Would love some ideas/input from you great people if you can. Already have learned so much from this site. Excuse long post but want to keep learning from those that have been there...
Quick outline: D is 17 y/o out of IP and W/R 4 months. Compliant with me plating 6 meals a day and eating choc, fats, carbs etc although restrictive in terms of meal variety. Beacuse of great advice on this forum, I upped calories over the last month to take her over weight target. It could be a co-incidence but in the last 2 weeks she has spontaneously started experimenting with different foods which could be related to her higher weight. Hope you don't mind if I bullet point these questions and would really appreciate some ideas:
1. She says she never feels hungry. (i know not to rely on h.cues and she has to eat regardless) is this normal? Counsellor suggested we might experiment with losing a snack or reducing snack volume as this might increase appetite for dinners and make 'fear foods' easier as some hunger would be there. She likes sugar though and might spontaneosuly eat sweets if they are around or ask for an ice-lolly after dinner or between meals.
2. We were on the rugby field yesterday during some cold, rainy weather. She was wrapped up but I noticed she was the only girl shivering with the cold. She is absolutely W/R, as said, recently above target and has a regular good intake of oils and fats and sugar. Related to anorexia do you think, or just one of those things?
3. She needs regular food, granted, but we had a breakthrough in terms of introducing new foods in the 1/2 term with more social stuff and off-the-cuff eating and 'just grabbing something out' to eat on our way to places. Food was regular but sometimes later, earlier than usual. She seemed to respond well to spontaneous eating. For example, we met family at a ice-cream parlour. The goal was just to see family and there was no pressure on her to eat anything - they all know her condition and she was welcome to just have a coffee. She said she'd have a scoop of ice-cream and I said: that's fine but we'd need to still have a little something later to make up the energy. She said: I'll have 2 scoops then (small smile like she really wanted it.) I said: cone or bowl? She said: cone. Also, took her shopping and we had to grab something to eat in the car on our way somewhere else. She opted for pasta pot (and she hasn't had pasta for 3 months.) At home she doesn't want to know about any meal plan or what food is coming. As I mentioned in another thread, in contrast to most, she gets bored and feels constrained by the same old, same old, I think. I know most kids don't seem to like a change of routine, but she seems to respond better to stimulation, new places and situations. She is 17 and so maybe this is why? Just wondering if people here have had breakthroughs in eating by changing things up, being spontaneous, eating off the cuff, 'shall we just get a xxxx out? It seems so much different than the typical. Is it a good idea to not be so rigid with our 6 meals a day and play around with 4 or 5 meals a day (as long as she eats every 4 hours) Counsellor said we could experiment a bit using a feedback not failure line but I'm nervous of disrupting a routine that has served us well so far. There are still ED cognitions, I am not sure she would eat if I wasn't around and of course, more variety is still needed though we are making slow headway here.
4. She wants to be a vegetarian. I know the risks and I've said no for now and I've told her that we are aiming for no restriction and that ED can use it as an excuse to not eat/eat less even if her motives are pure now. However, long before ED, she never especially liked meat, loved animals and adores them now (can watch a horror film without flinching but if an animal is threatened in it, she gets distressed) We are also working on her having more autonomy in life as she has been ill and out of life with CFS/anxiety for much of it. So, trying to balance this I've introduced vegetarian foods and have got over some fear foods this way - but we are still keeping on with the meat. I've said: if you can eat a range of veggie and meat options, that means there will always be something on a menu you can eat. It might mean you can then reduce your meat consumption overall in the future as you have a variety of great alternatives but variety is key and meat needs to be part of your life for some time. I hope I haven't opened a door to later restriction but with her age and psychiatric history (Pre ED physically poor health, suicidality, s/h,anxiety) it didn't feel right to close her down completely. Has anyone successfully accepted vegetarianism and seen s or d recover fully?
Thanks so much in advance for any insight, thoughts.....xx