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

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pheim
I haven't posted in a while, as my D14 w/ RAN has been doing pretty well...I think...and therein lies my need for some input and answers to the question of, "Where do I go from here?"
When my D was discharged from a 7-week stay in residential treatment, her weight was restored to 137lbs. (She is 5'4" and when admitted was at 110 lbs this past April.) Currently, her weight hovers at 124lbs., she gets her period every month, and is no longer purging. But restricting? That's a hard yes. In helping with her recovery I have been utilizing FBT, but not full-throttle; she is on her own most days for breakfast, a.m. snack, and lunch at school. After that, she eats what I serve her but craves input, ie: wants celery with Ranch dressing to which I say fine, but add a caloric beverage. If given the opportunity she would choose the least caloric items, plus she has great disdain for beverages with calories in them.
Recently, after her twice-monthly meeting with a therapist, I told her it's go-time...her weight has been trickling down and it needs to be restored again, that growing young women should be gaining weight, not losing which means ED is very much alive and kicking in her head.
Do I put myself back in the mind frame of refeeding my D back to weight restoration, and then some? Did anyone else find themselves in this situation? Sometimes I feel like it's hard to wrap my head around this disease...she doesn't look scary thin anymore and she does eat, even bars or cookies outside of my prompting. I just don't know what route to take...or maybe I do but need some voices to tell me where to go from here.
Thank you for reading.
"What's comin' will come and we'll meet it when it does."
-Hagrid
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teecee

Hi there and well done for getting her to where you are now. 

She is possibly compensating by allowing new foods whilst restricting others. It is a balancing act keeping them on track when they ‘fall off’ and have blips. 

Due to her age I would possibly keep control of meals for much longer to prevent the yo yo effect of weight fluctuations. I know this is tough but if you want her to be independent beyond 18 the hard work now will pay off later. My D is 18 in weeks so we are in a different situation than you. I really wished I could keep control of all meals for much longer but we had a choice to make in terms of allowing her to learn to feed and care for herself...which obviously includes lots of learning blips. Not ideal but if she is to go to university next year we had to implement it. 

It sounds like there are still many ED behaviours still present that need to be extinguished. There are lots of positives here so keep moving forward 😊

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pheim
Thanks teecee. You've confirmed what I've been thinking. My D has goals and plans and is very much a social butterfly...I want her to go forth in this world and live life the way she wants to, without ED nipping at her heels. And I feel for you, with your D about to turn 18...what should be so exciting, for our kids with ED is bittersweet and downright frightening...I'm 4 years out with my D and already scared for her. 🙁
"What's comin' will come and we'll meet it when it does."
-Hagrid
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teecee

Yes I feel the same as you.  My D lives a life that is unrecognisable from 2 years ago, for which I’m grateful but we still have a way to go. 

I truly live for today now and will deal with the university question when it comes. If it means her not going then so be it. I really hope she can go and live her life freely though....
Our kids will be just fine because we are the most caring parents who do life saving and life supporting work 😊👍🏻

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Torie
pheim wrote:
Recently, after her twice-monthly meeting with a therapist, I told her it's go-time...her weight has been trickling down and it needs to be restored again, that growing young women should be gaining weight, not losing which means ED is very much alive and kicking in her head.
Do I put myself back in the mind frame of refeeding my D back to weight restoration, and then some?

Sorry to say, it does sound like you need to re-feed her.  It takes a l-o-o-o-o-n-g time at a proper weight before they are able to maintain their weight semi-independently.  In your shoes, I would also ask her to use the bathroom before meals so that she can stay with you at least an hour afterwards to minimize the chances that she will start purging again. 

Keep swimming. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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ValentinaGermania
I can only add that it is important to get rid of ALL ED behaviour. If she is still restricting and not gaining normally (and she must gain until her mid 20s) this means that ED is still around in your house. Try to get her back to that WR weight and then add what she might normally have gained in the last year and keep her gaining slowly but steadily to start brain recovery. If you do not fight all ED behaviour out of your house you leave some door open for a relapse.

Did she grow in the last year? If not, this is also delayed due to not enough weight gain.
I wonder why the therapist did accept that weight loss (137 to 124 is 13 lbs) without making sure she needs to gain again. Normally no AN child should lose weight during FBT. Can you have a serious talk between 4 eyes with her/him before the next meeting?

You will need to feed her and supervise her meals for a long time until you are totally sure that ED is history and she is not restricting any more. Then it is enough time to start phase 2 with a 14 year old. It is normal for a kid of that age to have most meals with the family and not alone. Can you start with supervising breakfast again?

Can we help you with anything more than cheerleading to help you to get started?
Keep feeding. There is light at the end of the tunnel.
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Torie
pheim wrote:
she doesn't look scary thin anymore

I forgot to say, my d never looked scary thin, even when she extremely ill.  That confused me, too!  They don't need to be scary thin (or even thin at all) to be very ill. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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pheim

"Did she grow in the last year? If not, this is also delayed due to not enough weight gain."
I was just looking at her growth chart and she hasn't grown much in the last year, has been hovering pretty close to the 55th percentile whereas before ED she was tracking along the 75th. I'm going to talk with her therapist before the next appointment and discontinue seeing the dietician as it is of no use to my D right now (was figuring this would be the case, but thought we'd try).

"Can you start with supervising breakfast again?"
I've been thinking this is what needs to happen so that I can fortify her food and be sure she eats it all, plus adding juice or milk to drink.

"Can we help you with anything more than cheerleading to help you to get started?"
I think I've known for a while in my heart what needs to happen, and that this ED monster is still lurking around and whispering in her ear. I'm going to have a serious talk with D this evening about the adjustments that need to be made. I foresee coming back here for help with resistance and protest. 🙁
Thank you, ValentinaGermania.

"What's comin' will come and we'll meet it when it does."
-Hagrid
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pheim
"I forgot to say, my d never looked scary thin, even when she extremely ill.  That confused me, too!  They don't need to be scary thin (or even thin at all) to be very ill."
Torie, I see that now as well! Looking at my D you wouldn't know that she was sick with AN outright...but watch her in the presence of food and it's apparent.
"What's comin' will come and we'll meet it when it does."
-Hagrid
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Foodsupport_AUS
Pheim, I am with the others, that ideally that weight needs to go back on. Whether your D is still growing in height is hard to know, height gain usually stops soon after periods arrive in young women, but it is normal for them to continue to gain weight right into their twenties - so loss is definitely of concern. More to the point the behaviours that are leading to that loss are even more of a concern. You say her height was always on the 75th centile, where was her weight two years before ED arrived? This should give you an idea of where her weight should be. 

I don't know if she needs to gain the whole 13 pounds, or even how they came to her discharge weight in the past, but it may be this is where she was tracking in the past and it could be this is where she needs to go, and more to the point she may need to continue to gain from there. Your D is still young and there are great signs in her ability to choose foods and snacks outside of meals, but her tendency to go for the lowest calorie options suggests that there is still some work to do and it makes sense to address it now rather than just hope it will get better with time. 
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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Torie
pheim wrote:
I haven't posted in a while, as my D14 w/ RAN has been doing pretty well...I think...and therein lies my need for some input and answers to the question of, "Where do I go from here?"

pheim, my d was 14 (almost 15) when we started this journey.  It took years of intensive supervision and coaching before she was able to consistently make good choices about meals and snacks.  When it was time for her to head off to university, I was really grateful we had had all those years to prepare.  I wished we had had even more time!

Your d is lucky you are getting on top of this while she still has plenty of time for brain healing while under your watchful eye.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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pheim
"You say her height was always on the 75th centile, where was her weight two years before ED arrived?"
My D's weight at age 10 put her in the 90th percentile; by age 11 she had started restricting and exercising in response to anxiety fueled by a peer at school who referred to her as "fat." I know I need to help her get back to 137lbs so that she can grow and gain from there. We had started seeing a dietician (in addition to FBT therapist) but thinking about setting that aside because she restricts when she tries to feed herself (not surprised at all). If I'm not there to say "Add a beverage to your breakfast," or "Add some toast to that snack," she can't consume enough calories. Thank goodness she eats whatever I give her without a huge fuss right now, but as the weight goes back on I'm anticipating that may change.
"What's comin' will come and we'll meet it when it does."
-Hagrid
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pheim
Torie, that's where my head is these days...thinking about her future and wanting to set her up for a life without ED nipping at her heels. I'm glad you were able to send your D to university, scary though that was I'm sure! I've been supervising and coaching as well, but slowly sliding back into phase 1 as it's evident she needs me to keep plating and serving her food. ED just won't let her eat freely without beating her up inside.
"What's comin' will come and we'll meet it when it does."
-Hagrid
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Torie
pheim wrote:
ED just won't let her eat freely without beating her up inside.

Ugh.  Please let us know how we can help you tackle this monster illness.  It's great that she is eating what you serve at the moment.  Really great news, that. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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ValentinaGermania
pheim wrote:
I've been supervising and coaching as well, but slowly sliding back into phase 1 as it's evident she needs me to keep plating and serving her food. ED just won't let her eat freely without beating her up inside.


It took about a year after WR when mine was ready to go to phase 2. It really takes time and we needed to help a lot at the start. She was not able to feed herself enough, they nearly all aren´t able to, it is a long learning process. It is really great that she accepts you doing that and go back to phase 1.
Keep feeding. There is light at the end of the tunnel.
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MKR
Hi @pheim ,

These mini-relapses creep up on us oh so quietly.

You are right about watching the behaviour around food to assess the state.

So even if you have to go through a bit of a tough time for a while, you are armed with the knowledge, yay.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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