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

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hope21

Our journey started 4 yrs ago.  D age 12 started healthy eating on top of sport, skiing/snowboarding and running club.  Noticed weight loss March 2016.  IP August 2016, NG fed.   Slowly climbed way back up, no sports or PE. 
Eats lunch @school, can eat out.  But only eats three mealS and two snacks never out with.  Faced fear foods.  Eats chips/pizza etc. Drinks milk under duress.  2018 went to a friends house, trampoline accident landed on neck resulting in a whip lash injury down right side.  Arm in sling, crutch, fell between cracks of NHS due to age ie too old for sick kids but not an adult! 
Mussels school for 8 months, so much pain, flare up of restrictions but weight gain carried on.  162 inches 70kg weight.  2019 retuned to school part time, started to make new friendships.  

March 2020 - lockdown.  Still on crutch and shoulder problems but starts yoga.  90mins daily.  Also comes on dog walks (5-6 miles daily).   I’ve noticed clothes that fitted are now very loose, clothes that didn’t fit now fit.  Had the conversation about input and output must equal.  I have Said loosing weight but doesn’t say anything. Just looks away if pushed will agree and agree to eat more but doesn’t, seen an increase in behaviour on restricting.  But not refusal of eating.  

We don’t have scales and weighing was always triggering. 

Have brought back in tighter measures.  

We are no longer attached to CAMHS and would have to go back through gp for any referral in needed.

how worried should I be? Can some weight loss ever be sustained?  She was always as active child loved sports, always doing something.  And when she first fell was so low stayed in bed and wouldn’t get up it’s been a long climb to her back up from the injury.  But now I’m worried about compulsive exercising.  

 

 

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Enn

Ok so I think firstly you need to weigh her and get a sense of where she is and where she ought to be. I would try to scale back the exercise and see what happens to mood and behaviours if they yell ‘Ed’ to you you have your answer, I would guess. 

I think some weight loss and gain over time is acceptable so long as in a predetermined range for her height and historical  range. 

I think if you are seeing Ed as you state above it may be a bit of a blip and time to intervene again. I know it is harder at this age. Can you get the doctor to examine her and tell her she needs to get back on track?
Sounds a bit stressful right now hope it gets back to where she should be soon.

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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Foodsupport_AUS
I agree that small amounts of weight loss, wobbling up and down may be normal in adolescents, however, your post raises a number of red flags. There is still some restriction in eating, she requires guidance, won't eat when out, and is exercising apparently compulsively. 

As such I think it is important to assess what is happening - check weight, medical stability. If her eating disorder behaviours have increased it is likely she has enough of an energy deficit she needs to be increasing her intake and her weight. 
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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Foodsupport_AUS
BTW I am assuming she is 162 cm not 162 inches tall. 
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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Barberton
We are in a similar situation with my d who is 14. She participated in running club at school for 2 morning this week with 5km runs. !!!!! We too have discussed the input equalling output and the agreement that she will have to increase her meals on those two days to compensate. At the moment - because she is in a pretty good headspace - I am taking the view that her mental wellbeing of being in running club with her peers is more important than stopping her from participating because of fear that she will drop in weight.

When she does drop (okay I should have said "if", but I just know she will) then she has to learn (with my help) to manage this. She wants and needs her independence, but she has to learn responsibility. Please note that the only reason I can say this is because she's in an okay headspace at the moment. That could change daily. And my d has never participated in excessive exercise - she just restricts. But I always have in the back of my mind that I'm being hoodwinked by the ED.

Yes, I would be worried in your case because you have noted some red flags, but you are paying attention. Is there something you think would make a difference to her when you have talked to her about eating more? Are you serving up her extra food or are you asking her to do it herself? Would you feel better if you checked in with the GP?
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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hope21

Thank you all for your quick responses.  Yes sorry about height! In the mix having not grown for 2 years I think she has perhaps grown a little.  Which could account for some of the weight loss?  

 She was a compulsive exerciser when in the thick of it, in toilets waving her arms about, had to look under doors when out, eventually no going to loo on own! She would never sit, so we had to fight our way through that.  The compulsive leg shake.  


Lockdown has had a massive impact on us.  We couldn’t get lots of her usual food at first and of course we can’t go out to eat.   So I feel a lot of the things we could have done will be a struggle not get back in, for example we went out for cake and coffee at least once a week.  We went out for lunch a couple of times.  To help her know what was a good snack or lunch to buy when out with friends.  we are in Scotland so restaurants and cafes only just opened. However being in the high risk group (Asthma)we haven’t rushed out yet.  She is starting to see friends again but they are all now just going for walks as nothing is open. 

the yoga is helping so much with her injury.  Can walk more steps off the crutch etc. 


she still eats more or less to a meal plan, would never have a pudding unless forced.  

I would say in my heart she never been recovered but in a recovery sort of mode.  When CAMHS discharged us for ED they said they could do more we just had to go a live our lives and keep watch.  She never discussed ED and still glares at me if I try and talk about it.  So it’s hard to have the conversation and you have to pick the right time. 


We have been slipping in the dry food only ( hates a sauce) but I still serve that.  But we are definitely slipping in the variety.  I have always plated and cooked.  On occasion she has cooked with me and I watch the plating and I always have to say take more.  So we hadn’t progressed greatly with that to some extent.   We have been cooking more together in lockdown but she always wants to make noodles! She’s vegetarian hence she’s cooking with me as I cook meat version. 

I try to talk to her about wise choices when it comes to food and she agrees but doesn’t seem to be able to when push comes to shove.  

Your right I do need her weighed.  Physio therapy for her injury will start soon so I could get height and weight done then.  Or bite the bullet and tell her she needs gp appointment for check up.

when very she was very ill she was on bed rest for months as she had heart problems, fainting all time due to bp. Was having her heart monitored bi weekly and at one point every day when IP.  

H had a “chat” with her last night about that he thinks she’s only happy when exercising ie chatty on a walk and chatty after yoga but miserable in between.  But he said she just glared at him in response.  A lot of the glaring I’m guessing is normal teenage behaviour.

I just want her to be better understand the warning signs and be able to manage them or ask for help.  I’m at a loss on knowing how to do that.

She has hopes and dreams for uni, trips abroad etc which puts terror in me wondering how she will manage.  

I’m rambling a bit now, but good to get it off my chest.  People notice the weight loss but also grandparents thought she was a ‘good’ weight anyway and could loose a few pounds! but they have never understood it and are weight obsessed.  In fact having driven me slightly mad over the years! With the you don’t need lunch if you have had a big breakfast nonsense! 

 

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Foodsupport_AUS
It is so common that CAMHS stops offering treatment when kids are not fully recovered. So much of what you are mentioning indicates that there are things that still need to be worked at. 
The fact that she has special foods for example says ED is still present, did she always dislike all sauces or is that an ED thing too. Did her vegetarianism come with her ED? What happens if you prepare high calorie vegetarian foods. 

Growth never leads to weight loss, but it certainly can change physique. I would be surprised if old clothes got loose as someone who increases in height stretches their clothes vertically instead of by width even if they are exactly the same weight. 

I am so sorry, but I am concerned you are looking at relapse here and will need to move back to active treatment.
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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melstevUK
To be honest hope21, all this sounds like ed to me. 
The fact that your d is it bright when exercising and not so in between is a huge red flag. I would definitely weigh her. It will be interesting to see her reaction. How was she like when she was weighed before? Was it something she coped with.  If not, she does not need to know her weight. 

Eva Musby has created a new resource which helps you to calculate what your child's weight should be. It would definitely worth looking at. 

And if you still have compliance around eating, then use it to your advantage to get weight back on. Educating about portion sizes can all come later. Right now you need to get back on track and the path that offers the least effort and resistance at this point in time is the best one to take. If your d is back to ed thinking, then she will not be able to make choices around food which will allow her to gain weight in any case. So there is not much point worrying about that at this stage, is my thinking. 

I hope you can move forward again. 
Believe you can and you're halfway there.
Theodore Roosevelt.
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KLB
I have to agree, in my limited experience, with the others saying there are red flags here. The slipping backwards is the main one for me. I would definitely weigh her to see where she is and what you’re dealing with. The good thing is that you’re acutely aware and on top of things to catch her before she spirals. 
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Torie
Agree with the others.  A tiny bit of weight fluctuation is normal, but not so much that you can see such change in how her clothes fit.  In your shoes, I would start refeeding right away.  The clothes that used to fit should be getting tighter; not looser.  They need to gain a little each year through teen and young adult  years. 

Not clear to me if you need a doctor or not; whatever it takes to get that weight on is what I think you need.  So sorry about the injury.  Ugh.  And COVID.  Double ugh.  Best of luck and 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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Torie
P.S. Please don't weight to start re-feeding.  Regaining gets harder with each lost pound. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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hope21

Thanks for the replies and shared experiences.  Sometimes I think I’m going mad and imagining things or I’m making them worse or over reacting so it’s good to get the feedback.  Even writing it down makes me realise that we are perhaps slipping into that dark hole more than I realised.  


She was vegetarian a year before ED so was allowed to keep it when IP.

when everyone was panic buying loo roll here also buying up quorn so couldn’t get it for D at the beginning of lockdown.  Part of the deal to become vegetarian was she eats what we eat but with a quorn/meet free sub.  Ie If we have sausage and mash or chicken curry so does she but with meet free sub.

i think the sauce thing is a ED thing.  As a child ate everything, loved fish, Thai chicken curry was her fav.  Never ate condiments or peanut butter things like that.

we have only ever been on about 2500/3000 daily calories as she left left hospital on stage 6 meal plan.  I always added extras then, don’t so much now but will up that again.  I always felt her lack of activity due to accident helped with weight gain.  As now she is active again The weight is falling off.   I’d say she has dropped a dress size and I can see muscle tone in her legs.  Her face in very thin again.  I’ve gone through photos from March until now and I’d say the change started around end May/June.   shorts that were fitting if not tight in March are hanging on her.  When I ask to look at her she pulls away.  I’ve said if she wants to do activity  she needs to eat more.  Snacks were light as maintaining weight really.  Getting kick back on trying to up them. Dinner was always the biggest meal and the one I could get most in so I’ll have to re think some of them.  Never did shakes.  Has milk in the morning but only because that was prescribed (by hospital) and I just kept going with that.  

I’m guessing If weighed by a dr she would not be underweight yet as at 70 kg she would have been viewEd as overweight for her height!!! She was discharged at under 50kg weight restored and 100 plus from CAMHS but from this group I knew she was still underweight plus she was still showing so many ED traits. 


she did go and get ice scream with a friend last week as they had opened.
 But only got one scoop on the cone and we think she may have got a sorbet rather than I’ve  scream but had to walk a 8 mile round trip to get it! 

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