do 2-3 different meals for breakfast, and has trouble with different foods for the other meals as well.
I was reading about Exposure and Response, and was wondering if any of you have used it, and if so, was it productive?
It is basically using all kinds of different foods that they are afraid of, say cake, and having them eat it, and then watching them closely to not allow them to exercise or purge, and having them see that it's ok.

That is what we do with FBT. Present the food and supervise eating and avoid purging for at least an hour after meals/snacks.
What you call "different food" is "fear food" here on ATDT. You can use the "search" button to get more information.
It is normal that they have a very reduced meal plan at the beginning of refeeding but it is important to get back to what they have eaten before AN took over and it is important to have them fully nurished, that means to eat all parts of a normal meal including meat/fish, vegetable and potatoes/rice/noodles.
To present these "fear food" again there are two options discussed here on the forum:
Some parents re-introduce fear food from day one.
Some parents re-introduce it slowly after or at WR. We did that and re-introduced one fear food every week until the list was worked down.
I think it depends on how much stress this is for your kid and you and how much fear food items you have to tackle.

About the response: you will always get a negative response presenting fear food. The first time it is most difficult, then the second time less and the third time it is o.k. They must relearn to eat that like a toddler.

Keep feeding. There is light at the end of the tunnel.
Hi Bakeyser,

We took it easy with the fear foods and didn't force the issue. I was more concerned that she have enough calories and nutrients and be at an acceptable weight and eat three meals and two snacks. We did eat many of the same meals over and over again, and I tried to introduce a new meal once a week and we slowly widened the range of things she would eat.

She was frightened of pie, for example, just looking at one made her hands shake. So we did it in increments: first a bowl of fruit for dessert. Then Fruit with whipped cream on top. Then fruit with whipped cream on a pastry bottom. Then after she had been eating those things for awhile, she had a few bites of an apple pie and it was fine. Then a whole piece of pie. 

Eva Musby writes in her book about using this laddered approach and we found it quite effective.


We were like you Kali. In fact early on we had a fixed seven day menu, breakfast lunch and dinner with a selection of six snacks! Keeping D eating was much more important than variety for us early on. We had many many admissions to hospital for medical stabilisation in the setting of meal being unable to eat, so gently gently was a must. She now eats a very wide variety of foods, and that just happened over time as things loosened up. Getting back to normal is important but there are many ways to do that. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
Introducing fear foods too early was too stressful for my daughter. I started with "healthier" variations that she was more comfortable with like whole wheat bread and brown rice. I insisted only on the foods that were necessary for weight gain. When she was further along it was easier to switch these foods to white rice, macaroni, etc.