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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Manta111

Hello. I’m new to this forum and wondered if anyone could help. 

My D insists on food preparing herself and mostly will not
eat anything if I food prepare for her. I am really struggling with this behaviour as know I need to be presenting all the meals as I have previously. 

it becomes very combative and the best tool in her armoury is to refuse to eat at all and then that meal is lost. Any suggestions? 


Thank you

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ValentinaGermania
Hi Manta111 and a very warm welcome from Germany!

That is totally normal that she does not want that you prepare and you need to fight that battle through. She cannot make good food decisions any more at the moment so she lost the right to do that and to chose what she will eat. It is unhealthy what she does and you are the parent in charge and you need to take over.
It is normal that they go through the roof first and that they say they will stop eating totally but in most cases they only blackmail you.
Tell her that you will prepare and plate from now on and that she has 45 minutes to eat that meal (and 30 min for a snack) and that her life will stop until she has eaten. No phone, no TV, no friends, no school, no nothing. She can have bed rest if she is too sick to eat and you will spoon feed her if needed and if she refuses to eat at all you will take her to hospital and she will get fed by tube through her nose there.
In case that she does not eat and/or drink for more than 24 hours take her to ER/A&E to check the liquids and to get a higher level of care if needed.
Take the food with you because many kids here started to eat at the hospital parking...

Get her out of the kitchen, prepare all food ahead if possible, in the nights when she is sleeping if needed. Do not take her to the supermarket and do not buy any light or low caloric stuff any more. Normal full fat nutrition is needed now. It took me a while to learn that but most important was to change my parenting style and to dare to say NO to ED.

Try to make not eating impossible. Lock the doors if she tries to escape, get another adult around for the meals if possible, follow her with the food through the house. It takes about the whole day at the start to get all these 3 meals 3 snacks in but it is necessary to fight that through. It will get better after a a few days when she sees she has no other option than to eat. Make a meal plan and stay with that no matter what happens. It is hard to fight that through at the start but we all had to do that.

You are not alone with that, we have been in your shoes and can help you. Come here to ask all your questions and we can try to help.
Keep feeding. There is light at the end of the tunnel.
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KLB
We had this problem and still do to an extent, but it is the eating disorder talking not your daughter. Taking the responsibility of food prep away means ED has lost control of that element, which is why you see the push back and refusal to eat. Our s also refused to eat if he couldn't prepare it himself and we spent literally hours and hours at the table at first. I felt like he was holding me to ransom and I had no idea what to do initially. Valentina is right in that you have to make it impossible not to eat. I learned to follow my s around with the plate of food. If he managed to get up from the table we followed him with the food. If he threw it on the floor I gave him a new plate full (make extra to start with if you think your d is going to do that). If he sat and did nothing, we sat next to him and waited, then encouraged small steps. I kept telling him, "your only job is to eat what I give you and what I give you is exactly what you need to heal".

For food prep, is there anyone that can distract her while you prepare food? Can anyone take her out for an hour pre-meals?
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sandie
Hi Manta, and I am glad you have found this forum. I have found it to be an invaluable source of wise and kind advice which has helped us through some difficult times. 
it might be useful if you feel comfortable to share a little more info about your journey to date, as I am not clear whether you have just started out refeeding or whether you have done this before but experiencing new challenges. X


Courage is not the absence of despair; it is rather the capacity to move ahead in spite of despair
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MKR
Hi @Manta111,

Well done for battling alone, but you will get plenty support here.  How much weight has your daughter lost and where is she at now?

Stay strong!
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Enn
Welcome,
What you describe is quite normal for most EDs.
If you feel that you wish to share a few
more details about your situation, we be able to brainstorm a few ideas based on our personal experiences.
May I ask a few questions?
How old is she? What was is her diagnosis and how long have you been dealing with it?
Do you have a medical team/
ED team in place? Has she been deemed medically stable?
Do you have a partner ?
what is she eating?  Sorry, I hope these do not overwhelm you. It may help us to figure out how we can properly support you.

If she has less than 500 cal per day or not eating for up to 48 hrs or not drinking for 24 hrs then a trip to the local A an E would be in order.
Please read around the forum and 
FEAST-Ed.org for more information and resources.
sending kind thoughts your way.
please ask any question you have. We all do wish to help.
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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Manta111

Wow - instance responses and advice!
Thank you.

Ok, she is 15 and has special educational needs. We live with her 17 year old brother. Her father went off with someone 20 years younger and immediately had 2 more daughters, I broke my leg really badly and had 6 months in a wheelchair, we’ve had to move house from their lifelong home and then my dad, 2 aunts and an uncle died. A month later she stopped eating altogether (Oct 2018). Accessing services was really difficult but she was eventually admitted as she was almost in renal failure. After that, she was referred to FEDS but hated it from the get go and began massively self harming after the sessions. After plodding on for many months with it, (5 hour round trips each time), the general consensus was that it wasn’t beneficial to her and was contributing to her suicidality. The consultant agreed she should not continue with them and referred to CAMHS who have seen her once. We are waiting for some CBT. I take her to a counsellor that I pay for privately every week, and she is a recovered anorexic herself. I have some doubts however, as D comes home saying that it’s ok to eat “something”, but 3 spinach leaves do not constitute “something” in my book! Obviously I’m not privy to their conversations and D loves the “secret” relationship between them. It’s difficult to know objectively what guidance she is being given but she likes to go to talk to this lady. 
She is now a “healthy” weight, but her cognitions remain as strong as ever. Her only aim is to be 30kg.
She is due to take her exams this summer and I am trying to keep
her at school. She will not eat anything at school. I have to bring her home for lunch. I cannot make snacks happen as she simply won’t turn up for them. 

Today she has refused lunch, so I have taken her phone away. Much shouting and screaming ensued (her not me!) and she is currently wasting her time sulking in her bedroom. It’s difficult to know what’s stroppy teenager and what is ED. 

I have to work to keep us afloat, but am finding everything very overwhelming and exhausting now. I can’t go on like this much longer. 

She has “safe” foods - salad, salmon, cereal, fruit, fat free yoghurt, occasional crumpets, but it is ever so limited. Prior to this, she would eat literally anything. 

She is on meds for depression now and has Melatonin to help her sleep

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ValentinaGermania
"I take her to a counsellor that I pay for privately every week, and she is a recovered anorexic herself. I have some doubts however, as D comes home saying that it’s ok to eat “something”, but 3 spinach leaves do not constitute “something” in my book! Obviously I’m not privy to their conversations and D loves the “secret” relationship between them. It’s difficult to know objectively what guidance she is being given but she likes to go to talk to this lady."

So if you pay for that I would stop that asap. This sounds not professional at all. Can you see a licenced FBT therapist instead? Or any other real ED professional? This lady seems to be still anorexic and that can be a danger for your d...

"She is now a “healthy” weight, but her cognitions remain as strong as ever. Her only aim is to be 30kg."

What she thinks is a healthy weight or how has that been calculated? Is she on the percentile she was before ED moved in or even higher? It seems that brain recovery did not start up to now so she might need more weight first.

"She will not eat anything at school. I have to bring her home for lunch. I cannot make snacks happen as she simply won’t turn up for them."

If she does not eat at school she cannot go. It is too long break in between meals if she does not eat every 3-4 hours. Can the snack at school be supervised there? If not, she must stay at home until she is compliant and eats.
If she won´t turn up for snacks she must stay at home and cannot go out. Hide her shoes if needed 🙂.

"It’s difficult to know what’s stroppy teenager and what is ED. "

As we have all seen that behaviour with kids from age 7 to 21 here I can say very clear that it is ED. If she would fight for some new shoes or get her hair coloured blue or have a tatoo I would say it is teenage fight but if it is about food, it is 100% ED.

"I have to work to keep us afloat, but am finding everything very overwhelming and exhausting now. I can’t go on like this much longer. "


I do not know the laws in your state but can you take some carers leave? Is there another adult (friend, family) you could ask for help? As a single parent that is really too much to stand alone.

"She has “safe” foods - salad, salmon, cereal, fruit, fat free yoghurt, occasional crumpets, but it is ever so limited. Prior to this, she would eat literally anything."

So this is where she needs to go back and it is clear that she is not healthy at the moment and that the ED is still very strong. You will need to tackle fear food and to stop ED behaviour on all fronts I fear. Can you make a meal plan and stick to that? Can we help you with brainstorming ideas how to tackle all that?


Keep feeding. There is light at the end of the tunnel.
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Manta111
Well FEDS classed “healthy weight” as her periods returning. She was 98% height/weight ratio when she was last weighed, but that was months ago. Weighing her was causing too much self harm
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Manta111
I try to take her home for lunch every day, so she does get something in the middle of the day. I have tried everything at school from her coming to me for snack, being supervised by the medical centre, pastoral care and even tutors. Nothing works. She simply hid the snacks up her sleeves, wouldn’t turn up, put it in the bin, etc. 
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ValentinaGermania
There are scales that can be used without having the patient seeing any number. I think it is dangerous to stop weighing in that state.
Periods return, haha, that is really a good joke. Mine got her periods back at BMI 16 and the team was very surprised! Bad that they told her before that she will be healthy when periods are back. She had 3 in a row and then it stopped again for nearly a year before it came back at BMI 21.

Did she grow in the last year?
Keep feeding. There is light at the end of the tunnel.
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Manta111

Thank you Valentina. All advice greatly appreciated. I did all the meal plan stuff for months on end but she is now very, very resistant to any of that. There is simply nothing that I can do or say that enables her to believe that eating is worthwhile. The more I interfere, the less food she eats. I’m not scared of a challenge, but it is awful having constant discord in the house. I feel sorry for my son - he feels he has “lost his sister” and that I simply do not have time for him as she occupies most of the focus within the family. 

 

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ValentinaGermania
Manta111 wrote:
I try to take her home for lunch every day, so she does get something in the middle of the day. I have tried everything at school from her coming to me for snack, being supervised by the medical centre, pastoral care and even tutors. Nothing works. She simply hid the snacks up her sleeves, wouldn’t turn up, put it in the bin, etc. 


So all you can do is not count that snack in school and add it to the other meals. It is really great that you take her home for lunch every day. Can you drive her to school and give her a 2nd breakfast at the car park so the gap will be smaller?
Keep feeding. There is light at the end of the tunnel.
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ValentinaGermania
Manta111 wrote:

Thank you Valentina. All advice greatly appreciated. I did all the meal plan stuff for months on end but she is now very, very resistant to any of that. There is simply nothing that I can do or say that enables her to believe that eating is worthwhile. The more I interfere, the less food she eats. I’m not scared of a challenge, but it is awful having constant discord in the house. I feel sorry for my son - he feels he has “lost his sister” and that I simply do not have time for him as she occupies most of the focus within the family. 



It must be so hard for your son. Can you ask a friends mum to take him out now and then so he can have some special time?

I do not like to be blunt, but it does not help you to talk around the bush:
I fear you must go back to that meal plan and to insist on regular meals and fight that through. She will not change her behaviour unless you require that. She cannot see that she must eat and that it is worth to do that in this state. It took about a year after WR and after we tackled down all fear food until my d enjoyed eating again. She simply had no hunger cues. All tasted like paper for her. Eating was hard work. She could not enjoy it, she only did it to please us or to get rid of us (depends on daily state🙂).

You are the parent, you set rules. If you leave it up to her to decide what she want to eat or not she will be back to that number you mentioned very soon...It is normal that parents need to stick to rules and meal plans and control for some years in ED recovery.
Keep feeding. There is light at the end of the tunnel.
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Manta111
All points accepted as constructive. Yes, she has absolutely no hunger cues at all
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ValentinaGermania
Manta111 wrote:
All points accepted as constructive. Yes, she has absolutely no hunger cues at all


Oh, that is great that you can see it that way. I was the same, I wanted to hear what I could do exactly and get a honest reply. 🙂
So if she does not have any hunger cues, it is important that she eats by time rules. 4 p.m. coffee snack, no matter if you have hunger or not. 7 p.m. dinner (and so on). That helps them to get into a routine. Hunger cues come back in most cases after some time x but there are patients that never get them again. Then eating by time is saving their life.
Keep feeding. There is light at the end of the tunnel.
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Aggie
Hi Mantra111,
Sorry you are having such a tough time.  I don't know how private therapy works but if I was paying someone to help my daughter who was under the age of 16 I would expect input from them on what was being tackled and progress etc, surely there is a duty of care on their part.  If as she says she is a recovered anorexic, she would understand the nature of the beast and the complexities of the illness, you'd think she would be working with you to encourage your daughter to engage with a meal plan or am I being naive.
You mentioned that she has been seen once by CAMHS, in how long? Can you push them for further help, if she is being this resistant maybe she should be referred to the community ED team, if you can access that they may help to get refeeding kick started.
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Torie
Manta, wow, life has thrown your family so many curve balls in recent years!  You must be exhausted.  Is your broken leg okay now?

It sounds like your d may be close to weight restored but just not quite there yet.  Do you think that is possible?  It is very common that we are told our kids are weight restored, when actually they still need additional weight before brain healing can begin.  These final pounds/kilos can be very tough! 

My d's ped was a "former" anorectic.  She gave us terrible advice by telling my d that she didn't need to gain more weight when my d desperately needed to push through that last 10 pounds.  Once my d had gained those additional pounds, things started to get back to normal.

Please feel free to ask all the questions you like. xx

-Torie 
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Enn
Manta111,
It sounds like things are not going very well. The counsellor does not seem of help and she is not eating full nutrition.
As Aggie notes, the team does have duty of care. And I feel she needs more intensive specialized care.
I know others from the UK can better advise you, than I,  about different options at this point.
You have been dealing with this for over a year now, I think you need more support from the ED team.

You have had a very stressful year! Big hug 🤗 
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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MKR
Hi again @Manta111,

Thank you for providing more information.  Wow! You have got to 98%, so you know you are capable. And you can pick up slack if necessary, too.

Please look after yourself as well and give yourself breaks (miniature, 5-min breaks if that's all that time will allow). 

I hope your other child gets to have time with mum.  I am sure you let him know in other ways that you value his patience and that you would bring him back to health in the same way. 

Both my children have had a quiet bedtime chat (and a giggle, if possible) with me to this day, including throughout the AN. I simply wanted them to go to sleep on a good note and feeling loved.

Stay strong, 
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Foodsupport_AUS
Welcome. You have done a great job getting her to where she is. I like others would be very dubious of the therapist at this stage. A good therapist should either be offering some form of specific therapy for her eating disorder. CBT involves food diaries and challenges to keep increasing her intake. FBT is mostly recommended for teens and adolescents but is very intensive on families and harder to achieve in single parent families. It doesn't sound like any of this is occurring. 
Her behaviours don't sound like normal teen, rather they sound very much like a teen with a strong eating disorder, and her alliance with the therapist sounds like it may be more detrimental than beneficial. The therapist may not be able to discuss the details of what is being said, however she should be able to discuss goals of treatment, where things are heading, what treatment is being offered. You are after all paying for the service. 

The upshot of it is, it is inappropriate for a teen to be preparing her own and separate meals. Her insistence that she do this is very much her eating disorder. Normal teens just don't do this. 
You may have tried this already, but can you work with her on an agreed "meal plan" for the week? Sometimes the anxiety about what is coming is less if it is known. For others the reverse is true. 
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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