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

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Latina

My step daughter, my husband and I have a 6 year history of anorexia. It began when she was 12 years old and the trigger was the marriage of her father and me after he raised her on his own since she was 5. She was hospitalized in Sheppard Pratt. She recovered her weight. Had one relapse when she was 16 and she went to personal therapist and we 3 went to family therapy for some time. After that, she went to the therapist once in a while. During all that time she ate her food at house where I prepared her lunch and dinner and she fixed her breakfast. I always told my husband her breakfast seemed little to me but as she had an acceptable weight in general, he didn’t worry about it. She began to work part time last year and had more independence to eat outside. She graduated high school in May. Now she is 18 and in college, continues working part time, lives at home, has a boyfriend and has even more independence for eating outside. Around 90% of her lunch and dinner are outside. She continues doing her breakfast that I continue to consider is insufficient. Also few times she has prepared her lunch for taking to the college. She is 5 foot 7.5 inches tall. Her goal weight in treatment was 145. Her maximum weight after her recovery was 148 in April 2018. Then it dropped to 135.5 in Dec 18. Now is 136.5. On the weeks that she eats a little more at home she gains some weight, then she loses it the next week when she is not eating as much at home. That has been the tonic. But she hasn’t come back even to 140 since Dec. 18. So her weight loss is definitively related with her independence for picking up her meals. Due to her alleged stomach issues she doesn’t eat: milk, cheese, beans and a few other food that she says that make her produce gas. But she refuses to take Lactaid or other thing for helping with this matter. On a good note she doesn’t have problems to eat fries or some caloric desserts once in a while. Her father and I have told her that she has to increase the amount of food she eats but we haven’t been so successful. She has been consistently eating after her recovery but not the amount we think is healthy for her. Her weight consistently has been between 136 and 138 for most of this year. She has to be prepared to be 100% independent in her meals. She doesn’t have “the voice”, her mood is usually ok and her social life is active. Is this recovery? Please, if anybody can share their thoughts about this topic, we would appreciate it a lot.

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sk8r31
Welcome Latina, and hope that you find the peer support on the forum to be helpful.  Based on what you've written, it sounds as though your step d is not fully recovered, and still exhibiting some restricting behavior.  Ideally, she should be moving back to the weight that she was previously at, and should still be gaining 1-2 lbs/year until her mid-20's. 
 
When a young adult has more independence for eating, they may not intuitively be eating as much as is needed to reach and stay in recovery. She still may need more meal support at this stage.  I highly recommend Lauren Muhlheim's When Your Teenager has an eating disorder  and Tabitha Farrar's blog posts for further insight.
I expect you have some leverage with financial help and college tuition and can use this to your advantage with meal support...preparing a suitable breakfast that she must eat for example.

Sending warm support to you.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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kazi67
Hi Latina
does your step d still have regular checkups with either her GP or does she still see her treatment team at Sheppard occasionally? therapy sessions??

i think the education system is different where you are but also I’ve heard the colleges have health and councillor support available 
maybe you could talk to your d about making an appointment and having some tests done 
ie: bloods, blood pressure etc at either the college, GP, or treatment centre 

it sounds like you and your d have done an incredible job to have her re-engaging in life, study, work etc 

My d is doing well too but I will not stop the appointments until I’m 100 percent  sure she’s 
“out of the woods” (it’s our “safety net) and it gives  me peace of mind 
 Even though it’s costing me a fortune and it’s basically all I work to pay for.........
appointments and food and bills 😳
no holidays, clothes, shopping sprees etc ☹️

but I’ll take that any day than the return to IP
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Kali

Dear Latina, 

Welcome, and I hope that you will find support here.

I think that recovery is sometimes hard to define. But it sounds as though you and your husband have been doing a great job getting her into treatment and being supportive of her.

Is recovery when someone no longer needs to be hospitalized and is no longer so obsessed with thoughts about food and weight, that they cannot function? Is it when they are no longer so depressed that they can enjoy life and maintain an adequate weight? And have no overt symptoms such as purging or suicidiality or self harm? If so then I think your daughter is taking important steps in that direction. And these transition times: the end of high school, the start of college, etc are hard for our kids and they often lose weight during these times so it is helpful that you are keeping an eye on her.

Your daughter seems to be living her life and enjoying things. She is doing well in school and socially. She is eating but not quite enough and I understand how concerned you must be about that. Her bmi is around 21, so she is most likely not in any imminent medical danger.

However from what you are describing it does seem as though there are may be some residual eating disordered thoughts present; she has a list of foods she doesn't want to eat and then there is the fact that she lost weight. However she is holding steady at the weight she is at now, right and has been for some time? It is a very long process as you know and this place of being not critically ill but not totally recovered I think is quite common in young adults as they take their steps forward to become more independent.

Since she is living at home you can be proactive in preparing food when she eats at home. If she is having trouble with milk, Lactaid makes an excellent whole milk that I could recommend. It tastes just like regular milk.

https://www.lactaid.com/products/lactaid-whole-milk

There is also a cheese which is spanish, called Manchego, and I have found it to be the cheese which tastes the most like "regular" cheese. It also causes no discomfort since it is made from sheep's milk which is easier to digest than cow's milk.

https://www.castellocheese.com/en-us/cheese-types/semi-hard-cheese/manchego-cheese/

Since she is skimping on breakfast, can you start making breakfasts and eating them with her? Fruit smoothies made with the lactaid taste good for breakfast.

And just in general try and bump up the calories in the meals you are serving her at home and eat together as often as possible with your schedules?

warmly,

Kali

Food=Love
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Latina

Thank you so much sk8r31, kazi67  and Kali for your insights and kind words. We appreciate the time and efforts you put in them.

Kazi67: The family therapist we had in SP, that was relatively good, is not working there anymore. She helped more with the family dynamic regarding food and now we don’t consider it necessary. The personal therapist was not good at all. My step d saw her since she was 12 for more than 1 year very frequently. The therapist used to ask her how she was doing and as she said “ok”, then they began to speak about whatever but not her emotional health. That we got to know years later when she was 16, had a relapse and we wanted her to come back with this therapist. My husband and my step d are from the USA. I am from Latin America. I don’t know if it is a question of culture but in my country all the therapist of minors always give feedback to the parents (obviously not giving details of what the child shares) and made them be involved in the process. SP never gave any feedback to us regarding her personal therapy and when I told my husband he should ask he said that if she had any other serious issue they would let him know. Since she was 16 she has had 2 therapist supposedly specialist in anorexia and she has gone to see them (despite she didn’t want so much) twice a month for some periods and not in a regular basis in other moments. From my point of view none of this people has helped her to go to the root of her emotional issues which created her lack of self-esteem that, as all know, begins in the childhood (in her case, when her mom took care of her). Now my step d is not so willing to visit a therapist. But after conversations with her father about that difficult part of her life and due to her recent studies of Psychology in high school and college and the sharing with her classmates, she is getting to be more mature and understanding regarding her emotional issues. As we all know, it is a long path but I consider the emotional aspect of the ED is the only one that a person has the power to change (you can’t change genetics, you can’t change the social environment so much). She is getting there: she is getting along better with her father and she is contacting her mother a little more.

I am very glad the sessions are working for your daughter. And I can relate with the financial struggles the ED creates. You are being a good mom.

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kazi67
Hi Latina
i only asked  about the therapist/GP  because you seemed worried about her weigh loss and I just wondered if she had that extra support that they could check that 
but if she didn’t like the councellor then there is no point going really (they really need to find one they can trust and feel comfortable taking to)
it sounds as if you are doing a wonderful job and your step d is doing well, that’s fantastic

i don’t think it’s your culture at all, we get told nothing about our d sessions  either (even when it’s important, my d had 2 more re-admissions to hospital and no one even called us) and unfortunately I sometimes find it hard to believe my d  as my d ED has lied to us so much in the past and when I thought she was doing well she ended up being re-admitted to hospital so we continue to let her go to therapy until they say she’s finished 
this  could be  due to her age too though as she is YA

anyway  keep up the great job you d is lucky to have you and isn’t it wonderful when they start getting their lives back to normal 🙂
x
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Mamaroo
Welcome from me as well and sorry you need to find yourself here. It would be a great start to increase her breakfast. An easy way is to add liquid calories, such as an ensure, sustegen or even a glass of orange juice. I give my children coffee made with milk, so a lot of calories without making them feel full. Tell your d to add a snack such as a muesli or nut bar to lunch and give her a snack before bed time.
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
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Latina
Thank you very much Mamaroo!
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