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

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Frazzled
Hi everyone,
I need some help. My 10 year old (11 in Nov) was diagnosed with AN on June 22. We have doing FBT at home since then and she has went from 54 pounds to 70 pounds. She is almost on her growth curve (3 more pounds to go) and was doing very well. She was back to her old self for 3 weeks and laughing, joking around etc but this week has had increased anxiety and said that she feels like something is trying to pull her back down. She is also a lot moodier this week also. What is going on?? She is eating well. 3 meals and 7 snacks and also a shake everyday. 3,000 to 3,500 cals a day and gaining 2 # a week on average. She has started to have anxiety about the shake mainly and hasn’t had any anxiety about meals and snacks except for yesterday after dinner she told me she was still hungry and wanted dessert. She ate dessert but then later on in the day tried to cut out one of her snacks to compensate for it. She was upset about having dessert so I talked her through it and she was able to eat her late afternoon snacks ok. What is going on all of a sudden and how long does this part last?? I have been having that old PTSD feeling this week because of this and I hate it. Help!
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Enn
Hi I wonder if she is going through extinction burst. The closer she is to wr she may feel more anxious. Just keep feeding and reassure her. Please look it up too there is a great post from Irishup a few years ago, on extinction burst,if I recall correctly. Keep feeding it should get better but keep an eye out and watch for restricting behaviours too You are doing so well.
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Torie
Hi Frazzled - It sounds like you are doing a great job!!!  Yay, you!

Unfortunately, it's very common for the last 5 (or 10 pounds) to be really hard.  Sucks, but you have a lot of company there.  Just keep on doing what you're doing and you will get there.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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ValentinaGermania
Hi frazzled,
as the others said, you are doing great!
It is possible that this is extinction burst - we also had some setbacks with the last 2-3 kgs.
Another idea as your d is still very young:
Is it possible that she grew in this time and needs now more food? (I had that idea because she was still hungry after dinner...)
Is it possible that she will get her periods in the next time and so her body is growing in that area? You said she is moodier, that gave me the idea it might be hormons...
Nevertheless: keep feeding, keep talking her through that crisis and keep swimming. This is only a phase and will get better again soon.
Tina72
Keep feeding. There is light at the end of the tunnel.
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Frazzled
Hi Tina72, I just measured her this morning and she hasn’t grown. Since we started to refeed her she has grown an inch but did not lose any weight because she must have been getting enough at that time. She is still gaining steadily but it probably wouldn’t hurt to give her some more to get her through this part of the process. Just when you think your D is back the demon comes once again. So not fun! Thanks everyone on your replies! If this is an extinction burst I hope it doesn’t last very long.
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teecee
I think what you are describing is an extinction burst. When my daughter wrote about these moments she described them as being dragged down to the bottom of the seabed as if drowning before being able to be cut loose and rise to the surface to gasp for air. It sounds like the anxiety is overwhelming so yes lots of reassurance needed.
You’re doing an amazing job!!! Xx
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ValentinaGermania
Just keep swimming. You know what to do. You will have such experiences sometimes. Little setbacks happen. That is why they call phase 2 "the dance". We had some weeks with 2 steps forward one step backwards. But the direction is forwards and that is important.
Just feed her through this time and try to distract her and that´s it.
It will get better soon but nobody can tell you if it is just days or some weeks.
So take a deep breath and care for yourself so you have enough power for the next part of that marathon!

And about growing:
Sometimes they need more calories and put a bit weight on and then they grow. It might be that she now needs a bit more, try that and wait and see. Maybe it is only a bit more fat needed.

The demon is not back. You are not back to square one. He is just lurking around your house to see if you left some door open. Close it and go on. No panic![smile]
Keep feeding. There is light at the end of the tunnel.
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melstevUK
Frazzled

"she feels like something is trying to pull her back down."

These words appear to be striking terror in your heart but staying calm and stating that this is quite normal when people are recovering , and encouraging her to stay on track and keep eating, - in spite of what she is feeling or thinking - is the only way to achieve recovery.  

There is nothing wrong with acknowledging what she is feeling - but be clear that there is no backing down or fearing any thoughts of stopping eating.

You have to keep moving forward - and if talking about how the illness works and how other people feel during recovery helps, then I would speak openly about her experiences.

What she is experiencing is normal - and it may help to point this out.



Believe you can and you're halfway there.
Theodore Roosevelt.
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HopeNZ
Hi Frazzled

What others have said... Keep going, you're doing a great job!

I worry that there's a danger of oversimplifying aspects of the journey we all find ourselves on. The problem with this is that it can set up unrealistic expectations for where we may be on the road to recovery. The idea of 'extinction burst' is one of those aspects. It's beguiling to think of an uptick in anxiety and difficult ED behaviour as we approach WR as a predictable and inevitable milestone, and a sign that we're almost there! The downside is that if it doesn't happen at the expected weight or, as in our case, it seems to happen several times at unexpected points along the way, it can be alarming and confusing.

I finally found the excellent post by Irishup which scaredmom mentions! It is long, but brilliant, and explores the idea of 'extinction burst' in its complexity. I hope this helps to reassure those who don't see a recognisable 'extinction burst', or who see a few of them!

https://www.aroundthedinnertable.org/post/some-rather-long-musings-on-extinction-burst-relapse-and-recovery-6462360?full_version=1#gsc.tab=0
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Foodsupport_AUS
This does sound very normal. I am sure you are tired of hearing that it is very early days and this illness takes a long time. 12 months to recovery is considered very short and you are only a few months in. Recovery is also never a straight line. Keep pushing the food, keep her gaining and she will get there. If you have had such good results so far I am sure your journey is likely to be much shorter than many. 
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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Frazzled
Thanks everyone for responding! I did discuss with her what is going on and she understands that in order to beat this she has to eat a lot and not back down ever. Even after she “recovers” she can never diet etc. Also have been telling her that ED is a bully and wants her to be miserable etc. I will keep discussing the disease process with her every step of the way and help her through. I upped her fat intake today even more and she was in a better mood so not sure if it was that or just lucked out today. Hoping tomorrow is ok also 😬
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Frazzled
Just had a good talk with my D and she is upset because she feels like she is stumpy and wants to be taller and look different than she does. She says she doesn’t like herself at all and thinks she is ugly. She has a nice muscular build which she hates unfortunately and she is pretty although she doesn’t think she is. How do you respond to these body image issues? I told her that she is going to be going through the biggest growth spurt she has ever had soon and her body is going to be changing and she will look a lot different in a few years. I also told her beauty comes in all shapes and sizes etc. Maybe this is why she has been upset lately.
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deenl
Hi Frazzled,

Reading your post made me wonder if her hunger cues were returning. My son lost all feelings of hunger for a long time when he was ill. The return of these feelings can be very scary and many kids can't express them so fall back on roundabout questions about when dinner wil be ready etc.

Here is a blog post about extreme hunger feelings during recovery from restriction.

Warm wishes,

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

May 2017 Hovering around WR. Mood great, mostly. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. 2018 growing so fast hard to keep pace with weight. 2020 Off to university, healthy and happy.
  • 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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Foodsupport_AUS
It is very common for our children with ED's to pick faults with themselves. It is common that they see themselves as unlovable and unworthy. My own D has had issues from well prior to ED and always says the only reason I love her is because she is mine. It is truly heart breaking. Talking to this however, trying to reason with them is futile. Their brains cannot and will not see it, and very often manage to twist something we see as a positive into a negative. 

My best suggestion is to firstly say something along the lines that it is all to common for people to feel uncomfortable in their own skin. To not like various parts of their body, as well as to acknowledge that hers is changing. To also comment that some people seem to be able to rise over it. Then move on, suggest a distraction doing something you know she enjoys and likes so you can then say something a long the lines "you are really great at X" 
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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Torie
I agree with FoodSupport.

Our poor kids beat themselves up so badly - the self-loathing is unfortunately very common.  It's like they have a tape playing on repeat telling them they are ugly fat stupid worthless and every other negative adjective no matter how wrong and inappropriate.  My d hated pretty much every single thing about her appearance and every single thing about everything else that defined her.

Food was the cure.  Keep feeding.

And find a few mantras to get through the moment like FoodSupport says.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Frazzled
Hi there,
Thanks so much for all the great suggestions. I will definitely put those into play. Deenl, she did tell me yesterday that this week she has been hungry all the time so I bet your right that her hunger cues are back. This may be causing her some worry also. Thanks for the article!
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Foodsupport_AUS
This popped up on the FEAST Twitter feed. It is from a group in Australia producing ED resources. It is a great summary sheet of what we need to do to help. http://www.ceed.org.au/sites/default/files/resources/documents/Body%20Image%20Distress%20Parent%20Handout_070718.pdf
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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Frazzled
Great! Thank you!
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