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

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greekdude
Hello to all good people and parents from the FEAST community.

Just an article I found promising :

https://www.brainstimjrnl.com/article/S1935-861X(20)30026-7/fulltext
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MKR
Hi @greekdude,

I hope you and your family are doing well.

The article describes an invasive treatment that I am very uncomfortable with.

I am also concerned about the issue of consent from an adult patient who is at BMI of around 13, as I think that at weight that low there is no full mental capacity.

Sorry, just my thoughts at first glance.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Foodsupport_AUS
I commented yesterday but somehow must have deleted it. Greekdude I hope your son is doing well. 

I agree that it is an invasive treatment but think it is also positive that they are looking at options for long standing severe disease. As to the mental capacity - there definitely will be impairment, but most people with severe AN do have capacity to manage many aspects of their lives. They are considered able to consent to other surgical procedures, for example. The issue I can see is more the reluctance to consent to a procedure not because of risk but because of fear of weight gain. It could fall into the realm of special procedures where there are a number of limitations on consent. 

Here in Australia for example guardians can consent to most surgical procedures however they cannot consent to procedures such as termination of pregnancy, sterilisation procedures, organ donation. These procedures need to be evaluated before a court and consent is given by the court. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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greekdude
Dear @MKR hello! I hope your Ds are super well!
Dear @Foodsupport_AUS , exactly my thought, it is a relief to know that there is some hope out there somewhere. S is eating (not as much as we want) but keeps on going for secret runs, even with his hand badly injured (almost a fracture).  Yesterday he admitted this "thought" does not go away. In the meantime, the hospital, his psychiatrist all claim that AN is a thing of the past.
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Foodsupport_AUS
Thanks @greekdude my D is doing pretty well at the moment. I wish we could get your team to take his ongoing behaviours as signs of ongoing illness and even the fact that his thoughts don't go away. What do they make of his thoughts? Those of use who have been around for a while realise that thoughts don't just disappear with weight restoration. Many who have recovered not they still have these thoughts, they are just troubled less. When they lead to self destructive behaviours though they are signs of ongoing illness. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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MKR
Good point, @Foodsupport_AUS.  I forget that our ED kids paradoxically do very well in other areas where reasoning is required. Consent by adult ED patients on any other procedure is legal, you are right. But my gut feeling is food first, then treatment.

@greekdude, I think it is great that your S can acknowledge the "thoughts". To me, that's a huge step, as my d is forever in denial (everyone else is "wrong", she is "right" etc). It means your S is on your team, perhaps he will be able to actively fight the "thoughts" and distract himself whenever they try to overwhelm him?

At the moment D is still trying to access a gym to do weight lifting... I made enquiries and the minimum age for membership at the flash new one is 14 (!?!). So I will go there in person over the weekend with the note from the doctor, explain the risks and then see what boundaries around exercise and supervision they can offer. I am guessing it is too easy to sneak into the crowd and overstay.

Obviously, her father and I are now not very popular at the moment and she has even tried to restrict her meals a few times lately. We'd better get this right while we have most leverage, before she turns 18 next year.

Enjoy the summer, after the long lockdown!
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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greekdude
MKR wrote:
Good point, @Foodsupport_AUS.  I forget that our ED kids paradoxically do very well in other areas where reasoning is required. Consent by adult ED patients on any other procedure is legal, you are right. But my gut feeling is food first, then treatment.

@greekdude, I think it is great that your S can acknowledge the "thoughts". To me, that's a huge step, as my d is forever in denial (everyone else is "wrong", she is "right" etc). It means your S is on your team, perhaps he will be able to actively fight the "thoughts" and distract himself whenever they try to overwhelm him?

At the moment D is still trying to access a gym to do weight lifting... I made enquiries and the minimum age for membership at the flash new one is 14 (!?!). So I will go there in person over the weekend with the note from the doctor, explain the risks and then see what boundaries around exercise and supervision they can offer. I am guessing it is too easy to sneak into the crowd and overstay.

Obviously, her father and I are now not very popular at the moment and she has even tried to restrict her meals a few times lately. We'd better get this right while we have most leverage, before she turns 18 next year.

Enjoy the summer, after the long lockdown!


Dear @MKR , I just hope that by the time they are 30, a new focused and precise medical method might have been developed. When I told my S about this article (I cannot read the medical specifics, my english suck, just the math/stats part), he seemed relieved. Just by knowing that this can be fixed felt good, I saw it in his eyes. But with this hope come also the risks and dangers as in any surgery, so the fear of it might help them fight it with the conventional methods that we have (food + patience). 
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