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

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linefine
So, after a 14lb (6.3kg) weight gain over 10 weeks, this week D has lost 2.2lb (1kg) *sigh*.  Not hugely surprised as eating has been harder for her for reasons unknown, so daily calories have been down a bit.  When I add it up, though, over the whole week she was only 2,300 cal down on the previous week.

So frustrating.  Also, she keeps saying, "This isn't working, nothing is working."  Although she's gained weight (which she wants to do) she hasn't gained much visibly, and is still no better from the depression etc.  The hunger cues are still non-existent, and she still feels sick a lot of the time.  

I know we are very, very early in this process, and have told her over and over that it will take a long time, but she seems to expect much quicker results, and is demoralised when nothing seems to change.

Any tips on keeping her motivated for the long haul??
Heather

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always PROTECTS, always TRUSTS, always HOPES, always PERSEVERES. Love never fails.
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mjkz
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So frustrating.  Also, she keeps saying, "This isn't working, nothing is working."  Although she's gained weight (which she wants to do) she hasn't gained much visibly, and is still no better from the depression etc.  The hunger cues are still non-existent, and she still feels sick a lot of the time. 


It is frustrating because we all want results fast.  I would just keep reminding my daughter that going backward (i.e. not eating enough and losing weight) was something we had already tried and it made nothing better and that as hard as change is, we had to keep gaining.  The results will take a while to show.  Have you seen anything you could point out to her as positive in terms of what you have been able to see?
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linefine
mjkz wrote:


Have you seen anything you could point out to her as positive in terms of what you have been able to see?


Unfortunately not..... I'm afraid everything has got worse (except weight gain) - she never used to feel sick so much, or take sooooo long to eat.  Depression is up and down but more prevalent than before.  There are occasional tiny things but nothing which she would consider to be "progress".  That's what makes it so much harder!
Heather

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always PROTECTS, always TRUSTS, always HOPES, always PERSEVERES. Love never fails.
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Psycho_Mom
Hi,

Sometimes eating is harder. There are ups and downs and ed comes and goes. What I'd like to know is how can we help you to require full nutrition nonetheless. What happens when a meal is difficult? Does she sit there until one meal runs into the next, or does she run?

Also, after a time of weight gain there is a thing called hypermetabolism. The body starts to work again, and it sort of goes into overdrive and uses up more calories. (Search this site for a better explanation!) This is where you may be and if so, you just need to increase. I (secretly) kept track of caloric intake for my d, and she went from about 2200 up to 4500, was at 5000 for a time (hard!) all the while gaining 2 lbs a week and doing the same amount of activity.

As for noticing progress, she probably won't be able to. If it's hard for you to notice, it's harder for a kid; kids live in the moment and have a harder time seeing long range consequences and rewards. I'd go with sympathy and distraction. "This is a very hard time in your life. Probably the worst time you will ever go through. We'll get through it. Let's search YouTube for funny kitten videos."

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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Torie
linefine wrote:
Also, she keeps saying, "This isn't working, nothing is working."


Ah, yes, the "nothing is working" mantra. The best advice I read regarding that is to keep insisting that things will get better. When they are adrift in a stormy sea, your job is to stand on the shore waving a banner that says: IT DOES GET BETTER. Even if you feel yourself getting sucked out into the waves of despair, keep telling your d that it will get better. 

Although I couldn't see the effect at the time, I believe this really helped my d. 

Keep swimming. You're doing great. xx
Fish
-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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lorpat
My daughter had a lot of problems at some point in refeeding because her stomach hurt so much.  I explained to her that her whole body was recovering including her digestive tract and that she just needed to get through it.  Somehow, that helped my daughter.  We discovered she had developed lactose intolerance and an intestinal infection (probably caused by the anorexia).  We did get her GI specialist who helped a lot with this.  But, it is fairly common to feel sick eating.  Also, many brain chemicals are made in the stomach - so sometimes they can get out of whack during refeeding.  I would let her know that her body is working to get back to a "new normal" and that food is the medicine to get you there.  Somehow, letting my daughter know that it was the previous starvation that caused the problem (rather than the current eating) helped her to keep eating... and she did get over the sick/depressed part.  We are not out of the woods by any stretch of the imagination - but at least she is through that part.  Hang in there..  You are doing great!
One day at a time...

daughter diagnosed 8/15 when she was 16,
wr through maudesly method 1/16,
currently in potential first relapse
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Colleen
I kept a daily (or almost daily) journal.  I'd make very brief notes of lousy ED behaviors and hopeful d behaviors.  It helped ME because I also wanted progress to be a lot faster!  Change was so incremental, and setbacks were so devastating, that it often felt like we weren't making any progress at all.  But when I read back to a few months earlier, then, yes, I could see that she had moved forward.  (Just never as fast as I wanted it!!)

What if you made notes of positive things that you noticed?  The act of writing them down or keeping them in a spreadsheet (the engineer in me) helps put them in your mind, so when she feels discouraged, it's easier for you to pull them up.  "You sound discouraged.  But here's what I've noticed over the past few days.  You ate XYZ and it wasn't as hard for you as it was just (some time) ago.  You texted with your friend ABC.  That was nice; she's on your side." etc.  They may be tiny things but reminding her of them might help nudge her out of her funk.

The truth is that things DO get worse before they get better.  The fact that they are worse is a good sign!  It means that things are changing in her brain with the ongoing nutrition.  It means her body is confident that nutrition is coming in regularly enough that it's pressing ahead with brain healing.  Healing is often painful, no matter where it happens, but it's a positive sign that things are going in the right direction.  Express lots of confidence that this really is the way through--because it is.

But make sure that you truly are heading in the right direction.  You have some feedback about weight loss this week.  How can you close loopholes, up the calories, increase fats, increase supervision, do what needs to happen so that her weight gain does get going again?

Just a word of warning:  don't back off calories once she's w/r.  It takes that full complement of calories for a long time after w/r before the metabolism starts to stabilize.  What would be a maintenance level for a normal person isn't enough for someone recovering from malnutrition.

You are doing great and your d is doing great!!!
Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
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linefine
Thanks all, very encouraging (as always) [smile]
Heather

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always PROTECTS, always TRUSTS, always HOPES, always PERSEVERES. Love never fails.
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