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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nowisee
My 16-year-old daughter spent two very detrimental months at Remuda Ranch over the summer for an eating disorder and self harm. She restricts for 24 hours or more and then binges and feels horrible about herself. Her weight is fairly stable, but her orthostatic preasure, moods and clarity of thought are a roller coaster mess. She actually seemed to be doing better until we began to get involved in Halloween activities. She has been frighteningly withdrawn and depressed the last few days, and tonight I saw her going through a bag of candy she brought home from a carnival we worked. She would eat some, then trash it or ask me to put it in the garbage. Then she would dig it out to have more. I took it outside to the big garbage cans, but then she got into the Benadryl, one of the few meds I have not locked up, and took more than she should have. She has always had trouble sleeping, last night she didn't sleep hardly at all so apparently she wanted to be sure she slept. My main question tonight , now that I realize this candy is triggering her, is how do I handle giving out candy and having it in the house ? I have four other girls: 10, almost 13 and 14, and my eldest who is 18 and loves to hand out candy.
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Foodsupport_AUS
Welcome to the forum. Sorry that you have had to find your way here. 

You don't say much about what happened at Remuda ranch that was so detrimental, however you do report severe ongoing symptoms of marked restriction followed by bingeing. It is not surprising that her orthostatic changes are so bad if she is continuing with such severe symptoms. 

How are you helping your D, to stop her restriction and have regular full meals? This will be the key to helping her with her bingeing. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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nowisee
I would love suggestions. I provide meals and my other daughters eat. I cannot force my 16 year old to eat. Privileges are restricted if she does not eat meals, but it is difficult. Remuda told all of the parents that we were fired from the job of food police, and told us that other than making observations there was not much we could do. I take my daughter to have vitals checked weekly. She will go to see the nutritionist and a counselor, but she will just sit in their office and refuse to speak.
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Kali
Hi Nowisee,

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Remuda told all of the parents that we were fired from the job of food police, and told us that other than making observations there was not much we could do.


Don't listen to this sort of idea, it is nonsense and just colludes with the eating disorder. There are many parents on this board who have been successful in getting their kids to eat, if you read through some of the histories. I have found that with the right treatment, along with gentle and persistent encouragement and firm expectations that my d. will eat have worked here at home. And not backing down. Someone on ATDT had a great response to being called the food police; the mission of the police is to serve and protect and you can do the same. That being said, you have 4 other children and your d. is sounding very treatment resistant and symptomatic. Is there another center you might be able to look into for her? Since she is still 16 you can sign her in. Not sure where you are located but if you go to the part of the board which has recommendations for treatment centers, you can post any questions you might have and ask other parents about their kids experiences at the different treatment centers and ask for recommendations about providers in your area. 

As for Halloween today, can you leave your 18 year old or someone else in charge of your other girls and have them hand out candy (or maybe they will be out trick or treating?) and take your d. somewhere and do something together while this is going on? When your other kids come home with their candy, maybe you are going to have to lock it up so that your ill d. is not tempted by it. Is there a cabinet or drawer in your home which locks?

Have you read Eva Musby's book, she has practical suggestions about eating. 
Anorexia and Other Eating Disorders: How to Help Your Child Eat Well and Be Well: Practical Solutions, Compassionate Communication Tools and Emotional Support for Parents of Children and Teenagers

I agree with Toothfairy; look into other options if this is not working out. Sorry, this is such a terribly frustrating illness. Also if you can get some therapeutic help for yourself while you are going through this.

Kali

 
Food=Love
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Torie
Hi nowisee - So sorry you needed to join us here.

You have already received good advice from the forum members who responded. They already made most of the points I would like to say:

1)  Since her orthostatic blood pressure "is a roller coaster," your d urgently needs medical attention. What do they do when they find concerning numbers?

2) It really sucks that the paid help failed your family. It makes it really hard when the "professionals" collude with ED by trying to tie our hands. When I had this problem with my d's doctor, I had to find a true ED expert to counteract the damaging advice given by the first doc. I agree (with ToothFairy?) who suggested UCSD's 5 day program. Forum members who have attended report that they do a fabulous job educating the whole family, and they most certainly do NOT agree with advice to stop being the food police. Many have reported that it was a game changer for them.

3) We can't FORCE our kids to eat, but we can REQUIRE them to. It sounds like your d is still very ill and needs a firm and steady hand to get her to a better place. Especially if you don't currently feel you can successfully require your d to eat fully, a higher level of care is needed. 

4) Perhaps you already answered this, but does your d purge after eating the candy or other binge foods? In my opinion, the "bingeing" is not too worrying as long as she doesn't purge. Her body is sending urgent signals that she needs fuel ... given her fasting, the number of calories consumed in a binge is probably modest for the time period. So I would tell her it's OK that she ate the amount she ate and try to distract her and also watch like a hawk to make sure she doesn't purge.

5) One thing that helps (some) to reduce the urge to binge is eating balanced meals with a good mix of carbs, protein, and fats. 

6) ToothFairy is also spot on in saying that you need competent help NOW since your d is 16 and the window of time is limited where you have full parental authority to help her. Please call UCSD or other facility with excellent reputation, today.

7) I also agree with the suggestion to lock up all the candy. WHen someone (including ED D) wants some, you can give it to them. 

I'm so very sorry your family received such terrible "help." 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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EDAction
Hi nowisee,

Welcome to the forum.

I am so sorry that the "professionals" failed you.  In fact I am angry about it!!!  This happens way too often!!!

I agree with Tori, we can't force our kids to eat but we can require it.  In our case that meant there were times when D did not go to practice, a friend's, school etc until her meal/snack was eaten.  It was a fight, but it worked.  And after enforcing the rule several times ED knew we meant business.  On the forum this is called "LSUYE" or Life Stops Until You Eat.  

Are you familiar with FBT (Family Based Treatment)?  If not, I recommend the book "Help Your Teenager Beat an Eating Disorder" by doctors Locke & LaGrange.  It's a good place to start.  

Keep coming back nowisee.  





DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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nowisee
Thank you all so much. I should have added that I am a single parent as my husband of twenty -one years was living a vow and law-breaking double life that got exposed. Not a new story by any means, but one that ripped my family and kids' sense of self and right and wrong apart. Supervision is one of my biggest priorities and challenges as I am isolated from family. Just bought the book, Caregiver. Thank you.
Remuda and our dentist and doctor see no signs of oral purging. However, she was very focused on detox diets and supplements for months before i realized she had an eating disorder. She disappeared into the bathroom between candy episodes, so I do not know if she is now purging another way or self harming again. She has scary episodes with stomach pain when she eats too much.
I think family based is our best bet as institutions and any professionals shut her down completely. I have had three professionals try and try to reach her, and finally tell me to keep working from home because we are wasting our money. Her nutritionist touches base with me periodically via phone and keeps tabs on her vitals checks, but that is all she feels she can do. She literally just slumps in their office and either won't respond at all or gives mumbling monosyllables yes or no responses. And these are some of the most highly rated teen counselors in our area.
At the moment she is obsessed with the idea that she needs to go stay somewhere else for two months. The vitals nurse made a joking comment that she needed to come live with her, and she latched onto it and is in an absolute panic that that is what she needs to be able to get her head straight and move forward. Frankly, I sense that she wants to get out from under the requirements to eat well, but I understand her sense that this is an almost life saving need for her. The lies ED tells these kids are so difficult to combat because their thinking changes like the wind but it as stubborn as steel.
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iHateED
Hi and welcome to the group, but so sorry you need to be here.  I hope you are reading as much as you can from this website because you will learn so much here.  You have been given great advice so far from the others but I want to respond to your frustration that your d is not engaging with her therapy or docs right now.  SHE CAN'T ... her brain is not healthy enough yet for any sort of therapy to help at this point.  It is like trying to reason with an alcoholic who is still drunk.  Nothing will get through right now.  Your first and top priority is to get her weight up to where she should be on her growth curve and stop the binging.  When your D is weight restored (WR) then you can start therapy if you feel she needs it.  Frankly, with her being so ill right now, therapy is probably a waste of time.   My d was the same way, she would not even speak a word to anyone in the beginning. 

Your D wanting to go somewhere for treatment is not a bad sign.  If she were to attend one of the great facilities that offer evidence based treatment such as FBT, then she would not be able to get out of the requirements to eat.   I am so sorry that you were both let down by the so called professionals at Remuda.  Perhaps you might want to look into other facilities with better reputations such as UCSD, Avalon Hill, Center for Balanced Living, just to name a few that have been given high praise by some forum members.  If you want to share where you live, other folks may have some local suggestions for you. 

Hang in there! 
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nowisee
My apologies. After being up most of the night, I am not the clearest. My daughter does not in any way want to go into treatment. She "knows" without a doubt that she does Not have an eating disorder, all professionals and adults are stupid for thinking she has a problem or even daring to tell her how to eat, what she should weigh or how many calories she should invest per day. When we took her to Remuda, she had just talked two of her younger sisters into a 900 calorie per day diet and exercise program. She has a Very strong personality, I have hopes that it will serve her well in the future if she can get back into balance.
What my daughter is convinced she needs is to go live with another family and be part of their lives for two months. I cannot imagine asking someone else to try to handle the requirements and mind twist of this disorder. I would love for her to experience a healthy family with both parents and no sociopathic element, but we don't get to choose our family, unfortunately.
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Torie
nowisee wrote:
Remuda and our dentist and doctor see no signs of oral purging.


I will join you in hoping they are correct about that. But I will also tell you that after reading about the horrors of bullimia on this forum, I was obsessive about keeping an eye on my d to ensure that she either didn't start purging, or it was nipped in the bud. Many here were surprised to learn that their precious d had started purging, unbeknownst to them.

And so I explained to my d that she would need to use the bathroom before each meal so that she could stay with me for an hour after each meal. Oh how she hated that! And I listened at the door when she did use the bathroom. Not how anyone wants to live but oh so worth it if it keeps your d from starting this incredibly hard to break habit.

So sorry about your h. Reminds me of a card I once bought for someone that said, "Time wounds all heels." It's surely much harder when you have to go it alone, but others here have done that - it can be done.

As for the stomach pain after eating, yep, heartbreaking to witness but par or the course. On top of the mental anguish of eating, they also get physical pain. Some find that a hot water bottle or warm blanket helps (some) and most agree that distract distract distract after eating is a must. TV, video, crafts, games (that don't require much thought), reading to them, telling silly stories, whatever might take her mind off her difficulty a bit.

It does get better. But the only way out is through, and it might get worse before it gets better. xx

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

Welcome to the forum.  You will get great information and support here.  

In the summer of 2012, my daughter spent time at Remuda.  Upon her release, we too were told to not be the food police.  Thankfully, it was about that time that I found this forum and began to become educated on evidence based treatment. I will be very clear in saying that the no food police approach does not work.  Our kids are suffering from compromised brains and they can NOT make the right decisions to eat, but they need nutritional rehabilitation and weight restoration in order to recover. We wanderered in the wilderness until I understood this and started to make the necessary changes.  Today, my d is fully recovered.  Had I listened to Remuda (or many of the other ineffective providers we came across) she would not be.

It may be that you need some support to work to undo the damage that Remuda did and get everyone on the same page.  The 5 day mutli family program at UCSD might really help in that regard.  I looked into the program, but my d was too compromised at the time and it was not an option for us. I did a lot of research though and had many conversations with the staff there and was very impressed. Here is the link:

http://eatingdisorders.ucsd.edu/treatment/oneweek-intensive-treatment-programs.html

You would come away from it with skills to manage your d at home and help her eat.

Another thing that might help is medication. We had some bad experiences with psychiatrists over prescribing meds intially, but found zyperxa to be a game changer. It reduced my d's racing and intrusive toughts and her anxiety around eating.  She didn't need it forever, but it helped her to eat which led to her reocovery.




Enjoying my 23 year-old daughter's achievement of active recovery that was made possible by the resources and education I found on this forum.

Don't give up hope!
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rainydays
My daughter was bulimic. She was very quiet with it. There is something unique about bulimia which goes with the self harm. The vast majority of kids with an eating disorder who self harm are bulimic. This was the case for us too.

Dbt was helpful. Eating a balanced diet was helpful. Supervising after meals was helpful.

With anorexia a malnourished brain is shrunken and resistant to therapy. With bulimia your kid can be at weight but the purging, exercise purging, self harm behaviors are out of control and interfering with a good life.

It might be your daughter doesn't understand what is happening and why. Hopefully someone can get through to her. You will have your hands full being that person.

There's a DBT teleconference on the neabpd website called family connections so you can learn emotion regulation skills like validation. It was a caregiver support group.

Good luck. Glad you came here. Lots of good info.
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