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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Hello, my 14 year old daughter is 8 weeks into this journey. We are based in the UK and she has been seen by our local service. Her weight loss has been rapid and is terrifying to me. She has not been weighed for over a week but I’m sure she will have lost more this week. We have been given a meal plan and it is so far from what she is currently eating. We have seen some acceptance of a small amount of extra breakfast over the last 4 days. Yesterday she accepted a programme to gradually (and I mean gradually) increase her lunch and I have agreed to supervise this by taking her out of school to try to achieve this. She has not made any progress with dinner or daytime snacks. She will eat a small (about a third to a half of what is recommended) evening snack. Our biggest difficulty with the evening meal is trying to plate our her food. This is just not happening and she gets very angry. Do you think we have made enough progress or should I push to take control of her dinner plate? I expect she would refuse to eat the meal and go to bed hungry. It’s possible this may show her we are taking control but it may undermine the negotiations we have had over lunch and the progress there. This illness has just come out of nowhere and I really want to hope that we can turn it round quickly- although I appreciate theee are so many stories of this taking months or years... sorry for the long post
Aw, Ellen, I'm so sorry you needed to join us here.  This isn't a club anyone wants any part of.

It's so hard in the early days when the ground is shifting under your feet, and the child you have cherished her whole life morphs into someone you don't recognize.  Ugh.

The short answer is yes, you will need to take the bull by the horns and require your d to eat what she needs.  Most find it best to make sure their ED-kid stays away from the grocery shopping, food preparation, plating, etc. as their only job is to eat what you serve.  It is sometimes a help if you can seat her in between two adults so that she can't run off.  If she does, you can follow her with the plate of food and glass of (caloric) beverage and require her to finish.  

This is one of the hardest things in the world - getting a sufferer to regain the weight s/he needs.  But we are here to hold your hand and dust you off as needed.  Please feel free to ask all the questions you like - that's why we're here.  xx


P.S. this video by forum member Eva Musby was a huge help to me in the early days:
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Ellan, you're in the right place. Congratulations for finding this place with knowledgeable, experienced parents.

I agree with Torie. You will need to shift your approach to REQUIRING complete nutrition. It's hard to figure this out. It's not persuading or encouraging, it is a compassionate but firm (and not angry) requiring. She needs to eat what you give her, and what you give her is high-calorie stuff that she would in the old days have liked. 

It's up to you with the meal plan, but a lot of us here have ditched meal plans. You know how to feed your d,  you did it all her life. What matters now is not fruits and veggies, it's about calories and fats. Heavy cream, butter, canola oil, coconut oil, almond flour, stuff like that. 

Please also know that it is not really your d who is refusing. The ED is holding her hostage and not letting her eat. ED will get ugly and nasty when you require eating. Please think of your d as held hostage by this evil monster, and be compassionate while firm. No punishing her for not eating, no criticizing, it's just a requirement that she eat. 

Others here have other approaches, but I basically expected nothing else from my d except the eating. I ignored the nastiness, let her have tons of screen time to distract her, and tried to keep her entertained...all with the goal of full nutrition.
Just want to say Hi and welcome to the group.  So sorry that you need to be here but you will find so much helpful information on these web pages.  Read around as much as you can because knowledge is power in beating this illness.   Hang in there! 
Hi Ellan, welcome to the forum. It is a bewildering illness especially at first. Unfortunately yes, many of us are here for a long time. 

I think you know that the progress is not enough, even from your writing. Dealing with the distress of our children when we require them to do what has to happen is hard, you don't need to use a meal plan but she needs to eat at least as much as what is on the plan if not more. Her illness stops her from being able to do this. The video link above is excellent, and sometimes it really can work that easily. Other times not so much. Negotiating with your D at this stage is unhelpful. Even if she agrees to what needs to happen her illness is likely to stop her from following through. 

Don't be afraid of her refusing to eat because you have not agreed with what her eating disorder demands. This is the classic trap that we all fall into at some stage or another. So yes, plate her food, insist on her full meal plan ( or your alternate) being placed before her and insist that she eat. If she can't eat or refuses to eat anything, this is her illness and not your fault (a classic ED line). If she continues to lose weight then it is likely she will not be able to continue treatment at home. This is not something you can bargain with her about but she should know that you will insist on any treatment that is needed. That means taking her to emergency if needed, hospitalisation if needed, inpatient stays. Not eating is not an option. 

Ironically the more she knows you will insist and follow through, the easier you are making it for her. If she knows you won't give in, then she will find it easier to tell herself that she has no choice but to follow through with what is required. 

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.
Hello and a warm welcome from Germany.
It is much easier for them when you requiere what and how much was eaten. She will fight it first (so to say ED will fight it), but when you insist she can put all the blame on you. She can tell her inner voice "I am not quilty, I have to eat this, mom is quilty, she is requiring it from me". So then she will be able to eat again.
Take over control and plate everything. No choices. This must be eaten. No matter where. And how long it will take. Life stops until you have eaten this.
It is hard at the beginning.
Read Eva Musbys book and ask whatever you need. There are always some nice and experienced parents here.
And be aware that your meal-plan might be too low. Most kids here need a lot of calories to gain weight. We needed "only" 3000 but there are patients who needed up to 6000 cal a day. Add butter, cream and canola oil to everything. She needs a lot of fat to heal her brain.
Keep feeding. There is light at the end of the tunnel.
In the early days like many, I too fell into the trap of negotiating thinking I was talking to my daughter. The main thing to keep in mind is 3 meals 3 snacks. Really at this stage I would hope you were with a CAMHS team who were doing FBT and seeing you at least once a week if not twice, especially if she is still losing weight. I am in the UK too and my daughter was 14 when diagnosed. We were lucky to have had a very proactive local ED team, I know that can be the luck of the draw!
Throw the meal plan out the window and just start serving the food she has always eaten.  Three meals, three snacks and she gets up from the table when she had eaten everything she has been given.  It will be hell on earth for the first few days and then things will get easier.  You'll just think you're in hell after that[biggrin]  Use very short term rewards or consequences for any uneaten food (We'll go to school after you've eaten breakfast, After you finish dinner, you can have your phone back).  Distraction is the key after meals.  Do not negotiate (I used to say I don't negotiate with terrorists).  Glad to see you here.
We found it a lot easier to eat in front of TV and watch funny videos.
I added butter, cream and canola oil to everything possible. Get as much calories and especially fat in her as possible. She will need a lot.
Get plastic plates and take big ones so the food looks smaller.
Get some help from friends or family if possible. It would be great if someone could be there at the most difficult meals (lunch and dinner in most cases) to take over when you need a pause.
Keep feeding. There is light at the end of the tunnel.
You have received amazing advice! I want to add, if she throws the food keep replating. If she does not finish what you have given then give a supplement ie ensure plus to make up. We found that if my d refused we just sat with her until she ate. She got so mad at times and argued " It's only a little bit why do I have to eat it" we said because it was a little bit she COULD eat it. She knew we would sit all day and night with her to eat and we never had to because she knew we would sit and sit and sit and so she just ate it up to be done!
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)
You are getting excellent advice here. In our house, no one goes to school or work until the food is eaten. Don't negotiate. In the early days my d behaved like someone possessed at mealtimes but that was the ED fighting back and that only lasted a few weeks but tended to return every time there was a change to her routine, like an increase in calories or a change in school lunch supervision. Making the mental adjustment to separate your child from their ED behavior will save your sanity.

This forum has helped me greatly and I know you will find much support here.