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.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

Need to talk with another parent? F.E.A.S.T. parents offer peer support via:

Elinor
Greetings to all in this community. I've been lurking for a few months and found this to be a supportive, non judgemental and practical group - those who post, your struggles and suggestions are helping all the lurkers out there too.
I'm taking the plunge in introducing myself as the mother of a 16 year old daughter with a story similar to many of you - she has RAN. I'm from New Zealand and it's likely my daughter and I can be identified by other New Zealanders (there are not that many of us!) particularly as my question relates to my work as a GP (General Practitioner - that's a family physician/doctor to some of you) so I'm just dipping my toe in here with regards to details.
We are now 9 months into our journey and weight restored. I can now take a breather to look out over the landscape rather than just slogging up the mountain one foot in front of the other.
I thought I was accepting of my body. Through this process I've discovered that I'm not. Because of keeping my daughter company while eating I am now overweight and I don't like it. To weigh myself seems a betrayal, to restrict my intake seems a betrayal. I'm exercising moderately most days for my mental health not with my weight in mind. I have a family history of young age breast cancer, for which over weight is a risk factor, which is one of the reasons why I prefer my BMI at the top of the normal range - the other reasons are to do with my own self worth and social pressures - same as everyone .
And then there are my patients. Many are obese, many have diabetes. I am supposed to be telling them to reduce sugar, fat and total energy intake. I have long taken a 'look after your happiness and the weight will look after itself' approach ie exercise and a nutritious diet improve wellbeing - that is the goal, not weight loss. However the bottom line is reducing energy intake. How can I encourage my patients to accept themselves, to practice self compassion but also give them advice to reduce their eating?
I'm thinking of booking in with my daughters dietician (she is an eating disorder specialist with a 'no diet' approach) and asking her how she resolves this conflict. She has already told me that for me to eat intuitively is the best example for my daughter.  Are there any other caregiver/health professionals out there (or indeed any of you insightful people) who have any ideas for me?
Quote
MKR
Hello and welcome @Elinor from a Kiwi!

It's great to hear that you are able to look at (and enjoy) the landscape, there is life out there, after our slippery slope.

We mothers will always carry some inherent guilt around. But looks like you are ready to start enjoying the new chapter. The struggle is not over, but you have acquired lots of wisdom.

I can only offer the experience in my family, where not skipping meals, ie not allowing fluctuations in blood sugar is the key. And outside those 3-hourly meals and snacks, we are kept busy with life, away from food thoughts.

This has been working for my AN daughter and for my friend who was a compulsive eater for a couple of years and is now doing amazingly well, still full of life.

Lastly, self-care, doing things you enjoy, having fun, is equally important.

All the best,
Mum's Kitchen

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

Hi what I think is useful is the concept that everyone needs to eat what they need. I have put on weight also as likely many parents do during refeeding, as I found I needed to eat the same as my D esp at the start. 

I have also found myself eating more even without my D for a few reasons- because I have so many energy dense foods in the house; the stress of ED in the house; I also find myself drawn to eating foods I want my D to eat even when she is not there- for psychological reasons- something to do with making the choices that I would like my D to make. 

great that you are looking after your mental health. I agree challenging to think about restricting. And certainly I would not want my D to be aware of this. There is a big difference I think between restricting and choosing less energy dense foods for yourself and more fruit and veg.

From what I have read - compassion and taking a non-judgemental approach are recommended for approaching these discussions with your patients. Xx

 

Quote
teecee

A warm welcome from the north of England. 

I went through the same thing as you in eating the same as my D as a support mechanism and buying what I wanted her to eat so she saw it as ‘normal’ when in fact I am almost 50 and don’t exercise as I used to! The weight quickly piled on. 

Recently though I have been eating regularly and recognising what I need. I make sure I have a supper if I’m hungry and don’t feel bad about eating late as I know I need it to sustain me through the night. My Ds dietician was fantastic as she educated me and H when we thought we had a good diet!! Educated us about complex carbs and portion sizes. I think many of us think we know but actually we don’t. 

My amazing GP and counsellor helped me understand what self care really was and how being a good role model by practising self care would help educate my D to take good care of herself. I found that throughout this illness journey communication has a huge part to play. How we communicate with our kids, partners, friends, strangers....I worked in a job which was all about communication and it’s not until I’ve retired that I’ve realised I’ve only just really discovered the art of good communication. I was always praised re my communication skills...I had so much to learn!!!

Quote
Foodsupport_AUS
Welcome to the forum. I think many of us have felt conflicted about this and many of us gained weight with re-feeding. If all of the theory about this sort of weight gain is correct then moving back to your more intuitive eating style and continuing ensuring regular exercise should result in a correction of the blip from re-feeding your daughter. I certainly found things normalised more overtime without ever specifically going on a diet. Healthful behaviours are probably the most important things we can model and will help reduce those risks overall as well. 
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.
Quote
ValentinaGermania
Elinor wrote:

I'm thinking of booking in with my daughters dietician (she is an eating disorder specialist with a 'no diet' approach) and asking her how she resolves this conflict. She has already told me that for me to eat intuitively is the best example for my daughter.


Hello and a warm welcome from Germany!
I also gained weight in refeeding my d and I think your idea of asking the dietitian about it is a great start.
I made the "mistake" at the start of refeeding to think I must eat the same as my d and more than her to be a good role model.
We changed to "different meals for different people" in the last 2 years and that helped to stop me gaining (although I am not back to my former weight at the moment). I try to reduce my intake slowly and with my d in a recovered state it is more easy to do that now. She has no problems when I eat something different and a smaller portion than she needs to eat.

We are not back to intuitive eating because I am not sure if my d ever did that. She has no steady hunger cues, only now and then, she eats mostly by a schedule now because we all eat and I think she did that all her life before ED moved in. Not all patients can eat intuitivly.

I want to add that we had that problem here at one table: the grandparents live with us and eat now again with us (in the first weeks of refeeding we seperated them) and grandpa has diabetes type 2 and high cholesterol and he must eat low sugar and low fat while my d at the same table must eat high fat and sugar. So she learned very early in recovery here that the rules at our table are different for each family member.
Keep feeding. There is light at the end of the tunnel.
Quote
Enn
Hello,

As I see your post I see the two sides of the coin that you are trying to reconcile, or maybe it is three sides of a triangle?
How, as a professional person who deals with health all day long, do you give the best advice for every person? You just do as you have all along.
Those with diabetes, yes would benefit from weight loss and exercise and that is their prescription, your d needs to gain weight and you need to maintain. You ask how you help your patients  accept themselves? You can tell them so AND give them good advice.  (Also note that those with obesity and type 2 DM can have ED too like BED commonly) Also weight training for those with type 2 DM is really good for their sugars. The increase in muscle mass is metabolically active and will increase their insulin sensitivity and so it is a "better" exercise than "just" cardio ( As I am sure you understand well). 
You "just" need to give the "right" medicine for each of your patients and that includes YOU.
I understand your internal conflict. I think you will feel more comfortable about these apparent paradoxes soon enough- just give it time. ED does make us see food and health advice very differently doesn't it?
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)
Quote
debra18
I just wanted to say that I don't think that intuitive eating is a realistic goal for my daughter and I think this approach is somewhat controversial. What I do try to enforce in my family is regular consistent eating for everyone and a variety of foods. All kids in my house must eat "normal" food for breakfast, lunch , and dinner. For your patients , I would think that different prescriptions for different people would be necessary as said above. I have a child that is allergic to milk and for her milk is not good for her. My ED daughter needs to drink milkshakes everyday. That's just how it is. 
Quote
Elinor
Thanks for all your helpful thoughts. ED sure does make us see food and health advice differently - there are triggers all around us once we become aware - even the word 'healthy' is a trigger for my d - as she rightly points out what this usually means is 'low sugar/fat/energy.' We were reading Wuthering Heights aloud as a family shortly after diagnosis, I had completely forgotten that Cathy starves herself to death.
It seems advising anyone to restrict intake at the moment is triggering for me! I have barely uttered a word on the subject of weight to my patients in 9 months - but as you say I need to be able to give them the support and advice they need for their individual lives.
I have also become hyperalert to weight and eating in my young patients - sometimes they look a bit confused about why I am asking them about their eating - then I know I'm barking up the wrong tree. When I do uncover eating disordered thoughts, or when I'm dealing with those patients known to have ED, I find it emotionally challenging and spend a lot of time thinking about them out of work.
I went once to a face to face support group for ED parents - we sat in a circle and introduced our stories, by the time it got round to me I'd heard at least 4 bitter complaints about GPs under reacting or being insufficiently knowledgeable. Needless to say I didn't declare my occupation, and didn't go back (though that was largely because the parent's many years of suffering was too overwhelming for me at the start of our journey down a similar road) In defence of GPs - we are generalists and ED diagnosis and management is a highly specialised area, anosognosia and secrecy inherent in ED and the higher chance of other causes for distress (anxiety/depression/family dynamics/bullying/breakups/drugs etc.) make it difficult to identify and realise the severity of these illnesses. I didn't see it in my own home for 5 weeks until my d's friends told me. I knew something was up, but had absolutely no inkling that she was eating only one normal meal a day - dinner, the one we all eat together. In the busyness of our mornings I thought she was eating breakfast with my husband, and he thought she was eating with me. As a independent 16 year old we just assumed she was eating morning tea and lunch at school and getting herself afternoon tea.
Quote
teecee

I get what you are saying. Believe me I know what you mean about sitting in the group parent sessions. I was mortified that I was an expert in child safeguarding and yet missed this in my child and had a social worker ringing me after we presented at A&E!! As we did the round robin in the parent group I was relieved that others were saying “I’m an NHS manager and have never made a big thing out of food...I don’t know how we’ve got here.” I thought thank goodness it’s not just me!! 

I can look back and see the ironic side of this experience now but at the time I could cringe. The important thing to raise awareness about is that no one is to blame. People get ill and we were unlucky. My GP was amazing with me....she believed me and was non judgemental... she just listened when I was falling apart. My Ds GP had no experience of EDs and questioned why we needed certain bloods doing from CAMHS but, and it’s an important but, she was willing to learn and rang me for reassurance after researching things for me. She was full of compassion and didn’t try to hide the fact that she was not knowledgeable. I love professionals like that....they’re the ones you want in your corner. 

Quote
Enn

I know seeing patients with ED in your office can be triggering... right now. I wish you  to know a few things. 
Your very intimate knowledge of EDs is going to save a lot of kids. You will recognize it  very quickly in your patients  and save a lot of lives and families years of grief. You will be able to triage them and get them help, proper help. 


I agree that people come down hard on GPS (and other specialists). EDs are rare and unless you have studied about EDs a lot how could you know so much. I feel for the families let down by a medical system. It is hard all around for all parties when things don’t go smoothly with dx and treatment.  Just like a surgeon, how can they know a lot about the medical treatments for psychiatric illnesses, or gynaecology , or endocrine, or respirology. 

There is too much medicine to know and it is changing every minute. That is why it is called a practice. Physicians are life long students and even at the end of their careers there are still millions of things in their life they never saw and could not have known.
I am sensitive about the critical views I have seen. 

Thank you Elinor for being brave to bring that up. 

Over time I can see you becoming such an ED advocate and maybe a bit of a specialist yourself. Be compassionate and kind to yourself. Your medical knowledge has really grown and to your family’s benefit and to your community’s.
🌺

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)
Quote
PleaseEAT

Hi, glad to hear your d is now WR
keep up the great work, it’s exhausting but worth it (even when it takes longer than we want it to)

 I don’t comment on what anyone cares to eat anymore
i used to be a bit of a “healthy” meal type of person and “shouldn’t be feeding our kids all that rubbish/high sugar/fat type
now I’m like eat as much junk food/take away as you like!

i also had a GP comment to me on my BMI years ago which made me start to look at my eating habits more closely and now  after dealing with AN with my d for past 3 years I’ve also now put on weight 
im the heaviest I’ve ever been (but TRY not to let it bother me) but do think back to that moment with GP, I was a fit and healthy weight back then grrrrr!! How dare he say that I would love to be that weight now 

also another GP  failed to notice the seriousness of the illness in my d and failed to advise to refer to specialists 
which in hindsight wasted a lot of precious time as my d a YA and now is SO much harder to treat as others will understand with older kids and as you would know professional don’t have to share info with parents 

hopefully in your professional position you will be able to inform/educate/advocate or make aware to more of your colleagues how actually important it is to help parents/carers and the patient to get into treatment ASAP

now my d an adult I get told nothing but still worry as much as when she first became ill
as it’s a daily worry wondering is she going to appointments (they don’t need to tell me)
is she eating (she left home for a while) thankfully home again now but I still have little say in anything 

sorry you support group seemed a bit overwhelming (I too found that when I went to one when my d was first dx and like you I didn’t go back as I found it too depressing)I didn’t think  my kid was going to be sick for years! 
maybe she would not have become so entrenched in her AN if we got good help immediately but I will never know 
I hope you can see why parents may present as anxious when they bring their kid into an appointment we know there is a serious issue, and we  know our kids, (as you know yours)
it would be SO good if this could really be understood by ALL professional first port of calls where worried parents bring their kids, we also had very unhelpful comments from staff at A&E “ do you just vomit your food?” “Why don’t you just eat” 
I know I can’t turn back time and I’m not “blaming” anyone it is what it is 
but I just feel so sad and let down to see my d struggle in her life and what she has lost
i mean she is slowly putting her life together again but it’s NOT been easy that’s for sure!

I do hope there is change for the future sufferers and professionals 

the sad part about it is when I read old posts it seems parents have been banging on about this for years  🙁
fingers crossed for changes going into the future!
all the best 

Quote
ValentinaGermania
Elinor wrote:

I have also become hyperalert to weight and eating in my young patients - sometimes they look a bit confused about why I am asking them about their eating - then I know I'm barking up the wrong tree. When I do uncover eating disordered thoughts, or when I'm dealing with those patients known to have ED, I find it emotionally challenging and spend a lot of time thinking about them out of work.


Please do not beat yourself up for that. This is really hard for all of us. I tend to talk to parents of thin kids in the supermarket 🙂. I did not do it up to now but I was THAT close a few times...From my own experience and what you wrote about the parents experience with GPs in that group, I can tell you it is a blessing if you are aware of that now and better barking up the wrong tree a 100 times and do it at the right tree only once than NOT bark at all. Thanks for doing that!

Elinor wrote:
I didn't see it in my own home for 5 weeks until my d's friends told me. I knew something was up, but had absolutely no inkling that she was eating only one normal meal a day - dinner, the one we all eat together. In the busyness of our mornings I thought she was eating breakfast with my husband, and he thought she was eating with me. As a independent 16 year old we just assumed she was eating morning tea and lunch at school and getting herself afternoon tea.


Again, do not beat yourself up for that. We ALL did not see it coming. We ALL did not know much about EDs before it hit us. Somebody said here, "this was not in the baby books!"
Mine was 16/17 when she got ill and I did not see it for about 6 months and she lost 10 kg without us recognizing. So you were not THAT bad as you think 🙂!
Keep feeding. There is light at the end of the tunnel.
Quote
HopeNZ
Greetings, Elinor, from another Kiwi.  Congratulations on the WR!

My d was diagnosed with RAN almost exactly three years ago, aged 13.  She's now doing really well.  Gosh, I hear you about those long timeframes and how daunting they are at the beginning!  I must say I haven't been able to bring myself to join the support groups out there... 

Part of our journey as a family has been really changing the way we think and talk about 'healthy food', and I sense this might be where you are too.  We've really had to embrace the idea that what's healthy for one of us is not necessarily healthy for others, and we all have to eat different things, in different quantities.  At first, we all ate along with our d, to support her and try to help normalise the enormous, calorie-packed portions and never-ending snacks.  Needless to say, this was unsustainable!  Among the many legacies of refeeding for me is high cholesterol;  my non-ed son has developed a liking for full-fat dairy which he really doesn't need (unlike my d, he puts on weight by looking at food!);  and my husband now carries several extra kgs which he just cannot shake.  So we're all, in different ways, trying to get back to a more 'healthy' diet... healthy for each of us individually.  Although this is still sometimes difficult for my d, who has hollow legs and struggles to keep the weight on, she is far enough along the road to recovery to understand this.  It's been a subtle but strong culture shift in the way we have to think about 'healthy' food.

We are searching (so far in vain) for a GP in our relatively large North Island city who is aware of the current thinking around EDs and who is willing to enrol my d when she is discharged from CAMHS.  It's alarming how few GPs with a passing knowledge of these disorders there are in our area!  I'm so sorry your knowledge has come at such a personal cost.  I hope you don't mind me saying that future patients of yours will no doubt benefit from the awful experience you have had at the heart of your family.

Warmly
Hope
Quote
PurpleRain
Thanks for this:
We were reading Wuthering Heights aloud as a family shortly after diagnosis, I had completely forgotten that Cathy starves herself to death.
I had forgotten as well and someone just gave the book to my D. After reading your post, I asked her to lend it to me (she hasn't started it yet).
I have also have put on some weigh, which is not great for me due to high cholesterol, I would have to do something about it soon I guess. H and s have put on weight to but very little and in the case of s is a good thing cause he's very slim and will be 10 in a few weeks so it's in the growth spurt phase. I used to be ever so careful about food due in part to my high cholesterol tendencies, I'm much more flexible now (especially with the kids). It must be so difficult for you being a GP but I'm sure you'll be an asset for you patients. I love my kid's pediatrician because she has never said anything about "healthy food" or "healthy weight" to them. She weights them with their back to the scale and makes no comments! So refreshing. You'll be a god send to parents of kids with eating disorders!
13 yo d started to eat "healthy" September 2018, she had a growth spurt a bit later, followed by tummy bug. She started restricting breakfast and school lunch in January 2019 (that we know). We succesfully refed at home.
I have found inner strenght, patience and compassion that I did not know I had.
Never retreat, never surrender
keep feeding
 
Quote
Human
I have also put on weight! However, I just think it was worth it to get my daughter much better and to where she is now. What i am doing now though is eating less than her and walking everyday when she is st school. It's helping my mind as well as my body.
Quote
MarcellaUK
Welcome. I am not a GP but at the time my d was at her worst I was working for 90 of them. I found the criticism of "my" doctors, particularly by the CAMHS "professionals" very problematic. Some of them had no clue, others had outdated views, some of them knew more than the CAMHS people, but they could all order a blood test or ECG, not something that a social worker or psychologist can do. Certainly in our UK system and I'm sure in your NZ one, we need our GPs and should value them more. They need to be given the skills to work with and the support to do it, much like parents. Well done for helping your d to WR and keep up the vigilance in your practice. 
Fiona Marcella UK
Quote
Axioms
Dear Elinor- I had to reply to your post having had similar experiences hearing complaints about GPs and other specialists who have missed diagnoses. One of the families in our group had taken their daughter to a paediatric cardiologist for her bradycardia and he did not recognise her anorexia.. I am an emergency physician and my husband a medical specialist. I had a horrifying few weeks when I was absolutely certain my daughter (12) had anorexia and did not know where to turn for help- and that is from someone who is very familiar with our medical system. So i understand people's frustration and fear- and I know also that most doctors are trying to do their absolute best for their patients, and how difficult it can be to recognise eating disorders. I'm pretty hypervigilant now and have picked up a few ED patients coming through my department- also my approach towards patients with larger bodies has definitely changed.
I'm glad to hear your daughter is recovering- and sorry to hear you are uncomfortable about the weight gain. I completely get that too🙁
Mary
Quote
ValentinaGermania
I am not sure if I am overreacting but I think it is not really helpful for Elinor when we all tell her our bad experiences with GPs (that most of us had for sure) as she is already feeling bad about all that 🙂.
Keep feeding. There is light at the end of the tunnel.
Quote

        

WTadmin