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

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Djb88
Hi
This is my first post after weeks of reading others posts for advice and ideas.   My d is 13 and has restrictive anorexia and ocd.  Her ocd was diagnosed last summer and she was doing well with it after some ERP treatment.  Around December she began cutting out sweets and exercising and by January I was talking with her psychologist about my concerns that her ocd might be turning to food and weight issues.  She quickly went into rapid restriction in February and lost 15 lbs over those 2 months (off an already slight frame).  Before I could even get her in to see my family dr she ended up in emergency with a low heart rate.  She was in ip for 10 days and ate everything they gave  her without so much as a single protest which wasn’t surprising because she has always been an easygoing, kind and considerate child.

Since discharge we have been followed by the eating disorder program.  They gave us the option of putting my d in an intensive outpatient program for 14-24yrolds 5 days/week, 12 hours/day for 8-12 weeks or keep her home with weekly psychology visits with some family counseling and DBT.  After research and reading many books we decided to try to do FBT on our own to avoid the day program which we feared would be really difficult for my d being on the young end of the age of patients.  

So we have been trying to do FBT for about 4 woks now.  When we we first started things went reasonably well.  My daughter ate what she was given with some arguments and attempts to control and restrict. Then starting around the second week she began to become very distressed before eating and would run around the house screaming, throwing things, hitting and scratching up her stomach.  There is nothing we can really do to calm her.  This type of behaviour has been intermittent and other times she is more accepting and calm.  Unfortunately things escalated after her last weigh in earlier this week where although she didn’t find out her exact weight her dr told her she was on the right track.  This seems to have sent ED over the top and she has started to refuse entire meals.  We have tried to encourage her for hours to no avail.  She knows that the eating disorder program have been recommending their day program and we have said that if she doesn’t start to eat we will have to send her but she says she doesn’t care and seems despondent like she has given up on trying.  I’m getting scared that she is going to completely restrict again and she will be back in ip.  I  feel like it’s getting out of control again and my husband and I feel helpless and like failures. We feel like we might just have to send her to the day program.   I apologize for such a lengthy post but any advice or thoughts you may have would be wonderful!
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Foodsupport_AUS
Welcome to the forum. Sorry that you have had to find your way here. 

There is no doubt that re-feeding a child by yourself with minimal support is hard, and for some just can't be done initially. 

To be successful at home re-feeding you have to be able to set things up so not eating is not optional. You also need to be able to control any violence/self injuring behaviours and keep her and yourselves safe. For some kids it just won't work. My D required numerous hospital admissions. Surprisingly for her in the long run insisting on taking her back to hospital when she was struggling was a part of making not eating not optional. If she couldn't eat at home she had to eat in hospital. 

It is not a failure of parents if their child cannot be re-fed at home with minimal supports. Not only is it hard work, but sometimes the eating disorder is just far too strong to battle at home. 

What have you been trying so far as regards getting her to eat? Where have you been struggling with feeding?
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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deenl
Hi djb88 and welcome,

My kid had two admissions in-patient, one to a psychiatric ward which was a disaster and one to the local hospital for a month that went reasonably well. The thing is that re-feeding our kids is most likely the hardest thing that we have ever done in our lives and hopefully the hardest thing we will ever do. In the 3/4 months inbetween admissions we were not very successful in refeeding our son. We did manage to get a routine going eventually but could not get the calories up. He was someone who stayed generally calm but once he had decided he had eaten enough, it would have been easier to try to feed a rock. During and after the second admission went better because I had medical backup. We were able to make slow changes in his food and when he came home I refused to go back to the old habits. We have been on an upward trajectoy since then.

Very many families have put the beginning their children's recovery down to a period of professional/medical support. With the understanding, of course, that recovery takes much longer than we would wish and therefore most of it still happens at home. There is no doubt that the support in the beginning got us started. I was stressed at the time but now I look back and understand that my son's illness was too severe to be treated without medical support. That doesn't make us failures, that makes us parents of kids with severe illnesses. We are not doctors, nurses, therapists. It is not a failure to be unable to do within a couple of weeks something that they have learned and practiced to do over many years.

This is a spectrum illness; some have a more difficult form than others. In our case, I think it was that our son's weight was so incredibly low that his cognitive function was severely reduced and his anxiety and anosognosia was increased. He too had OCD symptoms but they have mostly disappeared with nutritional rehabilitation. This is not always the case, of course  but it does happen very often especially when the diagnosis is very close to the onset of an eating disorder. Oftern they have been sliding slowly into the illness for longer than we realisse - in fact, my son had two weight/height checkups in the year before he became ill and the professionals missed the signs too.

So I would (imagine me using my very kind and supportive voice!) suggest that you get together with your husband and think about what is the most useful, practical plan you can make going forward. Keep trying (we will give you lots of support and tips) or using the professional resources (no failure - you will still need to give LOADS of support, time, energy and work to your daughter's recovery over the coming months).

Wishing you continued strength and courage,

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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tina72
Djb88 wrote:
Hi
This is my first post after weeks of reading others posts for advice and ideas.   My d is 13 and has restrictive anorexia and ocd.  Her ocd was diagnosed last summer and she was doing well with it after some ERP treatment.  Around December she began cutting out sweets and exercising and by January I was talking with her psychologist about my concerns that her ocd might be turning to food and weight issues.  She quickly went into rapid restriction in February and lost 15 lbs over those 2 months (off an already slight frame).  Before I could even get her in to see my family dr she ended up in emergency with a low heart rate.  She was in ip for 10 days and ate everything they gave  her without so much as a single protest which wasn’t surprising because she has always been an easygoing, kind and considerate child.


Hi and a very warm welcome from Germany. They are always the easy going, charming no problem kids! That is part of their genetic ED character. And OCD is very often diagnosed with ED. In some cases it is a symptom of ED. In other cases (like ours) the OCD came with birth but was extremly increasing with ED. Good news is that in most cases OCD disapperas with weight restoration. If it was there since childhood (like here) it does not disappear totally but is much better now than it ever was before.

Djb88 wrote:
So we have been trying to do FBT for about 4 woks now.  When we we first started things went reasonably well.  My daughter ate what she was given with some arguments and attempts to control and restrict. Then starting around the second week she began to become very distressed before eating and would run around the house screaming, throwing things, hitting and scratching up her stomach.  There is nothing we can really do to calm her.  This type of behaviour has been intermittent and other times she is more accepting and calm.  


To be honest, you are still very early days and the behaviour you describe is normal. You really cannot do much about that but insist on eating although she is screaming and throwing things and try to keep you and herself safe (put away all knifes and the good china) and set rules for extreme behaviour (some here had to contact the police to have a mental health officer coming around to tell her that this behaviour is not acceptable). It will get better after a view weeks when they realise that you do not give in and they need to eat no matter what hell and high water comes. Try to get through this state. It is the tunnel to get out.

Djb88 wrote:
Unfortunately things escalated after her last weigh in earlier this week where although she didn’t find out her exact weight her dr told her she was on the right track.  This seems to have sent ED over the top and she has started to refuse entire meals.  We have tried to encourage her for hours to no avail.  She knows that the eating disorder program have been recommending their day program and we have said that if she doesn’t start to eat we will have to send her but she says she doesn’t care and seems despondent like she has given up on trying.  I’m getting scared that she is going to completely restrict again and she will be back in ip.  I  feel like it’s getting out of control again and my husband and I feel helpless and like failures. We feel like we might just have to send her to the day program.   I apologize for such a lengthy post but any advice or thoughts you may have would be wonderful!


Great that you started directly with blind weighing but you need to teach the dr about it (sad enough). Blind weighing meens NO COMMENTS at all to the patient and poker face. This was not your failure but the drs and you should talk about that.
It is no failure to not have send her to the day program as best version is to do FBT at home. With the day program you get help if it does not work at home but in the end you will get them back at home and you need to feed her there anyway. Refeeding at home does not work from day one and you will need a lot of try and error until you know how to do it.
So give it a new start and place the food in front of her and fake that you are convinced she will eat it. Offer distraction, watch TV, offer Ipad games, what ever is needed. At that age you can get them often with incentives. What is she keen on? Nail polish? Music downloads? Netflix? Offer her she can watch x when she has finished lunch. Offer her to go and buy a new nail polish after finishing the snack. Incentives work much better than punishment (although it will cost a lot 🙂).

Can you talk to the people of that day program and ask wether they offer tube feeding there? Can you go back to IP for tube feeding if needed? The threaten of tube feeding if meals were refused often works very well. My d was age 17 at diagnose and she refused to eat anything (also drinking) and she started to eat in hospital when she saw that tube feeding happens in reality. I can imagine that your d ate in IP because of that, too. If she needs to g back for that that is no failure but somethimes needed as plan B.

Do not give up and do not blame yourself for a failure. There is no failure with that, it is all learning by doing and no one of us knew how to do it from day one. It took the most families 4-6 weeks to learn how to do it.
Keep feeding. There is light at the end of the tunnel.
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Djb88
Thanks to everyone for your supportive replies.  It’s breakfast time here so I’m just about to start trying again. Fingers crossed we will be successful.  I’ll try to get back later today to answer some of your questions.  Thanks so much!
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tina72
It really helps to fake that you are CONVINCED that she will eat and that you are NOT afraid of ED!
Put your big girl pants on and think in your head that you will not give in to ED. Try to seperate your d (that is really hungry) from ED (that dares to not allow your beloved d to eat!!!).
Keep feeding. There is light at the end of the tunnel.
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scaredmom
Hello Djb88,
I see from your profile you are in Canada. May I ask where you are? I am in Canada too, Ontario.


We started our ED journey as IP for 3.5 weeks and it was helpful. I learned how to feed my d.  My d (11.9 at the time of diagnosis) was a very compliant "good" eater. Then at home it all went south in a hurry. It was helpful for me to know, that it gets worse before it gets better.
It is part of the illness. You have been given great advice above and there is such a steep learning curve on how to get our kids to eat and that is it. All kids respond differently to incentives, rewards. With my d to get her to eat, we had to be silent and not even look at her.
If your D is not eating enough in 48 hrs or not drinking in 24 hr, she needs urgent medical assessment.

As mentioned above, what are your struggling with right now? What is she eating? We can help get more calories in.

As for her distress, it is up to us to tolerate it. Distraction with things may help. My D and H played ping pong, or watched Netflix, or music etc.. Sometimes it worked and most times it did not, at the beginning.

There is no failure here, (bad word😊) It is feedback. We try one thing and it may work now or not, then we do something different and again it may or may not work. There is so much to learn and you will.
I am glad you found the forum and please read around and ask all the questions you have. There is always someone here who has literally been in your shoes.
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Djb88
Thanks for all your replies so far.  I’m on my own today so I don’t have much time to spare.  After 4hours she finally ate a slice of toast with almond butter and 1//2 banana.  Now I’m turning to lunch because there is no time to worry about snack.  I was starting to prepare an egg salad sandwich for lunch.  Unfortunately she can see me because of the layout of our house and she started screaming I’m not eating it please make me a cheese and veggie sandwich.  Is it a bad idea to give her that because it’s letting ED dictate or is ok to just go with it with the hope she is a least more likely to eat it which she desperately needs to do? 😫
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Ellesmum
Good job with the toast and almond butter. Others will disagree maybe but in these early toughest days I would have made the cheese sandwich, but tried to sound confident ‘sure you can have cheese instead’ like it was always a possibility. My thinking is that right now, today get the food in any which way possible while your real confidence grows over the coming weeks.  

Its a bit of a cat and mouse game at first. I guess lunch has been and gone, did she eat? 
Ellesmum
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Djb88
Thanks for your thoughts on lunch.  I did decide on giving her a cheese sandwich and it was a success.  It’s so hard to know where to draw the line when calories and nutrition are so immediately necessary.  We are still a long way from where she needs to be today but at least there has been some success.  Now we are going to spend some time doing something fun together and try to forget about the next looming snack and meal.  Thanks for all your time and support☺️
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scaredmom

Well she ate something! 

That is the goal, really at this stage. So that is great!

Many of us had to cook and prepare meals when our kids were not around and in the night too. 

What is she able to eat and drink.
Many here add a lot of extra calories via canola oil (into pasta sauce, apple sauce and other foods), heavy whipping cream ( I added to D's milk a bit at a time until she was at a few tablespoons per glass or so. Add cream to yogurt.) Can you add oil to the almond butter without her seeing? Extra butter, cheese, oils (olive, coconut, canola etc).
Juices: Grape has the highest calories per cup so try to get some into her
Smoothies: with whipping cream, oils yogurt, premium ice cream (Haagen Dazs, and ben and Jerry's have more calories per cup than others), juices and chocolate can be added with fruits too. Different combos and you can get up to 1000 or more into them.


Ultimately, it will be your decision what she eats. It is hard to learn that at the beginning and as long as she gets enough calories per day that is the goal. 
Just for an example at 13 she needs to grow a lot and we needed to get to 4000+ cal per day. With the help of a smoothie and the extras. It took a few weeks to get there. 
Don't be discouraged, it takes time to get the rhythm of the ED dance. 
What helped me at the beginning was to keep the schedule the same as the hospital's. And I tried the same foods as the hospital. That gave me more confidence and I would say " you ate it there and you will eat it here. It is the same here and the hospital". 

Being alone with ED is tough as she can see you preparing things with no one to distract her. Do you think you can make a few things later while someone distracts her like the egg salad for tomorrow? 

Hope snacks and dinner go well the rest of the day!
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Ellesmum
Yay, she ate the sandwich! 

It’s worth getting up early to pre-doctor things in the fridge like swapping out milk cartons by putting full fat into the low fat carton at this stage where you just have to get calories in and you’re finding your feet. 
Things like a bag of oats (for example) you can shake a whole bag of ground almonds into and they’re none the wiser.   Even a carton of juice can have castor sugar added, it dissolves well.   Basically anything you can swap out or bulk up in advance will be helpful in an open plan house.  
Ellesmum
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debra18
In my experience it was most important at the beginning to establish a schedule and get the calories and far in and weight on. I allowed my daughter to make choices at the beginning and started with what she considered healthy food. At a higher weight it was easier for me to introduce fear foods. Figure out what works for you and keep going!
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Mamaroo
Welcome from me as well and sorry you need to find yourself here. What you have mentioned about her behaviour is very normal. My d was too young for the day program and she attended the Eating Disorder program as an out patient. It is really an up and down process in the beginning and it took us 7 weeks after IP before she was able to have all the calories required. So, really, you are doing fine, I know it doesn't feel that way. I'm glad she had the sandwich. Another tip is to post the meal plan for the week on the fridge so that she has time to look at it and prepare herself mentally. As long as the swap has the same calories, it shouldn't be a problem, except when she is going backwards (going vegan or vegetarian if the family is not). Another thing you could do, if you have already made the sandwich is to tell her that her sandwich is already made, but that you will make her request the next day. She can even write it on the meal plan. 

This journey is more like a marathon and not a sprint, try and do something non-ed related every day to give yourself (and the rest of the family) some time away frim ED. Sending you lots of hugs 🤗🤗🤗🤗  
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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Djb88
Thanks for all the suggestions regarding adding calories to food.  My d had dinner last night  and only lunch so far today but refused any milk, smoothies, yogurt all day yesterday and again today.  She was drinking 3 glasses of whole milk a day and 10% yogurt for snacks for over a month but has suddenly stopped and become so fearful of them.  Her fear of it reminds me of her OCD fears prior to ED.  We are going to see ED doctor next week and potentially start an SSRI.  In the meantime she is definitely not getting enough calories which is tough.  We spend hours trying to get a meal in and as soon as we do she breaks down because she feels so guilty.  I know if we send her to the day program she would eat everything they gave her and I know they serve lots of foods that are fear foods for her.  I can’t decide if the might be too much for her to handle and when she would return home in the evening she may be uncontrollable with her ED behaviours like scratching herself, trying to exercise, throwing hitting etc. She has told me that when she was in hospital she didn’t have the guilt eating because she has no choice.  We have always been firm that she has no choice at home (and up until this week that was working) but somehow she now views it differently and we can’t convince her otherwise again .....I’m not sure what we are doing wrong....or if her fear has just become so high after her last weigh in our tactics are no longer enough.  We try to offer incentives but she just says she doesn’t care.  It’s tough to know what to do next.  Does anyone have any experience with SRRIs? Or a day program? Any advice when incentives don’t work? Thanks for your suggestions and taking time to reply and help, I appreciate it so much!
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scaredmom
Hi there,
Some parents literally spoon fed their kids when the child could not even pick up the utensils.
My d is on sertraline and she felt it helped her sleep and helped the anxiety a bit.
As for the day program, it may be worth a try as her weight would go on and that can help her brain. But I do understand the worry that when she gets home you may be back to square one.
She seems to be restricting more, that worries me. Is she losing weight? Does she need a medical assessment.As for the foods ie milk product refusal, try your best to get them in, even only one glass of milk per day. The more you allow ED to do, you will have no control at all.
this is the tug of war you need to win.
keep asking questions. Tell us what is going on. Someone may have the right answer/tool for you to use.
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Ronson
It is very hard - they do need to feel like they have no choice but to eat with you at home. Getting to this stage was so difficult for us and we used a number of techniques.  We had friends/family round to eat.  D always ate better in company.  We used life stopped until you eat and basically no phone/I pad etc until food started.  We re plated thrown food and represented. It is so hard.  And we made so many mistakes.  Just thinking of that time makes me feel panicky so I can relate to what you are going through.  Fake confidence and firmness and persevere.  Have an option for not eating, such as phone call to camhs, supplement etc.  We switched to blind weighing which was something of a turning point for us.  We also use fluoxetine.  It helps but works better at a better weight.  It does get better but it is so hard.  
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Djb88
Thanks for your replies.  My d will see her ED dr on Monday for an assessment.   If things keep going this way then she will most certainly have lost weight by then.  I fear perhaps the little weight she has gained (which was 3lbs over 4 weeks since IP discharge) will be lost.
I have tried desperately to get her to have milk and yogurt(with added canola oil as suggested) but it’s a total refusal.  I’ve tried distraction with games, tv computer.  I’ve tried to say “just take one spoonful, sip “ and brought close.  I’ve tried spoon feeding.  She enjoys going for walks so Ive tried to use that and school as an incentive.  We even had her grandparents over and it still took 20 minutes to get it in. ( I’m inviting them again tonight so hopefully that will work again....I fear it might not).  It’s bizarre the way it’s suddenly become an issue.   I’m going to make a dinner with as many calories as possible but her fear list is so great it becomes difficult.  I’m off to present an almond flour muffin and smoothie for snack and my husband is coming home early to help 🤞
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scaredmom
I hope your team discussed more intensive treatment modalities as it is so hard at home, at the moment.
sending you all my support
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Mamaroo
My d has lost all the weight she has gained during IP while I learned how to refeed. I'm glad she is going to the dr on Monday, could you use it to motivate her?

I hope the muffin and smoothie went well. We were told to limit meal and snack times to 20-30 minutes, if she doesn't eat, then she gets to rest on her bed with a book, no tv, no electronic for 30 minutes (frame it that she needs to rest to conserve calories). In that 30 minutes, you can take a break from ED and do something else. After 30 minutes present the food again. Rinse and repeat. Encourage her to just taste it. The first bite is the hardest. If she has the meal, immediately give her an whatever incentive you have up your sleeve (phone time etc). My d didn't have a tablet (I hate those things for children), but I allowed her to play on my tablet after every meal and snack. She ate just to play on it and quickly my tablet became her tablet. 

The feelings of guilt is part of the process and it took my d a long time to get over it. I hope Monday's appointment goes well.
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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tina72
Djb88 wrote:
  My d had dinner last night  and only lunch so far today but refused any milk, smoothies, yogurt all day yesterday and again today.  She was drinking 3 glasses of whole milk a day and 10% yogurt for snacks for over a month but has suddenly stopped and become so fearful of them. 


To restrict diary is very common in AN but also very dangerous as they run out of calcium very fast and that can damage her bones. Can you give her a calcium and vitamin D supplement? Did you have her blood checked for deficiencies?

Djb88 wrote:
She has told me that when she was in hospital she didn’t have the guilt eating because she has no choice.  We have always been firm that she has no choice at home (and up until this week that was working) but somehow she now views it differently and we can’t convince her otherwise again .....


The trick is to make them have no choice at home, too. So what was different in hospital? I suppose there was a meal plan and no negotiation about what to eat. Do that at home, too. What happens at the moment when she refuses to eat what you serve? What happened in hospital? Try to compare that and try to run your home like a hospital ward. We took nearly all rules home from hospital and run our home nearly the same until weight restoration.
Think about what could have happened that she thinks she has a choice now at home. Did you allow her to negotiate about something? Did you give her the choice what to eat? Did she refuse to eat something and got through with it with no consequence? What is different now then 2 weeks ago when she accepted it?
Keep feeding. There is light at the end of the tunnel.
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debra18
Many times kids give hints of how to help them. This was a recent discussion here. Look for hints your daughter is giving you. she said in the hospital she didn't have a choice of eating or not. Maybe this is a hint to you that she wants you to make it clear that she doesn't have a choice .my daughter also never responded to incentives. But I used very few words and no discussion. I told her the words "This is not a choice" and most of the time that worked. Those words became the saying in my house and my kids know when I say it I mean it. Keep trying until you find what works. 
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Foodsupport_AUS
This is never a failure on your part. If she is not eating it is generally because her ED is giving her a hard time. As others have said often the only way she can eat is to feel like she has no choice. Taking the choice away from her means she can justify to her ED that she had no choice, she is not disobeying.

My D still really struggled. In hospital if she couldn't eat a meal she was immediately given a meal replacement, and if that didn't go down she had the replacement down a NG tube. The absence of the NG tube at home meant that she wouldn't take a supplement either if she couldn't eat a meal. We were not able to negotiate with the hospital for a NG tube for missed meals until after her 9th ( and second last admission). If she continues not to be able to eat enough she is likely to need rehospitalisation/alternate care. Depending on her mental state she may be able to use this to eat, some kids never want to go back to hospital. 
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
Djb88 wrote:
I know if we send her to the day program she would eat everything they gave her and I know they serve lots of foods that are fear foods for her.  I can’t decide if the might be too much for her to handle and when she would return home in the evening she may be uncontrollable with her ED behaviours like scratching herself, trying to exercise, throwing hitting etc.


Sorry to be late to the party here.  In your shoes, I would send her to the day program.  Pretty much whatever it takes to get the calories in ... that is my motto.

While she is in day care, you can plan distractions for the evening - visits from friends/relatives, games, crafts, puzzles, virtual shopping ... whatever gets you through the moment.

Just my two cents. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Djb88
Hi again,

We have had our daughter in the day program for the past week and a half.  She is eating her meals and snacks except when they contain some of her fear foods, such as anything containing sugar.  She is offered a meal replacement drink to make up for lost calories but she bluntly refuses because it contains sugar and is also therefore a fear food.  However, she has managed to gain weight over the first week and weekend, which is good.  Unfortunately she is finding it extremely challenging emotionally.  She tells us that her ED is getting worse/stronger, especially hearing some of the other girls in the program discussing their ED behaviours in group therapy.  

She also finds it difficult to eat the meals with the other girls present, because some of them are struggling also, which she says makes her upset and makes her ED 'feel competitive'.  She has been very distressed this second week in the evenings (she's much calmer in the mornings) with behaviours including hiding, yelling, running out of the house, and complaining that nobody is listening to her when she says it's getting worse.  We do listen of course, but tell her we don't agree with her that she needs to come out of the program so as not to undermine her treatment.  We feel very torn however as we don't want to disregard her feeling that it's making her ED stronger. Wondering if anybody else has had children who have struggled in the day program, particularly with the feeling that the ED focus and being surrounded with others with ED, and has made things worse rather than better.  Or is this just part of the process of ED being challenged/confronted.

Any thoughts are much appreciated.  Thanks. 
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