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

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I_can
I need help.  My daughter has an eating disorder.  She says she is no longer purging but she unfortunately lies about many things and is defensive about her habits.  She is a junior in college.  Last semester she had 3 D's and 1 F.  This semester she has dropped at least half of her credits and her grades in the others are unknown.  She had an abortion last spring.  Her boyfriend "dumped" her.  She has her base at home for one and one half years.  I wanted to have her live at home to help with the stress of college and to give her a base for healthy eating, to eat together some, to have her grocery shop with me and to have food here to eat without her struggling where, when, and how to get food etc.  She lives in a mess.  She does not clean up her space.  When she is here she sleeps a lot.  She was fired from a job several months ago but has two new jobs - working at a Subway and a local restaurant as a hostess.  She is paying off her credit card debt to her father.  This aspect of her life is working.  She does not argue with him and he is her payee for her debt.  Do I ask her to move out and pay for her rent for six months or so?  Her living here is taking a toll on me - the sleeping, the mess, the waste of money on college, the depression ( she is taking Prozac and sees an MD who she trusts at her college).  Do I continue to pay for her college?  With a "normal" 21 year old I would have less fear about asking her to move out.  But I worry she will decline more into squalor, etc.  Or is this the push she needs?  Any advice out there is appreciated.  I read the forum weekly.  I haven't figured out how to successfully "reply" so if you don't hear from me I want to respond but don't know how and I read every reply.  Thanks!
Deb
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Colleen
Hi I_can,

I'm so sorry your d continues to struggle.

EDs are biological brain disorders triggered by low nutrition.  Everything you are describing is pretty par for the course--the lying, the depression, the resistance to changing her behavior.  This is a TREATABLE condition.

The three prongs of an ED dx are:
1. Inability to maintain a healthy weight (I interpret this to be healthy for that individual--and not just healthy in body (a return of periods, eg) but healthy in brain as well.
2.  Abnormal emotional reaction to eating and/or weight gain.  It's not normal to have fear foods, or to suffer from anxiety, depression, suicidality, OCD, etc as a result of weight gain (to that extent).
3.  Inability to see one's impairment, or the inability to act on it.

Your d can't see how impaired she is, but you can.  She can't act on her own behalf, no matter how old she is.  The organ she needs to make the good decision to seek treatment is the very organ impaired by this disorder.  She needs the loved ones in her life--you and her dad, probably--to take charge of this situation and get her out of ED's clutches.  It means treating her very differently than a neurotypical 21-year-old.

What kind of treatment is she getting right now?  Has she had any?  How does she eat and who is in charge of her eating?  Is she still under BMI 20 (note that BMI is a terrible indicator of health, but you've described your d as being BMI 19.something in the past, and that is pretty low, especially as she gets older).
Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
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Torie
Hi I_can,

Sounds like a difficult situation for everyone - I can certainly understand why you're looking to change things up.  I'm sure your d (your real d) must be feeling really lousy.  Clearly she needs help.  I wonder what you feel your options are ... maybe stop paying for college until she is better able to cope, and maybe help her clean up her space (set up a schedule) and then require her to do x minutes per day to keep it under control or some other agreement to keep her from getting buried under a literal and figurative mound of ... stuff.

Of course, as Colleen already noted, unless and until your d is at a proper weight for her, she won't be able to run her own life safely.  Can you provide 24/7 supervision for a while to see exactly what she is eating and to evaluate her claim that she isn't purging?

To reply to a thread, scroll down to the bottom of the last post in that thread and click "Reply" at the bottom right.  Then after you create your reply, click "Add Reply."

Please keep us posted. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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AUSSIEedfamily
Dear I_can,

Collen & Torie have given you great info & tips.

One of the things that helped me understand our D's situation was when her behaviours/symptoms were put into context by our special educator another mother. She likened the symptons/behaviours of our D to that of someone with a brain tumor or brain injury that impacts on behaviour & rational thought, a starved brain loses the abilities of rational & coherent decision making capacity. Once I got this concept I was able to reframe my way of thinking & my way of helping our D. We gave unconditional love & support even when it appeared as though our D was just being a combination of  irrational, recalcitrant, etc

The F.E.A.S.T family guide book might help you http://www.feast-ed.org/?page=neuroguide
ED Dad
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melstevUK
I_can,

As your d is far from well, to expect her to hold down two jobs and do college as well is way too big an ask.

Personally, I think there is time for college when she is in a better state and has a clearer idea of what she wants to do with her future.  I would be encouraging her to keep the jobs, to keep her living with you (however hard that is just now), help her to keep her room clean and tidy and explain that she will feel better mentally if she can have some kind of order around her.   While working she can pay off her debts and after that have a new start.  

She needs stability and routine - even around working shifts - and maybe more work on her self-esteem.  She must feel awful after and abortion and being dumped by her boyfriend.  And also encourage her to put recovery from the eating disorder at the forefront of her life now.  EDs are notorious for lying - it is part and parcel of the illness, but if you can encourage her with structure around eating and other areas of life, she will be in a better place later on to start college again.  You both need to make things as simple right now and focus on what is important.  Your d is still young and there is time enough later when she gets through what feels, on all levels, to be an unsatisfactory life for you both right now.


Believe you can and you're halfway there.
Theodore Roosevelt.
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I_can
Thanks everyone.  I really appreciate Aussie's approach to unconditional love.  I asked her if she and I could clean her space on a schedule as "dolphin" suggested and to my complete pleasure she agreed.  I am going to do that.  She is depressed about her boyfriend breaking up with her.  She wanted to marry him.  A high school girlfriend committed suicide recently - quite tragic.  And her cat died.  She cites all of these (including the cat) as reasons for failing in school. Last semester it was more the same with the boyfriend.  He is completely gone.  But as you all say it is the ED, more, and a general inability (due to ED) to cope.  My daughter completed an IOP about 18 months ago.  She sporadically sees a therapist now but misses appointments.  To my satisfaction  she says she weighs 135 (is 5 ft. 8 in.) and looks slightly heavier and has a better color.  She wears stretch pants and I have not seen her in her previous "regular" snap, zipper pants, size 4.  However, I have not officially weighed her for several months.  That fell by the "weigh" side.   Last year she was on a contract for college providing blood levels, weight, nutritionist and therapist appointments.  She did well, with all requirements, with her potassium at 4.5- 4.6.  This year the contract was for once a month blood levels, once a week therapist and a 2.0.  I have gotten no blood levels for three months and therapy is sporadic.  The grades are an unknown except she has dropped one half of classes.  I asked her gently why did you not "comply" with the contract.  She said she does not like to have to do things by a contract and wants things natural.  She unfortunately is quite "stubborn" and looking back has been so, etc.   It is hard for me to know the truth or what to do.  I am getting myself to the point of not paying for college as it is a waste of finances and more importantly, she is not coping well.  This  is difficult for me as I was invested in the degree in four years scenario.  I read a book by a MD, I think Dr. Ira Sacker, an original provider for ED, who said it was good if your child could stay in school as it was hard to get re started, etc. However,  I am thinking time off for her will be good.  I have offered a home for her, food support by shopping with her, having food she wants etc.  She will not eat with me regularly, only very sporadically.  Her lifestyle is chaotic.  Sometimes she will tell me after a meal "I am going to the bathroom, you can check, etc." as if she wants to assure me she is not purging and is aware of the totality of the situation. I will keep you posted, Torie.
Deb
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OneToughMomma
Hi, Deb,

What were the conditions of the contract? She has broken her agreement, so what were the consequences supposed to be?

OTM
D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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AUSSIEedfamily
Dear I_can,

Our D is now recovered & doing well.

I recall her years of education where in her last year of high school (year 12) 2005 she did a very much part time type of course & did not graduate. (AN was diagnosed in August  2004 her year 11 of school).  She then did a vocational course in business. This course enabled her to enter university via an alternate process. In late 2009 early 2010 relapse hit big time in her last year of university. Despite this relapse in mid 2010 she graduated with distiction with a bachelors degree in Commerce, human relations (HR) & industrial relations (IR). She did well at her job but the HR IR industry is a negative type of industry as it mostly dealing with employee/employer conflicts & problems. This was not an environment for our D in her recovery from the 2009/2010 relapse so in the early part of 2012 our D changed her occupation to become a personal trainer & is now doing exceptionally well & does personal training in a very different way. To be a personal trainer she had to do a Certificate IV vocational education course not a college/university dergee, her IR/HR bachelors degree did not give her any credits for this course & does not qualify her to do personal training.

For us we were glad our D was given the part time process back in high school & the alternate way into university. But what we a not happy about is the treatment process from first diagnosis in 2004 until relapse in 2009/2010. If this had been an FBT process & a full on hard hitting refeeding & brain restoration process we would not have had the huge relapse 5 years after first diagnosis.

I often read here about the education asperations of College/University. From my perspective a college/university education is always available whenever one is healthy & well. Unfortunately ED's are life threatening & need intensive treatment to avoid the worst of the disease. Treatment & recovery first then an education. If our offspring had any physical disease/illness that needed intensive treatment & possible hospitalisation to avoid the worst outcome would we send them off to school/college/university while applying only partial treatment. Treatment & recovery first would I think be the most popular choice.
ED Dad
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I_can
Dear One Tough Momma,

She was to provide blood work (potassium) the last day of the month, attend a therapy or group appointment once and week and earn a 2.0 (basic C average).  If she did not I would not pay for the next semester's tuition.  She has not provided the blood work, has not consistently attended therapy and has dropped six hours ( so that is a Withdraw, I think, maybe an F)  Grades are posted Dec. 21.  She will show me her grades; she has in the past.  Thanks Aussie,  I have trouble letting go of the four year for a degree idea, but this approach, my daughter, Ed etc., the degree idea is not working.
Deb
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Torie
I know they are all different, but my 5 foot 8 inch d is very ill at 135 pounds.  So maybe your d needs more weight?  One problem with "standard" BMI rangess is that they - in general - underestimate how much weight is needed for tall gals like ours.  (You can google that if you want to see a mathematical explanation of why that is so.)

Since your d has failed to meet her contract obligations, would it be a good time to write a new contract, perhaps with consequences all along the way ... for example, if she misses one of her appointments, one of you will promptly reschedule, you will pick her up and take her to the appointment and attend the appt with her.  If her blood work is suboptimal at any point, she will take a week off work, stay with you, and eat what you feed her. Or whatever.

Just tossing ideas out there - as always, feel free to ignore if unhelpful.

Best xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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OneToughMomma
Dear Deb,

You ask 'Should I continue to pay for college?'  And I think you know the answer.  Any money spent on her education is a patent waste, and is probably contributing to her stress and illness.

If you continue to back down from your agreement and continue to pay for college then you have lost all credibility.  Nothing you say will ever mean anything because in the back of her mind she will think, 'But she keeps paying even when I don't do what she wants me to.'

I think Torie has a good idea about making a contract with shorter time frames.  A semester is a long time.  She's been doing whatever ED wants for many months now with little intervention, support or consequences, if I understand you correctly. Did she actually breach the contract when her results came in from first semester?

ED is sneaky, manipulating, stubborn and egocentric.  Any appeal to your needs or wants (It's not fair to keep my house a mess when I pay for college.) will mean nothing to her.  Not because she's a nasty person or frustrating or selfish or hates you. Because she is impaired.  She has a brain injury caused by malnutrition.  She CANNOT make good choices or empathize right now.

You seem really stressed and unhappy to me.  You've mentioned a lot of different aspects of living with your d that worry or upset you.  What can you do to make your life better? What can you tolerate from her?  Is a messy room a deal breaker? Is her sleeping and eating schedule more than you can bear?  Does she HAVE to be going to college? Can you put up with her going to the bathroom immediately after meals? What could you overlook and what do you need--truly need--from her?

From there maybe we could help you draw up a plan, if you like.

I know this is tough (hence my screen name!).  It really is one of the most awful things a parent can face. If you are going to beat ED you have to be really strong, focused and consistent.  But you also have to take care of yourself.

How could you get restarted?

xoOTM

D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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I_can
Hi everyone (and One Tough Momma),

I would like help with a new plan.  She did not breach the contract when her results came in from first semester.  Once her potassium was 3.5, the lowest end of normal, but it came up the next time.  She provided me with all the doctor's comments that came with the potassium results. 

To make my life better I am traveling more, meeting with friends and playing badmitten.  But this is an area I constantly need to work on.  I have two adult children with disabilities in my home (a son with Down syndrome (27) and a daughter (23) with developmental delays that I am a caretaker for.

A messy room is hard for me to take, honestly.  But her room is squalor, empty bottles of gater ade, empty cat food cans, cat litter, clothes, dirty and clean, nick nacks, books, everywhere, etc. I truly and most importantly need her to not have/get over/recover/heal, etc. from her ED.  I truly need her to not purge (ever), eat three meals a day (she won't do that), not drink more than one alcoholic drink a day, and keep her responsibilities and go to work or class (as said, this is not happening with classes).  I can cope with her sleeping schedule if she takes responsibility and goes to work on time and doesn't purge.  I have come to terms that she does not have to go to college, though honestly, this is really hard for me.  I can't put up with her going to the bathroom immediately after meals when I know what she has eaten is a trigger food - ie.  Chinese food.  I can overlook her eating and sleeping schedule if she keeps her responsibility to go to work (or school - but that is not happening and I realize that).  I can overlook messiness in her room if she picks up used bottles, cat food containers, dirty dishes, and puts her clean clothes in a dresser type container and dirty clothes in a hamper. At her IOP they stressed recognizing hunger cues, etc. over a set meal schedule.  So she has adopted that approach to eating - hunger cues, what do I want etc. over any routine or habits with eating.
Deb
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Torie
I would like help with a new plan.  

It sounds like you have done the important groundwork to draw one up.  Just mainly restating what you've already said as a starting point:

For your end, you agree to pay for x,y, and z.  You agree to support her by daily room checks and eating all three meals per day with her, and staying with her for at least an hour after each meal (or at least after breakfast and dinner).  You will help get her room in shape, on ___ (date) or ___ minutes/hours per day until in order.  You will pay for college at such time as she is able to eat, keep her room presentable, perform other selfcare as is age appropriate.

She agrees to:
Eat three meals per day that meet your approval
Sign paperwork so that her healthcare team can speak to you
Go to appointments according to schedule, including especially potassium and weight
Stay with you for at least an hour after each meal (visit bathroom before meal)
Max of one alcoholic drink per day, (with __ exceptions allowed per month?)
Work __ hours per week at her job

Not sure what kind of help you're looking for on this, but I'm sure others can be more helpful. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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melstevUK
I_can,

I am so so sorry for your situation - and you are one amazing mother to have all the difficulties that you do and still keep on going.  You are incredibly strong.

It is clear that d's room is causing you a lot of distress so I think you need to make that very clear to her.  Your own wellbeing is important and she has to be made to understand that.  If she allows you to help her get it cleaned and get some kind of order in place, then it will be easier to maintain it.  I often think chaos is a sign of poor mental health but also I think there is a bit of a genetic element to tidiness/untidiness.  I find it incredibly difficult to be tidy - it takes real hard work and thinking time on my part to create order. I 'live in my head' most of the time and really don't see or notice things unless I put words to what I am observing. People have helped me by giving me tips, and I found the book by Marie Condo the first book that has ever been able to help me.   So it seems that your d needs help in this area - even clear rules, such as that she has to take any cans or pots or cutlery to the kitchen and not leave them in her bedroom.   

Of course, she may also be of an age when it seems unimportant and she expects you as her mother to do everything.  Well she has to learn that as part of growing up she has to take more responsibility.

I hear you on the college issue and how disappointed you are that it is not working out well.  The only alternative would be for her father to let her off with all her debts so that she can concentrate on college.  Is this an option and is this something she would want?

You are doing an amazing job given that you have two other children who need so much of your care as well.   
Believe you can and you're halfway there.
Theodore Roosevelt.
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I_can
Hello again,

I recently read an article in the Wall Street Journal about Xmas gifts, including financial gifts.  One idea was to pay off someone's debt as a Xmas present.  I was thinking of doing that for my daughter.  She balks at contracts and says "she is an adult, not a child and it is her responsibility" etc.  I like Torie's idea of the contract; however last semester's contract completely flopped.  I need to be a tougher momma and enforce no pay when she breaches the contract.  Yet, she would put herself in a position of sleeping in her vehicle or couch surfing if conflict with me escalates.  Also, in my community, there have been two young adults, 18 and 21, commit suicide in the last month and I think about this and do not want to push her to desperation.  However, she does not talk about suicide or threaten to do so.   I often back off, but I am putting an idea by Dale Carnegie into effect by letting someone save face.  For example, when she didn't get up to go to work, I woke her up with about ten minutes to spare, saying I know you took your brother out last night and that might have thrown you off schedule, off routine and I wanted to remind you said you work at 8,  etc.  She took it well and I avoided a fight with her.

I have a difficult situation, that is for sure.  My 23 year old daughter takes a lot of interventions and de escalations.  My son, actually is a benefit and a unifier.  in reality, my daughter here is the only one with a chance of a "normal" future so steps and mis steps are very important.

Thanks again.
Deb
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mjkz
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She balks at contracts and says "she is an adult, not a child and it is her responsibility" etc.  I like Torie's idea of the contract; however last semester's contract completely flopped.  I need to be a tougher momma and enforce no pay when she breaches the contract.


I was in a very similar situation with my daughter.  I had to get the bathroom she used repiped because the acid from her vomiting ruined the plumbing. 

We have a very strict contract and everything is spelled out.  She cannot purge at all at home.  If she is going to purge she needs to do it someplace else.  If she binges on my food or other people's food, she is responsible for replacing it.  Her room got cleaned once or twice a week to my satisfaction.  She had one chance and then I hired a cleaner and she paid for the cleaner.  She has weekly blood tests, sees a therapist, psychiatrist and doctor.  If I catch her purging at home even once, she knows she will be packing her bags and headed to a higher level of care.

The things you are asking for are reasonable and should be well within what an adult can do.  If she doesn't like the thought of a contract, then she needs to start looking for someplace else to live.  It is your house, your rules and with your other two children, you need to have strict guidelines to keep things going smoothly.  If she chooses to couch surf or sleep in her car, then that is a choice she can make.  My daughter threatened that and did if for awhile until all her friends knew better than to try to live with her.  I would not pay for more college and I certainly would not pay off her debt because she has no reason to keep on working if she has no debt.  She needs the structure.

It is so hard to see your kid struggling but you have two others plus yourself that you need to look out for.  If you got the contract before, you can certainly get another one.  Good luck.  Let us know if you need more ideas on how to construct a contract that works for you.
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AUSSIEedfamily
Dear I_can,

One of the difficult things for someone with an eating disorder to manage is the noise in their head. Its like having several or more radios on at the same time, all at full volume, all with the loudest nastiest arrogant/abusive shock jocks, each trying to out compete each other in their efforts at picking on the person & putting them down and at the same time abusing each other. This head noise goes on all the time & often happens when they sleep.

This was just shear brilliance on your part & well done!!
For example, when she didn't get up to go to work, I woke her up with about ten minutes to spare, saying I know you took your brother out last night and that might have thrown you off schedule, off routine and I wanted to remind you said you work at 8,  etc.  She took it well and I avoided a fight with her.

You helped your D and I believe the fight you avoided was a fight with ED, you also avoided a possible collaboration with ED & maybe a joint combination of simultaneously fighting & collaborating with ED, ED would have joined with you & used you if you showed any level of displeasure/disappointment/frustration etc. EDs are just experts at using any situation & anyone to work their horible ways.

This comment of yours is one that I think ED will just make the most of "A messy room is hard for me to take, honestly". ED will pick up on this & make the most of it if you express this to your D in words or body/manner display, etc. EDs love to make the most of this type of scenario.

I like this comment My son, actually is a benefit and a unifier. There are many atributes of downes syndrome that you might be able to draw upon & use to help you & your D. The messy room situation might be one where you can use your S & your "Dale Carnegie" strategy to change the messy room situation where your D does participate in tyding the room & gets help with tyding the room from your S, your D saves some face & ED gets nothing out of it other than being defeated & ignored.




ED Dad
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Colleen
Hey Deb,

I don't want to add more to your advice here, but you mentioned something earlier:

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I read a book by a MD, I think Dr. Ira Sacker, an original provider for ED, who said it was good if your child could stay in school as it was hard to get re started, etc.


I've read some of Ira Sacker's work and it is complete and utter BS.  There are lots of "ED experts" out there--and many have written books--who don't use science but just their own feels for defining and treating EDs.  We used to talk about these theories as 'feathers and beads'.

If you're going to read about EDs, read the books that have actual science behind them:
Help Your Teenager Beat an Eating Disorder by Lock and LeGrange,
Decoding Anorexia by Carrie Arnold,
Eating with Your Anorexic by Laura Collins
Brave Girl Eating by Harriet Brown

And for a quick read on how to implement refeeding at home, get "Throwing Starfish Across the Sea" by Laura Collins and Charlotte Bevan.

As long as you're reading something, make it helpful to your d.

I question her IOP's method of telling someone with an ED to "listen to their hunger cues" rather than eating in a structured way.  That sounds really sketchy to me.

Lastly, I second Torie's idea of making the contract a daily thing rather than waiting for her to fail at the end of a semester or at the next doctor visit.  The contract should include eating three meals/2-3 snacks at regular times TODAY.  We found that our d could not act on consequences that were further away than the absolute immediate future.  It had to be like this:  "You can go to school as soon as your breakfast is 100% eaten."  It couldn't be "If you've lost weight this week, you will lose your phone privileges" because going to the doctor might have been days in the future--that would not motivate her to eat TODAY.  The part of the brain you need for consequences to work is the prefrontal cortex, and this is still developing till the mid-20s--plus it's just OUT OF COMMISSION when someone with ED is underweight/malnourished.  It's just not even possible for her to access this.  Try something else to get her to eat would be my recommendation.

And I agree with the others that you are doing heroic work!  This d can still have a normal adulthood!  EDs are TREATABLE illnesses.  You are in the right place!
Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
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Colleen
Hey Deb,

I don't want to nitpick, but you mentioned something earlier:

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I read a book by a MD, I think Dr. Ira Sacker, an original provider for ED, who said it was good if your child could stay in school as it was hard to get re started, etc.


I've read some of Ira Sacker's work and it is complete and utter BS.  There are lots of "ED experts" out there--and many have written books--who don't use science but just their own feels for defining and treating EDs.  We used to talk about these theories as 'feathers and beads'.

If you're going to read about EDs, read the books that have actual science behind them:
Help Your Teenager Beat an Eating Disorder by Lock and LeGrange,
Decoding Anorexia by Carrie Arnold,
Eating with Your Anorexic by Laura Collins
Brave Girl Eating by Harriet Brown

And for a quick read on how to implement refeeding at home, get "Throwing Starfish Across the Sea" by Laura Collins and Charlotte Bevan.

As long as you're reading something, make it helpful to your d.

I question her IOP's method of telling someone with an ED to "listen to their hunger cues" rather than eating in a structured way.  That sounds really sketchy to me.

Lastly, I second Torie's idea of making the contract a daily thing rather than waiting for her to fail at the end of a semester or at the next doctor visit.  The contract should include eating three meals/2-3 snacks at regular times TODAY.  We found that our d could not act on consequences that were further away than the absolute immediate future.  It had to be like this:  "You can go to school as soon as your breakfast is 100% eaten."  It couldn't be "If you've lost weight this week, you will lose your phone privileges" because going to the doctor might have been days in the future--that would not motivate her to eat TODAY.  The part of the brain you need for consequences to work is the prefrontal cortex, and this is still developing till the mid-20s--plus it's just OUT OF COMMISSION when someone with ED is underweight/malnourished.  It's just not even possible for her to access this.  Try something else to get her to eat would be my recommendation.

And I agree with the others that you are doing heroic work!  This d can still have a normal adulthood!  EDs are TREATABLE illnesses.  You are in the right place!
Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
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I_can
Thank you everyone; I am getting some recommended books today and starting over. Any further advice is much appreciated.
Deb
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I_can
I fixed my daughter breakfast with bagels she had bought and asked her to eat; I woke her up at 9:00 a.m.  She got furious, told me to F off and stormed out.  I noticed a box of cookies in the freezer gotten into last night (the lid was left off).  Janet Treasure says every mistake is a treasure.  That did not work.
Deb
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mjkz
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She got furious, told me to F off and stormed out.


Yup. Sounds about right. As hard as it is, you know you are hitting where you need to by the reaction that you get.  You are right on target.
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Torie
I read here on the forum that having an ED stunts their emotional growth.  Your d is most likely much "younger" emotionally than her chronological age would indicate.  It helped me to keep that in mind ... and to adjust my expectations downward accordingly.  

To my way of thinking, my d needed to:

Eat (every meal, every bite)
Not purge
Comply with medical monitoring

That was it.  Anything else was gravy.

It sounds like your d is too ill to manage school right now.  That's really ok - doesn't mean forever; just means for now.

If she can't keep her space clean enough, perhaps you could hire someone to come in weekly and require her to pay out of her earnings (provided she continues to hold down her job/s).

Living with an ED is hell, but having one is even worse.  

Hang in there.  Your d is lucky to have you. xx

-Torie

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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OneToughMomma
Okay, I can,

You asked for help with a plan, and you listed things you can and cannot tolerate. I've edited and bullet pointed them below.

  • not purge (ever)
  • eat three meals a day
  • not drink more than one alcoholic drink a day
  • keep her responsibilities and go to work or class 
  • pick up used bottles, cat food containers, dirty dishes, and put her clean clothes in a dresser type container and dirty clothes in a hamper

This is the order in which you listed them, and I think number one would be a great place to start.  I know you've got conflicting advice about how much your d should be able to do (an adult vs impaired and struggling), and I would start with one thing.  How can you prevent her from purging?  Does she have a bathroom ensuite?  Can you lock the bathroom from the outside with a key (horrible I know, especially for your other kids.)? Turn off the water? With this new rule, how will you encourage her to stick to it and what are the consequences if she can't?

Would you like to make a plan for a purge-free home, and we could help you go from there?

xoOTM

PS I think it's important to remind you that, as mjkz says, she is at least nominally an adult and can choose to leave.  My d chose at the age of 16 that she didn't like the ED-fighting rules we had in our house and she did leave.  It broke my heart, but we would not allow ED to thrive in our house any longer.  We told her that we always loved her, and she was welcome in our home as long as she was actively fighting ED.  Eventually she came back, of course. 
D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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I_can
Thanks Mjkz, Torie and One Tough Momma,

I do want help for a purge free home. I know she will say she does not purge anymore, she's 21 and can handle her own meals, etc.  She is opaque.  Thanks for helping me sort this out.  I so want a purge free home and for her to eat 3 meals a day.  Tough Momma you are lucky your daughter came back and sounds like she is doing well.  I know my daughter will balk at any contract and control.  Janet Treasure says to have medical rules and house rules.  She suggests meetings that include the daughter to get her ideas and buy in of the rules.  I could encourage her to stick to the no purging rule by saying no bathroom for an hour after eating and if she purges she will need to do ED treatment again.  I've approached this similarly in the past and she has gotten very angry (that's okay, too bad for her etc.) when I clean the bathroom, look for vomit, say I smelled vomit in the bathroom, etc.  I am leaving town for a few days but I'm determined to keep trying. 
Deb
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