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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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kimbeth
Hi all,
My DD is 22, was diagnosed with AN about 18 months ago, she also has ADHD, anxiety, & PTSD. She was hospitalized spring 2019, went to rehab summer of 2019. Rehab really helped, she learned DBT and what she needs to eat for 3 meals and 3 snacks. She took off Fall semester and went back to college this spring taking a very light course load and with doctor/DBT therapy support system. She didn't do well and due to COVID is home and i'm helping her eat 3x3 and she's at a good weight now, but not able to eat /take meds/vitamins on her own initiative. That is where we are at.
My DD thinks she is ready to go back to school in the fall (it's not clear if there will be in person classes yet). I'm looking for advice on how to help her understand and figure out on her own where she is in her recovery and that returning to college in the Fall will likely lead to relapse again and prolong her overall recovery.
Thank you so much for your insights and advice.
Kim
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Barberton
Hi kimbeth,

I don't think you can do much to help her understand where she is in her recovery. That's stuff we have to do for them. My suggestion would be to try gentle and compassionate questioning and suggestions for coping/managing.

You: I think it's terrific that you have done so well since coming home. How do you think you will go when you go back to school?

DD: (Shrug of shoulders) Fine.

You: Okay. But how exactly will you do that? Will you be able to take your meds/vitamins every day or would you like me to send you a reminder message?

DD: Yeah, maybe.

You: Great. I'll send you a message at 8am to remind you to take them. What about your snacks? Would you like me to write up a list of snacks for you?

And so on...

Someone can correct me if I'm wrong, but if they (our darling children) had the self-awareness to accept where they are in their recovery, they wouldn't relapse. And one day they might not relapse. But until then, we just have to keep picking them up, dusting them off and pushing them in the right direction again.

Good luck.
 
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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kimbeth
Hi Barberton,
I think you are right about using questions. Right now every question I come up with is a sentence disguised as a question conveying that I think she's not ready and she sees right through it. I need to work on my mindset and ask questions from a genuinely honest and curious perspective.

It's really hard. She wanted to go back to school so bad last semester so we let her go and she would call me multiple times a day needing morale support and encouragement to go food shopping, eat her meals, go to DBT--that's what not ready looks like, now that I have lived through it. I now think her desire to go back to school is a motivation to move on with her life, wanting a normal college experience but also she thinks if she leaves where she is right now (which is home) she will also be leaving behind her anxiety--like the next destination is somehow a paradise free from suffering.

Last night during snack, I mentioned that 'we' (me, DH, DD) need to think hard and figure out what is the best next step in terms of school.  I offered up some suggestions, like she could transfer to the local college and live at home. She got very upset and said she didn't want me helping her (she asked me to weigh her every other day and make sure she eats her meals). I remained calm and said okay, it's your decision. I thought, if I let go managing her meals, it will be more obvious to her that she is not able manage on her own yet. I will leave her be for the day and check in with her this evening. 

Another idea i had was maybe we just put out one bottom line for us - she has to manage her meds, meals and snacks on her own and maintain her weight for 4 months or so without help and then she can go away to college.  It is simple, fair and it still gives her choices and options.  

Thank you so much for your thoughts and ideas,
Kim



 
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Kali

Hi Kim,

Here is a blog post by Dr. Lauren Mulheim which I also read when my d. was getting ready to go back to college after being home for a year in treatment. It has some good points to consider.

https://www.eatingdisordertherapyla.com/is-your-young-adult-with-an-eating-disorder-ready-for-college/

and here is a link to a podcast she did:

https://www.edcatalogue.com/episode-77-dr-lauren-muhlheim-determining-college-readiness/

It is important for the person in recovery to be able to eat enough on their own to maintain their weight, so that they will be able to be successful in returning to college.

We had kind of a gradual return to college. After 9 months of pretty intense treatment, weight restoration and regular meals and snacks, our d. lived at home for an additional semester and commuted to a local college. When she completed that semester at a higher weight than she started at, had been able to handle the stress well, and had been able to have lunches on her own, we let her go back to her university which was 4 hours away.  Still it was not an easy transition and I was involved. So perhaps if she cannot yet eat independently, you could have her try the fall semester nearby while living at home and let her know that if she is able to do well with her eating and weight, you would be open to supporting her returning to her other college after that. How far away is the school that she was attending? Depending on where she is attending school, there are currently colleges which are discussing whether they should continue having online classes in the fall due to covid. 

warmly,
Kali

 

Food=Love
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kimbeth
Hi Kali,
Thank you for the link to the article/podcast; super helpful.  And thank you for sharing your story.
We are in SF bay area in Cal, my DD goes to school in So. Cal. I suspect that online will be an option for fall, which works in our favor. Even if some classes move to in person, they will have to make accommodations for high risk students and teachers who can't afford the risk of going on campus, even with physical distancing, masks, etc. 

My DH and I communicated our bottom line last night and my DD was a little upset/anxious.  As we proposed a plan to transition to independence, she started to embrace the idea and asked for changes to support her needs, like asking one of us to sit with her while she eats. She wants to take over all meals and snacks as of today which is not a transition--we suggested baby steps but that's not what she wanted so, we agreed and will have to adjust as things proceed. She asked that we write up the plan which she took a photo of.  I'm also creating a grid to check off each successful meal/snack/meds for each day. That way she can see her progress and success and if things are not progressing as needed to go back to school, then we have clear evidence of that. 

This feels like generally the right approach for us/her but i'm not confident we have the transition part right, but i guess we will have to just assess it day by day. i'm going to enjoy this one little success for now.
Thanks,
Kim
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Kali

Hi Kimbeth,

I think that it will be important for someone to be sitting with her and eating their meals also so that there will be true accountability. 

We did the transition to independent eating a little more gradually.
First our d. portioned her own meals and drinks (we ate together so we could make sure she was taking enough)
Then she picked snacks on her own and ate those (again I was paying attention that she did that)
Then she was able to try eating some meals with friends out of the house (probably not an option for your d. right now but important to be able to do that as she moves along since being able to eat with friends at college is part of a good social life there )
We also worked on eating in restaurants and being able to order from a menu. (again probably not an option right now but a skill she will need for the future)
Then she was tasked with taking her own lunches while at the local college three days a week. Her weight was being monitored so we could see if she lost anything, so that when she did we tightened up the situation with more support. 
Throughout this time we kept a binder full of the recipes which she had been able to eat and cook, many of which used simple ingredients and were fairly easy and quick to cook, and when she left for college I sent her off with her "cookbook". 
We also had her live in an apartment with a kitchen, so that she could prepare her own food, after some disastrous issues with the school cafeteria her first year. So she had a very rudimentary meal plan which meant she could eat a few meals a week in the caf with friends for lunch, and then she took breakfast and made dinner at home.

We did let her try at one point entirely on her own before she was ready; she took a trip with some friends for a few weeks the summer before that fall semester. It was kind of a test to see if she could be ready to go back to college for the fall semester and feed herself. She lost weight and came to the conclusion herself that she was not yet ready. And that is why she took that semester at home. 

So by all means allow your daughter to try but IMO it is important to monitor her weight at the same time. If she loses, then you know that more support is needed from you. And be careful to make sure that this is not a ploy by the ED in order to restrict her diet, but an honest attempt to try and get ready to be able to go back to college and be successful. A person who doesn't have an eating disorder eats with others and doesn't need to be "in control" of their food. 

I think it is important to try and point her in a direction where she can believe that she will be successful and take the steps as a support person so that she can do so. Also, it is not a straight line to recovery. She may lose some weight and then you will need to discuss how to rectify that and keep her on track. You may need to step in again if she does. My d. was also very motivated to be able to be successful at returning to college, and it helped push her ahead to recovery. But still there were times when she backtracked weight wise. So see how you can harness that motivation to keep your daughter focused on moving ahead with her recovery.

We often cook together and here is a blog I especially love with recipes:

https://familystylefood.com/

It is not particularly high calorie, so good for someone who is weight restored and wants to expand the variety of foods that they will eat, however it uses a reasonable amount of fats, oils, etc. Maybe cooking together and letting her choose some recipes might help her to be able to be more independent. As long as she eats large enough portions, and the food has enough calories and nutrients, and she is not restricting.

The New York times cooking section (subscription required) also has a great collection of menus.

We got into the habit of planning meals for the week together, and then getting the ingredients for them and cooking some of them together.

Another thing I did and this again, may not be possible until later, was that I went shopping with her every few weeks, so we planned menus and bought what she needed when she returned to school. At first I took the lead, however as time went on she knew what she needed and was able to fill the cart properly. Try to be creative with cooking and to get her interested in making good food. We used fresh herbs whenever possible (I have a little kitchen herb garden in the yard)

I sent her to college with an eating disorder, and she came home after graduation having learned how to shop, cook, eat with others, take snacks and make sure she ate enough, and maintain a reasonable weight. These things as meaningful as the classes she took since they mean she will be able to have a full and independent life.

This was a girl who couldn't order a meal in a restaurant, feed herself, eat in a cafeteria, whose hands shook when she even looked at an apple pie, and who wrote a suicide note and wanted to jump off a building and spent 3 months in the hospital. Hoping that some of this might be helpful for your family and daughter.

warmly,

Kali




Food=Love
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Torie
It sounds like you are making good progress.

I would just note that parental authority erodes very quickly during the teen and young adult years; you will never again have as much parental authority as you do today.  So I would urge you to err on the side of caution and keeping as much control as you can for as long as you can. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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kimbeth
Hi Torie,
Thank you for reinforcing the importance of right now. My DD is 22, a young 22, as she has struggled with a number of mental health challenges which has slowed her maturity. But none the less, the days are numbered before she is out there on her own. In this phase i seem to have just enough authority -- i'm an authority figure that her ED doesn't want to go up against, but I also have to step back and be a coach and let mistakes happen and be there to help her get back on track.
I just hate ED so much, it's ruthless.
Thanks again for your advice,
KIm
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