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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Muminhope
Hi I am back. I posted in the forum to update my AN D to make great progress since last December a couple weeks ago. She met the range of her weight and her period came back in April. Her mood looks much better and she was willing to take one more bite of food after she finished her meals. She was always willing to take her 3 snacks whenever late or on time. But since last week it seems the situation getting worse. She argued a lot about the amount of food when lunch or dinner. She felt anxious before lunch today and struggled to take a bigger meat roll. Although she finally accepted to have a bigger one she was quite depressed. She refused to take her night snack today. She told me we were too harsh to her and she doesn’t feel any kindness from me. I told her last night that if she sometime feels uncomfortable physically I would think over her status and probably she could eat less occasionally. Before that we gave D some flexibility to have her favorite options for breakfast on Saturday and Sunday rather than the same menu we practice from Monday to Friday. Looking at her status recently I realized that we probably gave D flexibility too early. My H and I told D today that we should follow doctor ‘s instructions and insist on current meal plan all time until we are told that no need to follow our plan any more by the Staff. D is very sad and told me she would not follow the meal plan because she feels we gave her too much. She said she’s depressed all time and struggles with those voice(She said it’s what we said). She said she doesn’t like me to say “eating disorder”. She said that was the past thing and she never wanted me to say it again. She said she doesn’t care what the doctor says or the dietician says. Does anyone has the same experience? I don’t know if this is extinction burst or relapse? I am quite worried about her situation. Thank you so much for your comments in advance!
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Foodsupport_AUS
It sounds like your D's eating disorder is still quite strong. You have done a great job getting her weight up, and it is great to hear that her period is now back. Given it has only just returned it is likely that she is only now getting close to a weight that she needs to be and you are seeing extinction burst. She should be having regular monthly cycles to say help confirm she is at the appropriate weight for her. 

It is really common for our children to get upset hearing about their eating disorder. My own D needed acknowledgement that she was sick, others refuse to accept they are ill. Our most important role is to not let this interfere with our work in providing for them. The less engagement the better. I think you did the right thing on saying that you were going to stick to the meal plan. It really doesn't matter too much whether it is your plan or the clinics but rather that you are deciding how much you need to feed her and her ED is not deciding how much she should eat. If I knew things would push my D's ED thoughts I did tend to avoid those triggers to make it easier for her to eat. I also tried to spend a lot of time and engage with her outside her eating disorder as well. Right now I am sure she is quite miserable, it is to be expected, but she will get better as time goes on. 
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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Enn
Well done!
I would agree with all that Foodsupport says above. We had to keep up with 3 meals and three snacks AND 4000 cal + per day for over two years. It takes time and keeping the routine you have built up is going to help you get over this hump. 
Her upset is expected. Keep going! 
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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teecee

Great advice above....the answer is always food. My D would get angry with me if I referred to the ED as separate to her but now it’s not ‘her’ illness and she WAS sick when she speaks about it. 

You are doing great...have faith in yourself, you know less food is not the answer. Yes they will feel upset and have physical tummy aches etc as their body has taken a lot of stress. It will recover with food...use distraction...hot water bottles, paracetamol etc....👍🏻😊

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Muminhope
Thank you so much for all of your comments! They are so helpful and so warm to me. Due to being lockdown the clinic D has no weight number since the end of Feb. Considering her worse mood recently I tried to have her blind weight at home. But she’s quite reluctant. Hope I won’t wait too long time for her weight.
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teecee

Personally we haven’t weighed regularly in a long time. My H has a very good eye for accurately knowing her weight. I made him do it once this year for my peace of mind but we were ok. its more of a reassurance thing for me. My D takes it rather personally...that she’s doing something wrong...I am not saying don’t weigh I’m just saying maybe don’t focus and worry about that right now. Keep feeding 😊
You are doing great 👍🏻

 

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debra18
I also stopped weighing and just keep feeding. My experience also is to have as little discussion as possible. Just to have simple phrases like "this is what you need to eat. Please eat it." I have been feeding my daughter for over two years. Keep feeding! 
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mamabear

Her period returning is fantastic news but it does not mean that she’s at the weight she needs to be at. Goal weights are almost always set too low. And we all need to focus on feeding to full BRAIN nutritional rehabilitation. Keep feeding her. Do not rush into anything that she is not ready for. In order to move into some choices etc I believe they should have several months under their belt of zero arguing, eating what is given to them without issue etc. Keep her fats and calories up. 

And remember- you are still in early days of this. 4-5 months in is early days. This is a long process and ur sounds to me like you e done very well to get to this point! Now is the time to dig your heels in, put your head down, and push through. Don’t let ED. Intimidate you or use your maternal instinct to not “ cause” anxiety manipulate you. Every bite matters all day every day. And if you dig in and up her cals etc it will be a rough few days, week or two- but you will reap the rewards because you will see the arguing etc dissipate as her brain gets what it needs. 

Persistent, consistent vigilance!
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Muminhope
This is really helpful to me! Thank you for all of your comments. I haven’t realized to weigh her until I saw her mood to be up and down recently. I’m afraid and not sure if this is related with her weight down. Normally I can cook her meals when she was in school before pandemic. But right now she’s in home all day and all time, I am quite frustrated how you could manage it for high cal and fat food to be cooked. She refuses to take any high energy shake or liquid or some serving. And to be honest, she has taken her max points for her snack choices . I really appreciate if you can give me some ideas about how can I increase her intake. I have benecalorie, whole milk, etc. but only can be added in her congee on breakfast before she gets up. And no idea in following meals. She has complained to me several times that why she feels so full after breakfast. She told me she would not to eat congee any more. I don’t have other choices any more
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Foodsupport_AUS
It is normal for them to be very scared and resistant of eating higher fat meals, and of course there are some kids that it is just about impossible to do this with. At the same time the more insistent you are that food goes in, and the less room she has to not eat the better. 
Some parents have managed to just start out with high fat foods  high cal foods from the start - and waited their child out. They couldn't do anything else till they ate what was in front of them. 
Others have found this just leads to complete refusal and medical compromise - that was us. My D ended up in hospital numerous times, but in the end the thing that worked for us was a kind of compromise - her eating what she thought was safe foods which I then added things like butter to, and increased serving sizes. We just kept on plugging away at it. 
Ironically she will feel less full if you use high fat foods with a small volume than if you make larger volume lower density foods. 

As much as you can you just have to insist that she eats. It also sounds like you really need to be insisting on some form of physical assessment and that is likely to start with needing to get a weight at home or somewhere else. 
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
Hi @Muminhope,

Do you think your daughter has grown a little and needs more food, even if she weighs more?

I would add a rich sauce to all her vegetables and add fried egg to her stirfries. Maybe coat meat with flour before frying it?
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Muminhope
The current menu is made and discussed among us, D and the dietician. Normally she eats breakfast 6 ounces of congee(I can add some high cal), milk, 1 egg with water boiled and 3 pieces of hams, several pieces of fruit usually. And for lunch and dinner meals, she eats a bowl of rice(I can add some high cal before pandemic but unable to manage it when she’s no school), a bowl of meat/pawn/salmon with oil fried or steamed, half bowl of vegetables with oil fried. She eats 3 snacks and in morning she eats two pies/kind bar(size of pies equals a cookie, the dietician says it’s 2 points for each), in the afternoon she eats 2 pies with 1 juice and 1 yogurt, she eats night snack 2 pies and 1 drink. I believe she needs more intake but she’s so rigid for her choices, e.g she insists to eat egg with water boiled. Actually she doesn’t have much fear food except all kinds of cheese), she eats ice cream, cakes(no chocolate cake although), oil spicy food sometime, cream cheese,etc. The issue of her is that she always scares to take more which is beyond her meal plan even just a little.
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Foodsupport_AUS
It is normal for them not to want to take a bite more than their "meal plan" and they are often terrified to eat that as well. The thing is, if her meal plan was bigger in the past, because you were adding to it, then you know she is not getting enough now. Are you able to quietly have a discussion/email with the dietitian to let them know that you need a larger meal plan. Can you do a phone consult then with the dietitian to talk about monitoring and increasing. I think what you are referring to is that your D is watching you closely which makes it very hard to add in extras, and you are struggling to keep her out of the kitchen or sight.. If so then the only option is to require a larger intake. She won't want to accept this - it is part of the illness - however the question is how to make sure it is eaten anyway. 
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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LaraB
Could you prepare some food like rice at night when she is asleep and add what you did before. 
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Muminhope
Normally we cook food including rice 1 hour before lunch or dinner. D likes warm and fresh cooked food. If I do it at night I’m afraid she would have more suspicions to me. Besides, I bet she will sneak into the kitchen to watch my cooking at night if she doubts me. 
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Foodsupport_AUS
It sounds to me like you are quite scared of your D's / ED's reaction to changes. Fear is one of the most important feature driving eating disorders. It makes us suspicious and untrusting. Your D is like this at present with foods.Telling her that it is safe is unlikely to alleviate her fears, in fact it may increase her fears as it can reconfirm there is something to be scared of. Your D does need to eat the food that you prepare. Whether you make higher calorie food just for her, add things in to the same meals as your own, or you all eat the same things - the end result still needs to be that she eats the food her body requires. If we give in to ED's thoughts we are doing just what ED wants. You do get to decide how to move forward. Rather than trying to deny things it may be better to let her know that she is scared when she questions things or is suspicious. Being prepared to sit things out if she is struggling or using whatever other motivational tools / negotiation tools you have. Try not to do what ED wants you to. 
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
Is there anyone who can keep your daughter busy while you cook? Or can she do a particular job at that time, such as study, or practice an instrument? I know that the lovely smell of food makes her come into the kitchen when her body is hungry.

Trying to cook while my ED daughter wad watching was soooo stressful! Especially in the beginning when she tried to pour food or sauce away. Open plan kitchens are very fashionable but I wish I could just close the door until I am ready to serve.

I agree that your dietitian should support you in increasing the quantities.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Enn
Try not to do what ED wants you to. 


This is such great advice. I understand how hard it is. We get so anxious about upsetting our kids. We are traumatized but what has happened to our kid and our home life. 
When I took a strong stance against ED and played out the worst possible  situations and had plans for all of that ,like screaming, running away, violence, food thrown, I felt stronger and able. Then when she did eventually yell and scream, she knew that would not be tolerated and she was sent to her room for a few minutes. If she ran after me to hit, dad kept her in the kitchen while I went to my room. When she threw food, we replaced over and over again. 
Having a plan really does help. This is something you and your h need to decide how it will go. Does your h watch over her while you make the food, My h would play ping pong with d in the basement prior to having the smoothie that I doctored. 

And honestly, it does not matter if she is suspicious of you. Right now is not the time to build trust, it is to get her healthy. And over time when she is ++ better she may not recall any of this at all. It is ok to feel the upset, hers and yours. That is supposed to happen. It is difficult to feel these upsetting emotions, but it is part of the process.  Understanding that we were going to feel awful for awhile, was helpful to me. 
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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Aefw001
Hi there, the one place where we can load up our D's calories is her daily milkshake. You mentioned your D won't due nutritional drink supplements? If she'd take a milkshake, we do 1/2 cup of heavy cream, 1 cup of Haagen Daz ice cream (it has the highest calorie and fat content by A LOT!), peanut or almond butter, chocolate syrup, etc. If it's a vanilla one, we put fresh strawberries, etc.  and sometimes use protein powders in it as well.  They actually taste yummy and can be adjusted based on fruit/flavor preferences.
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Muminhope
Thank you for all of your support! This is really encouraging to me. We cook Asian food. Except breakfast we normally share all dishes at the table. However, we plate rice and dishes for D. Before she’s sick I occasionally did milk shake and D was happy to take it. After her illness, she seldom takes milk shake during her meals. We had D blind weigh last Saturday after we insisted in it and we got two different numbers. I doubt D hid something with her although she denied it. We made appointment with the clinics on May 15th. I am thinking to keep the current meals in order D can stick with her meal plan and decide if we need to add more food after the appointment.
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MKR
Sounds good.

Just a thought - when I cook with coconut milk I replace with coconut cream for my ED daughter's food.  I also find food from restaurants and take-aways richer than anything I could cook myself. I suspect they use marinades and thickeners for sauces. But I trust in your skill 😉.
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Muminhope
@MKR Totally agree with you. D likes spicy food. We ordered take away food spicy and oily taste in restaurants. They are much thicker than that we cook. Everytime D is so happy to finish up all food not asking us to share with her. BTW, I follow another Mum’s idea who responded me earlier in this topic that I started to deliver different food to D on this breakfast and D accepted it. It works! Thank you so much for all of your creative ideas!!
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MKR
Yay!

Muminhope winning against ED!!
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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