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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sunny6
Hello.

I have a question.  I watched a video on the Minnie Maud approach to eating and refeeding once the individual is out of danger.  The recommendation was to feed essentially a teenage maintenance level of 3000 to 3500 and let the body gain weight until it reaches homeostasis and never change the level as that is the real need for the body and any teenager who isn't anorexic.  Our FBT individual told us 1 kg per week gain and I understand the importance of increasing the nutrients during the hypermetabolism phase; however, I am looking for a different approach.

We were given a maintenance meal plan and a weight gaining plan.  When looking at the MM approach, it is really in-between but close to the maintenance plan.  So, we have found that whenever weight is lost and we have to go to an increasing plan, it becomes a battle.  We have told them all along that the body will stop gaining once they reach their weight, but they do not trust that.

After the recent relapse, I am wondering if feeding the MM plan and letting the weight come on slower and getting them comfortable with normal eating rather than always doing the high calorie eating for weight gain would work.  Has anyone tried this approach?
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ValentinaGermania
There was a question about Minnie Maud some time ago. Please use the search button to find it.

It is normal that increasing the meal plan is a battle. Target should be that no weight is lost 🙂. A maintenance meal plan can only happen when they are grown out at mid 20s. Up to then they have to gain, slowly but steadily. The body needs to grow and to develop.

It is evidence based that a quick WR and quick gaining means faster brain recovery and a slow gaining only lengthens the pain. They need to get through that and you need to stand that fights. It is a sign that they are not recovered when they still fight weight gain and increasing meal plan.
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
When weight is lost or any meal skipped ED will come roaring back in my experience, to answer you though, at the start for us it was as much food, in large quantities as possible and if that meant chocolate and cake and crisps for breakfast so be it. We chomped through mountains of burgers and chocolate bars and pancakes etc and weight was gained fairly quickly and mental improvement came quickly too by which I mean the meltdowns receded and she seemed a bit happier and could talk with an amount of logic.  

NIne months in there’s still daily ice cream, cookies etc but I’m steering the food to look a little more like a regular persons day so perhaps cereal, toast and juice for breakfast but if she asks for crisps she gets them, it’s just she’s socialising again and starting tentatively to have sleepovers where she probably be offered more normal breakfast foods although dinners for teenagers on such occasions still tend to be pizza and treaty things which are perfect.   Most teenagers without an ED have hollow legs for food, they need a lot of calories just to be active and grow after all.     Any sign of AN poking her warty nose in and food gets immediately boosted with all the usual helpful things.  I’m not slowing down exactly it’s more training for regular life,  I’m not sure where you are but here CAMHs are way to eager to pull back and maintain which is why I’m certain full recovery is so hard for many to reach.  Our kids won’t trust the process early on, it’s to be hoped that once they get to their particular sweet spot they’ll no longer care.  The problem can be that CAMHs don’t believe it either and start to panic at gain they feel is too high.  Pulling back too soon leaves the sufferer in anguish, a heavier body yet plagued by ed thoughts, the quicker we release them the better.  Having said that some have taken a slower approach with good results. Whichever the approach it’s clear to me that to recover a person mustn’t be bound by ‘target weights’ or have the rug pulled from under them.   As someone wiser than me said ‘being overweight may harm my child in 50 years time, AN could kill her next week, I’ll take 50’    The main thing is to try and ensure no weight is lost, we have had a slight loss here which is hard to know if it’s a fluctuation. 
Ellesmum
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debra18
You told the team that your daughter will stop gaining once she reaches her weight? She is gaining on 3000-3500 calories? That is true that they can be gaining on around 3000-3500 calories and once they reach a healthy weight they still need that amount of calories to maintain a healthy weight. For my daughter about 3000 calories was what she needed to gain during refeeding and continue on her growth curve. It didn't change.
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Mamaroo
My d gained 1 kg a week as an inpatient, as an out patient the expected weight gain was 0.5 kg a week, a target we only reached around half the time, so her weight gain was very slow. It took about a year to reach WR. Her metabolism was higher than her sister's for another 2 years post WR, and although she now eats less than before, she still packs in more than her sister. I suppose that she naturally has a higher metabolism and I will always plate her meals with more food for the foreseeable future. 
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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