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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Heyjac
Hi guys, we are trying to help our 18 yr old son who has been diagnosed with anorexia. He went in residential for 11 days, left, came home and we have been doing things at home. We tried the Children's Hospital ED program, but that did not go well at all. We are back trying to do this at home with help from a nutritionist, and therapist. He has put on 18lbs since July, but now he wants to quit. CHOP was trying to get him to eat sooo much 4200-4700 calories a day. He got so discouraged and even threw up a few times, he says from feeling nauseous and over full and uncomfortable. So now we are back to doing this on our own with so little help and support and I feel so very overwhelmed. I don't know if I can keep doing this. I don't know if he will still cooperate with us. I don't know how to proceed so he can feel better but still gain weight. The stress with this is almost unbearable for me. Im exhausted when I go to bed and just as exhausted when I wake up in the morning. Sometimes Im not sure IM going to make it through this!! I need more help and support. we are in south jersey. are there any coffee break groups in SJ? I desperately need more help and support!!
Thanks
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tina72
Hi from a mum of a 19 year old d from Germany! I am so sorry that you need to be here with us but I am sure you will find a lot of help here.
First I want you to know that this is a public forum and names can be found by google. So if you like to change that you can use the pencil that you can find at the 3 points on the right top of your post and edit your post.
Coming home is a difficult time and you need a lot of power to keep up all the rules from hospital but that is needed for a long time or he will relapse quickly.
The amount of calories you talk about is totally normal for a boy with AN. Some families needed even more for weight gain. See KLBs posts.
Try to distract him while and after eating. TV, video games, card games, whatever. That helps against feeling nauseous and full. If he is not over exercising think about taking him for a short walk.
Cooperation: as long as he lives with you and is financially dependend you have some great incentives and leverage. You still have a lot of power although he is "adult". You pay for school, phone, insurances, living. So you set the rules. We have a contract with our d. It says what we do for her (pay for all that is mentioned above and her car in addition) and what she needs to do for that (maintain her weight, go to weighings, see the GP for blood and heart checks, eat 3 meals 2 snacks and so on).
Ask what ever you need here, there are so many nice parents here from all over the world and there is always someone here that has been in your shoes! How can we help you?
Keep feeding. There is light at the end of the tunnel.
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Heyjac
I don't know. He is refusing to keep going and I just don't know how to carry on. He hates us. He is miserable and depressed. I just don't know if I can do this any more. I want to help him, but doesn't he have to want to help himself? I can't force feed him. we have tried threatening him with his car and phone and such. He just gets angry.  I have backed off a bit, but im still trying to get him to eat. so far today is not a good day. Nothing in him yet and its 10:15 am.
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kazi67
Welcome Heyjac
Is your h home to help you, it sounds like you may need him for support 
im sure it can’t be easy dealing with an angry 18 YO young man on your own 
possibly you’ve tried this but can you require that he must eat the next meal or you take his phone away?
we did this with our d as well as computer and car keys 
i would word it “once you’ve eaten you can have phone etc back” 
Im not suggesting this will work or is going to be easy
just an idea and what we did when our d wouldn’t eat I would simply say ok if you can’t eat please give me your phone/computer/keys, and thankfully she would then eat 

but it’s not easy, as with them being older once they are off in their car they can be purging or over exersizing etc, as they have the freedom unlike a younger child where you can have more control over them 24/7
even though we did manage to initially get our d weight on she lost it all plus more and was admitted to IP
If your s is purging he may also need a higher level of care if you can’t stop that behaviour 
Do you have contact with his treatment team at all? If so I would be contacting them for advise 
I know it’s very difficult at this age my d developed her ED  at 17:5 YO and once she turned 18 she has chosen not to include us in her treatment (although we fully support her)
if you can encourage your s to continue with his treatment team they may be able to help him decide what is best for him moving forward 
our d can be re admitted to IP under the MHA by her phycologist or physciatrist if they deem it necessary or she can go in voluntarily 
hoping you have a good team for support, I would be giving them a call 
are you able to get support/help from CHOP?
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tina72
Heyjac wrote:
I don't know. He is refusing to keep going and I just don't know how to carry on. He hates us. He is miserable and depressed. I just don't know if I can do this any more. I want to help him, but doesn't he have to want to help himself? I can't force feed him. we have tried threatening him with his car and phone and such. He just gets angry.  I have backed off a bit, but im still trying to get him to eat. so far today is not a good day. Nothing in him yet and its 10:15 am.


The one moment that changed something here was the moment we dared to say NO to ED. No matter that she hated us. No matter what words she called us. The moment we decided it is better to lose her friendship then to lose her life was the first day of recovery from ED.
He does not need to want to get better. He cannot want that in that state. He has a big bully in his head that does not allow him to eat.
You say you cannot force feed him. That is true. But you can set rules. No school, no car, no phone, no internet when he does not eat. Say it positive: You can go to school when you have eaten your breakfast. You can get your phone/internet access back the moment you have finished lunch. You can get your car key tomorrow when you have finished your meals and snacks today. He needs to be fit and not with low blood sugar when he drives. He is a risk for all other members of traffic if he faints while driving.

He will for sure get angry. He may call you very bad words, he may even try to hit you. My d first freaked out when we told her what the rules were. We still have spinach on the ceiling from that day 🙂. And surprisingly accepted it a few days later with not that resistance that we expected. She wanted to have these rules. She wanted us to stopp that bully ED. She wanted someone who has more power and that she could blame for eating so it was not her fault any more. It was very hard to get through that state but if you do not act now nobody will help him. Imagine he has cancer. If he would refuse to have that chemotherapy that could safe his life, what would you do? You would sit besides his bed and tell him that you will not leave before he has not taken that pills. That you love him but that you must insist on that now. Eating is his chemotherapy. It is that serious.
Keep feeding. There is light at the end of the tunnel.
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sk8r31
I wonder if you might consider the 5 Day program at Center for Balanced Living in Ohio?  They do an FBT-based program for those 18-35 with one or more support people.  I do know someone who went with their 22 yo, and it was very successful.  You will learn skills, tools & put together a contract that is specific to your s and your family.  Might be worth contacting them to see if this might be an option for your family.

Sending warm support to you!
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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Ettin
Hi Heyjac, I have been lurking on here for a couple of months, almost posted a few times, but didn't. Your post inspired me to say something because our daughter (18)was diagnosed at CHOP back in June (we live just north of Philly) and is being treated by them. I'm so sorry they did not work out for you - if it's any consolation our daughter absolutely detests the Dr in charge and has not been very happy with family based therapy, either. The ED has very obviously told her not to trust most of the adults in her life, so, really none of this reaction by her was a surprise to myself and my husband. We had a lot of conversation with them at the beginning and realized that here was a group of Drs who we felt had a great deal of knowledge about this horrible monster of an illness, we read the Locke and LeGrange book on helping your teen with an ED and we knew they were going to ask us to do some really hard stuff, and they did! Recovery is so, so, hard, some days I have just wanted to give up and run out of the house screaming. Eating is always a huge problem on the days we have to trek into the city to see the Drs and most drs visits and FBT end with our daughter in tears. They asked us to up the calories at one point, to very similar to what your son was asked to do, and she had a purple fit about it and said it was impossible, the dietician gave me a handout that advised how to increase calories without increasing bulk and I told her I would build it up gradually - the next day she was up to the new level of calories and has been ever since - though some days it is a HUGE struggle to eat it and it did make her nauseated and she did threaten that she would throw up, but didn't (and the drs offered to prescribe meds to help with that, but, actually she did fine on 1/8 tsp ginger in hot water - ginger is a natural anti-emetic)  After a while of rotating through some of the many drs they have, she DID bump into one that really connected with her and that made all the difference, but, even so, there has been endless second guessing and complaining that she wants to be allowed to do it 'her way' which mostly means gain weight only slowly whilst seeing a local therapist, just to talk. - No - we are not doing that, that is the reason so many adults are in recovery for years and years, I suspect. How do we get her to eat? from the start I have always said that everything stops until eating is done, half an hour for trying to eat, with distraction (mostly tv and you-tube videos, no talk about eating or the whys and wherefores of what we are doing, there is no rationality coming from that girl at mealtimes!) and then, whatever is left gets converted into carnation breakfast shake. 
Our result? On the brink of weight restoration (as far as Drs very educated guess is concerned) and now our daughter has been additionally diagnosed with Generalized Anxiety Disorder, put on Zoloft and we are just working on getting her hooked up with some CBT. She still hates food and struggles, but, since the Zoloft, things have become emotionally easier for all of us. 
Sorry, I just ran on and on about our own stuff, I don't have any other advice, only what we have been through so far, such a nightmare! I don't feel like I am any kind of expert on this, at all, I just hope you can gain a sense of 'being in the same boat' as me, just a little! Hang in there and just try whatever you think might help, until you do hit upon something that works for you and your son and lean on whoever you have in life who can help you at all in any way!
Take care! 
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Heyjac
[QUOTE username=kazi67 userid=5463594 postid=1309725134]Welcome Heyjac
Is your h home to help you, it sounds like you may need him for support 
im sure it can’t be easy dealing with an angry 18 YO young man on your own 
possibly you’ve tried this but can you require that he must eat the next meal or you take his phone away?
we did this with our d as well as computer and car keys 
i would word it “once you’ve eaten you can have phone etc back” 
Im not suggesting this will work or is going to be easy
just an idea and what we did when our d wouldn’t eat I would simply say ok if you can’t eat please give me your phone/computer/keys, and thankfully she would then eat 

but it’s not easy, as with them being older once they are off in their car they can be purging or over exersizing etc, as they have the freedom unlike a younger child where you can have more control over them 24/7
even though we did manage to initially get our d weight on she lost it all plus more and was admitted to IP
If your s is purging he may also need a higher level of care if you can’t stop that behaviour 
Do you have contact with his treatment team at all? If so I would be contacting them for advise 
I know it’s very difficult at this age my d developed her ED  at 17:5 YO and once she turned 18 she has chosen not to include us in her treatment (although we fully support her)
if you can encourage your s to continue with his treatment team they may be able to help him decide what is best for him moving forward 
our d can be re admitted to IP under the MHA by her phycologist or physciatrist if they deem it necessary or she can go in voluntarily 
hoping you have a good team for support, I would be giving them a call 
are you able to get support/help from CHOP?
My h is helping the best he can. He works from home but he has a very demanding job. He is doing all he can while still keep his job. I did just threaten him with taking away the phone. Now I have to follow through with it if he doesn't finish his supplement. But he said he had a headache and needed to lie down with the promise of coming down in an hour to finish it. Ugh
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Heyjac
Ettin wrote:
Hi Heyjac, I have been lurking on here for a couple of months, almost posted a few times, but didn't. Your post inspired me to say something because our daughter (18)was diagnosed at CHOP back in June (we live just north of Philly) and is being treated by them. I'm so sorry they did not work out for you - if it's any consolation our daughter absolutely detests the Dr in charge and has not been very happy with family based therapy, either. The ED has very obviously told her not to trust most of the adults in her life, so, really none of this reaction by her was a surprise to myself and my husband. We had a lot of conversation with them at the beginning and realized that here was a group of Drs who we felt had a great deal of knowledge about this horrible monster of an illness, we read the Locke and LeGrange book on helping your teen with an ED and we knew they were going to ask us to do some really hard stuff, and they did! Recovery is so, so, hard, some days I have just wanted to give up and run out of the house screaming. Eating is always a huge problem on the days we have to trek into the city to see the Drs and most drs visits and FBT end with our daughter in tears. They asked us to up the calories at one point, to very similar to what your son was asked to do, and she had a purple fit about it and said it was impossible, the dietician gave me a handout that advised how to increase calories without increasing bulk and I told her I would build it up gradually - the next day she was up to the new level of calories and has been ever since - though some days it is a HUGE struggle to eat it and it did make her nauseated and she did threaten that she would throw up, but didn't (and the drs offered to prescribe meds to help with that, but, actually she did fine on 1/8 tsp ginger in hot water - ginger is a natural anti-emetic)  After a while of rotating through some of the many drs they have, she DID bump into one that really connected with her and that made all the difference, but, even so, there has been endless second guessing and complaining that she wants to be allowed to do it 'her way' which mostly means gain weight only slowly whilst seeing a local therapist, just to talk. - No - we are not doing that, that is the reason so many adults are in recovery for years and years, I suspect. How do we get her to eat? from the start I have always said that everything stops until eating is done, half an hour for trying to eat, with distraction (mostly tv and you-tube videos, no talk about eating or the whys and wherefores of what we are doing, there is no rationality coming from that girl at mealtimes!) and then, whatever is left gets converted into carnation breakfast shake. 
Our result? On the brink of weight restoration (as far as Drs very educated guess is concerned) and now our daughter has been additionally diagnosed with Generalized Anxiety Disorder, put on Zoloft and we are just working on getting her hooked up with some CBT. She still hates food and struggles, but, since the Zoloft, things have become emotionally easier for all of us. 
Sorry, I just ran on and on about our own stuff, I don't have any other advice, only what we have been through so far, such a nightmare! I don't feel like I am any kind of expert on this, at all, I just hope you can gain a sense of 'being in the same boat' as me, just a little! Hang in there and just try whatever you think might help, until you do hit upon something that works for you and your son and lean on whoever you have in life who can help you at all in any way!
Take care! 
.    on one of his very first visits he spoke to the therapist alone. the next time we went in, she told us what he had said in front of him. He was very angry, He said it was a breach of dr  patient confidentiality and he would not speak to her again. also, since starting there he hadn't gained any weight. we felt it wasn't a good fit. It is so hard. I think I was starting to give up, but Im starting to come back. Im kind of nervous, my husband leaves on business tomorrow and he will be gone for 3 days. I have to fight this battle alone for 3 days and thats kind of scary. No back up!! I hope I can get him to eat.
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Heyjac
sk8r31 wrote:
I wonder if you might consider the 5 Day program at Center for Balanced Living in Ohio?  They do an FBT-based program for those 18-35 with one or more support people.  I do know someone who went with their 22 yo, and it was very successful.  You will learn skills, tools & put together a contract that is specific to your s and your family.  Might be worth contacting them to see if this might be an option for your family.

Sending warm support to you!
I haven't heard of them but I would consider doing anything possible!
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tina72
Please use us for back up. We are here. You are not alone with that.
He needs to gain weight or he will never get better. The Ohio program is a good idea, contact them for more information.
Runs the car and the insurance for it on his name or yours? In our case it is on hubbys name so hubby decides who gets the car key...🙂
Keep feeding. There is light at the end of the tunnel.
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Ettin
Wow, Heyjac - I would not be cool with the therapist telling you his private conversation in front of him, either! Yikes, that's very unprofessional and also destructive of trust (which tends to be in short supply anyway with teens who have an ED - at least that's been our experience!) It is so hard to deal with a teen who wants to be treated as an adult and at the same time is exhibiting long periods of irrational thinking. Ugh! it drives me nuts and makes me feel so horrible and as if everything I do and say is WRONG, but really it's us vs the eating disorder.
One other thing I have tried in my desperation were the coaching that Eva Musby gives on short videos on her website around how to get your child/teen to eat successfully....that helped me to be more compassionate and determined about it, when I was ready to snap and lash out and answer her pain with mine.
Two weeks ago, it was us who were considering if an inpatient program might be the right way to go, because she seemed stuck, but, for us, we have reached weight restored (I think?) or maybe a bit more and the Zoloft is having a good, calming impact.
I hope you can find the strength to keep trying things and finding out what is best for you and your son - my heart goes out to you being alone with this for 3 days - Do you have anyone else at all who could take over one meal or snack or anything?
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Heyjac
tina72 wrote:
Please use us for back up. We are here. You are not alone with that.
He needs to gain weight or he will never get better. The Ohio program is a good idea, contact them for more information.
Runs the car and the insurance for it on his name or yours? In our case it is on hubbys name so hubby decides who gets the car key...🙂


Yes the car ins is in my husbands name. we just had to hide his car keys today because he slept in his car last night with his gf. so no more car for now. we went to dr today and he put him on Nexium to help with the nausea and stomach discomfort. He's talking to therapist tomorrow about anti anxiety meds. and we are still pushing for residential. one foot in front of the other. its all I can do.
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sk8r31
Absolutely...one step at a time, one day at a time.  If it's helpful at all, though your s is a YA and typically in society we give our YAs more independence and autonomy, these freedoms and this parenting stage needs to be changed up with an ED.  Once your s is moving well towards recovery, that independence is given back slowly.  

Incentives and consequences and certainly a contract are all important at this stage.  Please do take care of yourself as well!
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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