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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formygirl
We've been struggling for 6 years. Our D's residential team and physician tell us our daughter (19) has to be ready to recover. Every other forum insists the only way is to take control and re-feed. What do we do when it doesn't work that way? We have fought over and over to re-feed, she has now missed her sophomore year of college (she was very happy there, had wonderful friends and was doing well academically) and yet she will not allow us to take control. We can't be the only family where FBT has been impossible, are we? Isn't it possible that the combination of my husband and me and my daughter just cannot re-feed? She just returned from 2 months in res and she has not improved at all...
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Foodsupport_AUS
I am sorry your D and you are still struggling with this illness. 

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Every other forum insists the only way is to take control and re-feed. What do we do when it doesn't work that way?


You are right this doesn't always work but to date it is probably the most effective method, with the best long term success. It didn't work for my D either. My first question is what has happened with her two months in residential? What does she has not improved at all mean? Does this mean they failed to help her gain weight or they failed to get her focused on recovery?

There seems little doubt that recovery from a restrictive eating disorder does not occur without normalisation of eating, including weight gain. Working on mood or motivation don't seem to work as many of the changes presenting seem to be as a direct result of the malnutrition. To overcome that food restriction there are two options - someone (most commonly the parents) takes over the feeding part to reverse the malnutrition until the person with ED is able to overcome it themselves, the second option is that the person with the illness is willing to take charge or be coached in their feeding to reverse the malnutrition. Some would call this ready for recovery - others would consider it open enough to recovery that they are willing to work on it. 

Right now how are you trying to do things?
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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Kali
formygirl,

I'm sorry that your daughter does not seem to be improving and that you are feeling discouraged by the amount of time this has gone on. How did the RTC do with her weight restoration? Were they able to at least move her in the right direction? How far is she from the weight that her growth curve would indicate she should be at?

I also have a young adult daughter who we brought home from college and then she was in RTC. Then she lived at home afterwards and took a year off college. We found that the period at home after she left the RTC was just as important as the time she spent in treatment. She was in some in between place where she both expressed that she wanted to be well enough so that she could go back to college, but she clearly also wanted to lose weight at the same time because that is what she kept trying to do. Her perfect recovery at that time would have been being able to be slightly underweight but still able to function. So she was not better when she left residential although she was no longer at a dangerous weight. Based on that, I believe that even if someone doesn't say that they want to recover it is still possible to help make sure they are fully nourished. It takes a long time. My d. had times where she lost weight and I and her team stepped in to support her in gaining it back. My daughter became ill at 15 and it is first now, at 22, that I feel she has a real possibility of full recovery because her behavior indicates that she understands how important it is for her to continue to eat. She still has sessions with her therapist.

I found, during that period, that focusing on having her eat as many meals as possible with family, as well as her continued interaction with her outpatient team who all gave her the message that she needed to keep eating, seemed to get us through. I made sure that there were three meals served in my house and that they were packed with enough nutrition in order to help her. We tried not to discuss anything which was difficult at mealtimes. Put on some music in the background, try to keep calm, and make some conversation which has nothing to do with eating disorders. When she faltered or had difficulty eating I just sat and waited. I did have limits. If she asked if she could leave food on her plate I said no. If she wanted to only drink water with meals, I said no, there had to be a caloric beverage. I cooked high calorie meals and tried to up my game and make the food more interesting. However, and this flies against strict FBT, because she was a young adult we made a menu at the beginning of each week. She had had the opportunity to choose between meals at the RTC and when she came home, as long as her meals had enough calories I had no problem encouraging her to find meals that she liked and choosing them. The RTC dietitian had her write down a list of breakfasts, lunches and dinners that she would agree to eat after she came home, and they had been vetted for portion size and nutrition, so we started with those and then just broadened the menu slowly. Because she had also had a problem with purging, and had not been allowed to go to the bathroom at all after eating for 3 months in the RTC, I also checked the bathroom frequently after she had been there to reassure myself that she was staying on track. Another thing we let her do when she came home was to plate her own food. However, if she did not take enough, we asked her to take more. I made sure I ate the same amounts that she did so our plates looked the same.

It seems that now could be great opportunity to be able to be home together and make meals, if you are in an area which is affected by the shutdowns and stay at home orders. How are the family meals going at the moment? Maybe you can reframe the "control" issue and, because we are in an unusual situation due to the virus, and limiting our time out of the house, do a weekly shopping, do some meal planning while including her, and then make meals for everyone and have everyone sit down and eat together. 

Let us know how we can help you.
warmly,

Kali
Food=Love
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deenl
Hi formygirl,

I am so touched to hear about your long struggle, you must be worn out and very worried about her.

You are absolutely not the only one who has not had success with FBT. My son was younger and I did take over meal preparation and supervision but not in the more typical way. We had to take ideas we found here and adapt them to what worked for my son. Since he was a toddler he has needed more firm coaching than parental authority. We muddled along just fine until ED came along and found a way afterwards too.

formygirl wrote:
Isn't it possible that the combination of my husband and me and my daughter just cannot re-feed? She just returned from 2 months in res and she has not improved at all...


Well... It's obviously not simply the combination of your family members if the resedential place could not manage any improvment either! Eating disorders are like all illnesses, they come in mild, moderate and more serious forms.  It could be that your daughter is more towards the serious side of things. That is not to say that she cannot or will not improve. I know of incredible tales of recovery, after very serious and long term illness. 

You might find some comfort in reading some of the varied, creative and determined answers in this thread where I asked what people had done when Life Stops Until You Eat and Magic Plate didn't work.

As I said, my son is younger (now 17), happy and at a good weight but I am at the stage where I need to adapt my methods to ensure collaboration with a young adult on relapse prevention. Some of the resources that I have come accross might be of interest to you. 
  • Tabitha Farrar - has a helpful website, great books and does coaching for adults with eating disorders but really stresses using your loved ones as assets to recovery
  • The New Maudsley Approach has communication tools that are more suitable for adults (incl many young adults) that is more collaborative in encouraging change.

Wishing you continued strength and courage,

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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