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

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Tahirua27
Hello

My 16 year old daughter M has AN and has just come out of hospital after 2 weeks, now at a normal weight but with strong AN thinking ongoing. We are starting FBT in a few weeks and doing the best we can to keep up the hospital routine while we wait for our appointment.

M is very social but has only told two of her closest (very supportive) friends about the AN - the rest think she was "on holiday"! Even during the worst of her AN, she would save up her calories or restrict afterwards in order to be able to eat and drink normally with her friends.

We have found that the prospect of being allowed to go out with her friends is the only thing that motivates her to eat. The only reason she played along and was discharged from hospital was that she wanted to be allowed to go to her friend's house for New Years (with all her meals eaten). When she thought she was not going to be allowed this, she refused to eat and only started again when she was reassured she could work towards that. (She is very strong and ended up in hospital after refusing to eat for 2.5 days when I told her she couldn't be vegan anymore).

We have just come back from two days at our our beach house with the two friends. M ate with them and us very normally, including all the meals and snacks and more "just because it is yummy" food.

We suspected that all this pretence of normality might have a reaction and it has happened! Tonight she has refused dinner for the first time in 4 days and says she is full. Right now the consequence of this refusal and (I suspect) the refusal of the snack later on will be staying at home tomorrow and thereafter until she as eaten all her meals and snacks for a full day.

Is this something others have experienced too? How should we approach this - to not take away everything that she values, but also to set her up for success?

Thank you!
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Foodsupport_AUS
Welcome to the forum. This is very common and very normal for kids with AN. Although it is not their fault they are ill they sometimes can show enormous control over being able to eat or not eat and often ED will get them to manipulate others to achieve an outcome too. 

The most important thing is that she eats and keeps on eating. Although normal weight it is quite possible she may need to keep on gaining weight to recover. It is common for them to need to a higher weight than they have ever been before. 

If she is manipulating you by eating or not then this is not normal behaviour. Starving yourself to achieve an aim is also not considered normal behaviour. Your plan of making sure she eats all meals and snacks is a good one. It may be that it is worth making there be a positive thing after each meal or snack has been eaten but of course you don't want to get into the situation where she is only eating when there is something to eat for. I would also make it clear that if she loses weight it is possible she may need to be hospitalised again. 

If you can - it is worth sitting with her and allowing no other activity until she has eaten. For many life stops until you eat or life starts when you eat can be a really useful way of getting food in. It takes great patience and persistence from parents, because we have to sit around too and can't do what we need to do. It also takes away from siblings but right now keeping her eating is truly important- every snack or meal. 
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.
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Tahirua27
Thank you for this 😉

Yes, we do all the "right things" by sitting with her for each meal etc. I think she is clever enough to stay out of hospital for now by eating at least a few meals each day, and maybe that will be enough to keep her at her current weight until we can get into the FBT programme. Fingers crossed!

This is all complicated by the fact that my younger daughter is very underweight and is likely to have an anorexia diagnosis made too, with a lot of refeeding required. I'm finding it really hard to hold both of these special needs in the front of my mind - I'm all over one, and take my energy slightly off the other, and then vice versa, all during one day. I'm just hoping that I can get better at it!

 
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tina72
Here it worked to make her THINK she will eat less when she wanted to go with her friends and eat normal with them. I said something like "I will give you a light califower soup for lunch when you want to go out later" and she thought it is light and it only vegetable but really, it wasn´t....[wink]
Keep feeding. There is light at the end of the tunnel.
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