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

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Hi everyone

You have no idea how nice it is to find somewhere where it feels like people are actually going to understand what I'm going through - and that hopefully I can support in return

I'm currently trying to support my 34 year old sister - she has had an ED (anorexia) since she was 16 - albeit to differing extents including 3 lots of IP treatment- however she is currently in the midst of a relapse...(I'm not sure if it still counts as a relapse when it's been going on for 4 years but hey!) and, whilst she is (just about) managing to hold down work, her life outside of that is non existent - she wakes up, goes to work, eats and sleeps ….and attends a once weekly therapy session. The other thing she also spends a lot of time doing is walking/standing up.
She is currently eating around 1400 calories I day (I believe) and she crams most of it into the evening as she's scared that if she spreads it through the day she will get to the evening and be hungry and have "used up" all her calories...

She has asked me to help her but, if I'm being honest, I don't really know where to start....all of the resources out there seem to focus on adolescents - not grown ups - she has seen a dietician who has given her a meal plan but she just doesn't seem able to stick to it. She says she doesn't want to lose weight (and to be fair to her after a blip at Xmas where she lost weight she has put on around 2kg) however at the same time she doesn't seem able to do the things that she needs to do to make the improvements she says she wants in order to get her life back...!

I really don't know what is best to do....I want to try and help her but I don't know where to begin and, because of the warped healthcare system in the UK, it looks like if I don't help her then nobody else will (unless things get really bad I guess) - and we can't afford to get her private treatment.

Thanks so much in advance for any support or wisdom that anyone can offer and please know that you have all inspire me on a daily basis with what you are doing for your loved ones - your children are very lucky

Dear Blondie,
You are a wonderful person to reach out for help and to try and be there for your sister.

I think that helping your sister could involve becoming a good meal support person for her as well as trying to help her resume a life outside of work and her eating disorder which is more fulfilling for her.

"she has seen a dietician who has given her a meal plan but she just doesn't seem able to stick to it." 

She is likely to have difficulty in sticking to the meal plan on her own, that is part of the illness. 
Does she live on her own, or near you, and could she come and stay with you for awhile and see if you can help her regulate her eating a little better?
And plan some activities together which she might find interesting?

Is she under the care of an MD to make sure that her heart and her electrolytes are not compromised? If not, you might want to encourage her to reach out to a doctor for a thorough checkup. I'm attaching the AED medical guidelines in case you want to take a look.


Welcome Blondie. As Kali has mentioned her inability to follow the plan to restore weight and stabilise  is typical and expected. If it was that easy everyone would recover quickly. As much as possible the best help you can give is to support her to do what needs to be done. That is eating regularly, increasing her amounts and following a meal plan that is more than 1400 calories a day. Hearing her anxiety as she gains some weight, and supporting her. Offer her distractions when her anxiety increases over various things. Helping her to get the ongoing monitoring she needs. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
Hi Blondie,

I think Decoding Anorexia by Carrie Arnold may be an interesting book for you to read. Carrie is a science researcher and someone who recovered from long term anorexia as an adult with the help of her mother. Although she has a scientific background it is not very technical so ideal for us non-scientists. 

Tabitha Ferrar also recovered as an adult and has a very informative website.

Much of the understanding surrounding eating disorders has changed since your sister first got sick. I believe that informed loved ones are a crucial support, no matter what age and what stage of recovery.

Warm wishes,

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.
Hi and a very warm welcome from Germany! Sorry that you have to be here...
"I really don't know what is best to do....I want to try and help her but I don't know where to begin"
First step would be to get her day scheduled and the meal plan done (and not all in the evening, it is important to keep her blood sugar level constant). So can you get her to live with you for some time x and to eat with you? Would she eat what you cook and plate?
Can you join her for as many meals as possible to help her eating?
Keep feeding. There is light at the end of the tunnel.
Thank you all SO much for your replies - it was so nice to finally be able to get all of that off my chest without worrying about being judged

Unfortunately my sister lives about an hour away from me - and on her own - I can't temporarily move there as it's just one bedroom plus it would make my commute to work hell - and she flat out refuses to come and stay with me saying that she doesn't want to impose and also because it would then make HER commute an issue - and to be honest I'm not happy about her driving as it is so I really don't want to do anything that will mean she has to spend longer in the car.
I think, based on all of your advice, I'm going to have to be a bit more involved at meal-times - so I will see if I can convince her to come stay (or I will go to her) next Friday night and stay until Sunday night so that I can try and get a more regular eating pattern established...and then I will see what she thinks about doing breakfast/lunch/dinner via Facetime during the week - not sure if anyone has ever done that but surely all this new technology has to be good for something!! I would go this weekend but I already have plans and I really can't cancel them - wedding and christening of close friends. I will definitely look into those books and websites that you've suggested though and see if I can get her to look too

She sees the Dr sporadically - normally just when she needs a repeat prescription of her anti-depressants and, as far as I can make out, he's not concerned - although he did prescribe her some supplement powder drinks just before Xmas - I doubt she has had any of them though

Something else she struggles with is eating carbohydrate other than fruit/veg - especially on days where she perceives she "hasn't done enough" - I keep trying to tell her that her body desperately needs it to survive AS WELL AS protein but it seems to go in one ear and come straight out the other - has anyone struggled with/overcome something similar? It's so strange to see how a grown adult turns into a scared child as soon as they're around food ….
And if I never see another bottle/can of Pepsi Max it will be too soon!!
That sounds like you have a bit of a plan. There are quite a few parents who have skyped/facetimed their children for lunches. A number of the recovery coaches do meal coaching etc. via these as well. So yes there is a lot to be said for this new technology.

Your sister's fear around food is normal and expected for someone with ED. Yes it is baffling and confusing, but it is very typical. Most parents here will have struggled with those fears. One thing that can work is stopping trying to reason her out  of  it. Yes she does need the food but her brain is too fearful to be overcome with reason. Rather than reasoning address the fear, and say it has to be done anyway. So acknowledge she is scared, and then ask how how can she move forward anyway. Should she start with a small bite, does she find some carbs easier than others?The expectation is that it is done even though she is scared but not trying to reason away the fear. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
Thank you so much for your reply! I'm definitely guilty of trying to reason with her when she tells me her fears/reasons why she can't/shouldn't eat XYZ - it's exhausting - and so hopefully going with the approach you suggest will be more successful and easier/quicker
With the carbs, I think she got sucked into a lot of that "clean eating" nonsense that was around a year or so ago and so the ones she tends to find easier are things like oats, quinoa, wholemeal bread - although she won't eat sweet potato (no great shame there!) - I suggested a hot cross bun the other day and the look I got was as if I had suggested murder!
To be honest if I could get her eating some carbohydrate at every meal I would be happy - at this stage I'm not too fussy about what it is ...anything would be an improvement!
Read "Decoding Anorexia" and you will undestand better how her brain works at the moment and what she needs to eat to getter better nurishment.
Would she eat something that you cooked without her seeing it?
You could start with califlower soup. Do it with a roux and add some vegetable stock. Then you have a white sauce. You can hide 200 ml cream and 100 g cheese (let it melt in it) inside. That gives you some fat that she needs desperately for her brain recovery.
If she eats wholemeal bread buy her some with bigger slices and more calories in and put away the packaging. Can you try whole wheat pasta?
Keep feeding. There is light at the end of the tunnel.
Hi and welcome from me as well and it is great that you want to help your sister. I just had a thought that maybe she could come over weekends and you both make her meals for the week and freeze them. You can even freeze sandwiches. If she knows the meals are all made, then it may be easier to eat them. You can cook meals for dinner, make sandwiches for lunch and bake huge, Texas muffins for breakfast. Take the mealplan, which the dietitian has prescribed and write it out on a weekly mealplan so that she can see that the meals are the same. Write in snacks and make sure she has them in her pantry - also encourage her to not eat low fat options. I saw an article the other day, which says that full fat dairy is healthier than the low fat versions:  http://time.com/3734033/whole-milk-dairy-fat/
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
Where is she located?
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
Sorry for the delay in replying!
No, she definitely wouldn't let me cook something for her without her seeing me do it ...that's if she would let me at all which I'm not sure. And I know she definitely wouldn't eat anything with cheese (unless it's low fat cottage cheese)

Mamaroo thank you so much for the suggestion - she is coming over this weekend and I will see if I can get her to make some meals for the week whilst she's with me and write down her meal plan for the week - even if she won't cook with me then at least she and I will be able to talk through what she's going to eat for meals/snacks and maybe shop for any bits she needs (I know she finds supermarkets daunting) so that she has no excuses ….I hadn't thought about freezing sandwiches - such a good idea though - thank you!

She lives in the South East of the UK - we both do