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

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chillsey
Hello

I've just joined this forum as around 6 weeks ago my 12 year old son was diagnosed with anorexia.
It all started innocently back in April 2019 with him wanting to lose a bit of weight and eat healthier.  Unfortunately this appeared to spiral out of control quite rapidly and before we knew it he was exhibiting all the traits of an eating disorder.
He lost around 3 stone in a very short space of time but my wife and I managed to catch it at the point where he was just borderline into the underweight category. 

Since his diagnosis and referral to cahms around 6 weeks ago we have been implementing a family based support (with cahms appointments) procedure where for the most part he has (very reluctantly) had breakfast, lunch and dinner but no snacks, and only certain 'safe' foods.  My son is very honest and has explained all about the voice in his head and we have had many lengthy conversations about this.

However just in the last 2 days he now flat out refuses to eat or drink anything other than water.  All the usual techniques that my wife and I have used with some success are not working.  He just says 'I cant do it anymore' and 'the voice is too powerful' no matter how long we spend trying to tell him that he can do it and re-assuring him, he just will not eat anything at all.   I feel like I don't know what to do now and I am so worried that he will continue this behaviour.

Please would anybody have any tips or help as to how to get my son through this and to start eating again, even if its just small amounts to start with?

Many thanks
Chris
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scaredmom

Hello and welcome!

I hope you find the support and information you need to help your son.
There are a few here with sons. I will name a few and you may search their threads as well: deenl, KLB, Scarlettt81, McMum. There are many more as well. 

We all have very similar stories about "healthy eating". I am so sorry this happened.
Right now with no eating for 2 days, this could be a medical emergency. Are you able to get a medical assessment today? Some have needed our children to be hospitalized when our kids are unstable. This is not a failure, it is a sign that the ED is very strong. It is just like other medical illnesses, sometimes you can deal with it at home and sometimes you cannot. 

Here are some guidelines. Please print and take to the ER when you go.  https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr168.pdf?sfvrsn=e38d0c3b_2
No eating for 48 hr ( I say 24 hr) and/or no fluids for 24 hr is a medical emergency.
Please feel free to question us. We all have been there is some way, shape and form and are wishing to help in anyway we can.
Please let us know how it goes today. 
I cannot stress enough that he should be seen today by a medical team. This is not to scare you. It is to arm you and to get your son care.

Sending a big hug.


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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KP

Hi Chillsey 
I absolutely agree with scaredmom, you need to get him assessed by a medic as soon as possible to ensure that he is medically stable. It is so hard at the weekends as usual services just aren’t available,  but I would want him seen today and then longer term you need to discuss possible alternatives for treatment options with the team. 

Sounds like you’ve been doing a brilliant job. Sometimes the illness is just too strong and our kids need more help than we as parents can provide. So so difficult. 

good luck to you all

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chillsey
Hello Scaredmom and thank you so much for taking the trouble to reply 🙂.

Actually my wife and I were thinking along the lines of the hospital as I couldn't see any way in which my son was going to attempt to eat.
However just as I finished my post above I made some lunch (scrambled eggs on toast) and I made my son sit at the table to have his in the misguided hope that he would even look at it and to my great surprise he said to me that he was really hungry and that he really wanted the lunch but couldn't.  However after a bit of back and forth he finally ate it and then had a big glass of milk afterwards.  Finally he's eaten something!  This is such a battle and I still have trouble believing its real at the moment.    
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chillsey
Hi KP

Thank you so much for your kind and encouraging words.  I totally agree that this is so unbelievably difficult and nothing can prepare you for what lies ahead.  Also the range of emotions and anxiety levels that we as parents go through too.  I find it hard to believe that the human brain is capable of doing this to itself 🙁   
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scaredmom

I am so pleased he has eaten! That is a win! He truly is hungry, so hungry but the ED does not allow them to eat. Having you stand up to ED and give him permission to eat is the ticket. If you take the "blame" for him eating, he can assuage his guilt. It really is so so sad, what they are going through. 

Now if he is eating less than 600 cal per day, he still does need to get medical attention. 
I see you are on three meals only and no snacks. I would suggest you try to get to  3 meals and 2-3 snacks per day. I know we don't want to "push them" as it is scary enough. But the longer you do wait to get up to full nutrition you may be allowing the ED to dig in its heels more and more and then it is harder later. It will be painful no matter one meal per day or 10. How can we help you get more in?

Some have added in extra calories through butter, cheese, cream to milk, oil to anyfood that can take it. Smoothies/shakes that appear healthy with fruit (and ice cream and cream and oil and yogurt) have been a godsend here. 1000 cal smoothies is what helped us to gain faster. 

Is there purging, or compulsive exercise (even in the middle of the night)? 
Having a plan A , B and C in place can be helpful. That way when you have an issues you have have the next plan. It helped me to know that if she did X I had to do Y. It took some of the stress away.
We had violence and throwing of plates and cups and food. So I would suggest paper/plastic utensils and plates. 
Hope the rest of the food goes in well today.
Another thought, at age 12 he will need an enormous amount of calories to fuel growth and development. My d needed 4000 and still does not basketball days. Some kids both boys and girls needed even up to 6000 cal per day. That is just FYI and it may feel odd right now when he was eating so little, so don't be surprised if and when he needs so much more in the way of calories. 





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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sk8r31
Welcome from me too, though sorry you have a need to be here.  Great job for starting strong; there is such an incredible learning curve with this illness!
As mentioned above, medical attention is definitely required when there has been no eating for a day or two or no drinking for 24 hours.  Things can go south very quickly, and medical stabilization may be necessary.  This is not a failure, but simply needing a higher level of care for a while.

This was the case with our d too...starting out wanting to eat more healthfully and be a better athlete.  She lost weight quite rapidly but was never below what was considered a 'normal' range for her height.  But the rapid loss triggered medical instability and she needed to be hospitalized for a week.  And then we were in the throes of a full-blown ED.  

I highly recommend a book that I wish had been available when we were starting this journey When Your Teen has an Eating Disorder by Lauren Muhlheim.  And Eva Musby has excellent resources as well, available here.

Distractions with meals and snacks may be helpful; playing a game, watching a TV show.    Things you wouldn't normally do at mealtime, but which can take the focus off the food & perhaps make it easier for your d to eat.

Sending warm support to you.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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chillsey
Thank you all again for the lovely replies and support and helpful tips.  We went out for a gentle walk earlier and then I have just sat with my son for around 30-40 minutes at the dinner table trying to get him to have his afternoon glass of milk and 1 dried date.  During this I experienced 'Freddie' which is his name for the voice. He did throw a couple of things and try to escape numerous times but I dug my heels in and didn't give in.  Eventually I was successful with this so that is very positive.  Just the evening meal to come a little later.  May be a repeat performance at the table though.  

Regarding compulsive exercising, yes he's done that in the middle of the night and we found out when he actually told us in a rage a couple of weeks ago.  Since then its resorted to hiding all the TV remotes, phones, ipad etc every night and setting the ground floor house alarm which he knows will go off if he tries to get to the TV.
It's so crazy, you always feel like you have to think one step ahead of the voice and its exhausting.

I like the sound of the plan A, B, C.  Do you have any particular examples of things that you have done with these different plans that may be of use please?
Also thank you sk8r31 for the book recommendation as well.  I'm reading a book called 'Please eat' I think at the moment which is about a teenage boy with ED.

Once again thanks to everyone on here for your kind and warm support.  It means so much 🙂

Chris
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scaredmom
Re compulsive exercise some have had to sleep with their child to stop it.
As for plans: like this mentioned above ,if no eating go to the ER. Sometimes the child knowing that will happen will ‘make’ them eat.
And do not back down. If  he does not eat go to the hospital. Bring a meal to eat as he may decide to eat in the car park or while waiting endlessly in the ER waiting room for assessment. 
another plan: if they don’t eat the meal, have ensure replacement drink  ready.
Also if they don’t eat, no school, no videos, etc... whatever incentive you can come
up with. In those cases some have put the child to bed as they have not eaten so they should not expend energy. Some have used Life stops until you eat (LSUYE) or life begins when you eat eg. you can go out to school, with friends, have your cell phone’ when you eat.
Others have done crafts, pottery, games as a reward after eating.

There are so many ways to get there. At the beginning figuring out what your son’s ED’s incentives are to eat can be the hardest thing.
For us at the beginning we could not talk to d about food or even look at her when she ate. 
We could not say ‘well done’.
my d loves school so she knew if she did not eat breakfast or her lunch at school, she would be home with me to eat. We did have to do that for a few days. It is not punishment it is ensuring her life saving medicine is administered. 
Feeding them is an courageous loving act. The weight gain over time and time itself is healing. Some kids have other co morbid mental health issues. My d has anxiety treated with meds and she is  better every year.
If you need support with that get it. You may find just feeding helps. Just be aware. 

Do you have other children? How are you and your wife doing? Please take time for a break. A nap, massage, a coffee with a friend. 
All the best.


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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scaredmom
Oh also wished to add we did have some violence and so we had a plan for that. If she threw, hit broke things, she was sent to her room. We had told her that was the plan as we did not accept violence. She was also told that if there was serious violence that the police would be called. I was prepared to do it, but thankfully it never got to that point. Be prepared to follow through, I know how hard and gut wrenching this is. You are saving his life and you are doing so well.
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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Mcmum
Hello and welcome from me too. You've had lots of good advice and this forum is a God send so do keep posting and asking.  It's a horrendous illness and a completely surreal and stressful experience but it certainly helped me to know that I wasn't alone.  The book that helped us the most was the Eva Musby one. 
So we also have a boy and he was 9 when diagnosed last year but is much better now.  It's a steep learning curve and everyone is different but we essentially put everything on hold to try to get 3 meals and 3 snacks in. This mostly went very badly at first!  Our son also started with healthy eating and also compulsively exercised. Smoothies made the biggest difference for us but there was violence and torment and general distress before, during and after every piece of food or drink.  We spent a lot of the summer before last at the hospital and many here have needed medical intervention of one kind or another.  It got slowly better though and although our lives are now dominated by food, we're not in the abyss of the early days.  You too can survive this. 
Our son still needs a ridiculous amount of calories just to maintain and at 12 your boy will need a lot too. You're making an excellent start and I want to reassure you that the horrible voice can recede and your boy can come back to you.  
Have you got support as a family? ? How is your camhs? ? 
Wishing you strength and hope.  It's a tough one but there are roads through 
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chillsey
Hello again (Hi Mcmum 🙂 and thank you so much for your continuing support and advice.  We are definitely now implementing a LSUYE strategy (especially with the re-assurances above) as this appears to be the only thing at the moment that will work.  We managed to get S to eat his dinner last night although 'Freddie' made a very grand appearance last night before the meal.  There was shouting, he fell off his chair and curled into a ball on the sofa shouting 'get away from me'.  However after 5 mins or so he calmed down and we were able to bring him back to the table and he eventually had his meal.  Breakfast successful too this morning 🙂

Snacks have always been an issue for us (S saying 'what's the point' etc) but we are going to try and start doing smoothies.  S was having some dried fruit and nuts too but recently he's being refusing this.  We'll try again though.

My wife and I have been to hell and back with this but certainly now that we are putting down the LSUYE method and if necessary, prepared to sit for hours at the table until the food is eaten, we feel that hopefully S will have no choice but to eat.

We don't have any other children so can focus solely on S and currently not feeling great but not too bad although anxiety is never far away.

A couple more questions if I may also.  Mcmum, could you possibly suggest other forms of snacks that are high calorie but may not be completely off putting to S at the present time?  Also S has been looking forward to a trip to Alton Towers theme park this coming Saturday with his school (he's been before he got ED).  He absolutely loves theme parks and I'm really happy for him to be going and having a day out with his friends, also so wife and I can have a break 😉 !!
However regarding this, I will be making him a big breakfast in the morning with some extra things that he will have to eat or he wont be allowed to go.  After that he will be all day at the park without us and even though I will make him 2 packed lunches to take, I very much doubt he will eat any of it.  Am I doing the right thing letting him go even though he may miss 2 meals as he wont be home until quite late in the evening and will be very tired when he gets home?  Maybe we should have dinner ready for him anyway when he gets home even if he just wants to go to bed?

Thanks to you all again and I really appreciate your support
Chris















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Foodsupport_AUS
It sounds like you are really making some headway. As much as it would be nice for you son to go, I do think it is important that he doesn't miss meals. By letting him go when you know he may not eat, it is giving the message to ED that it is not important. Right now there is nothing more important than full nutrition every day.

My D required full supervision of all meals for the best part of four years. Many kids don't need it for so long but putting a plan into place to make sure that there is no other choice but to eat is important. 

For my D when there were excursions or trips I let the teachers know that she required supervision of all meals (they were well aware of her illness). At school I either supervised, or she would go to the nurse. D knew that she was being watched, and also knew that if she did not eat that I would be called to come and pick her up. Is there anything that could be done along those lines? 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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scaredmom
At the beginning it is important to ensure he is getting full nutrition everyday. It is his medicine. I know it may feel awful to take away the Alton Towers trip. He is not well right now, not well enough to go. These kids can get so sick so fast. The issue is the exercise/running around in a park and likely the lack of food that is a dangerous combination.
I think if he is motivated by those types of things, you can book them in the future and let him know that you may go as a family when he is better. Right now it is food and weight gain and working on the ED behaviours and thoughts.
Planning a day with his friends at home can also allow him some social time in the near future. I am sorry, many of us had to sacrifice the "normal" happy activities at the start. 
I am taking a point from Foodsupport above, do the teachers know? Is he going to school and how is lunch supervised? 

High cal snacks: nuts, dried fruit are great! We also did yogurt with added heavy whipping cream and a glass of milk (with cream again) and a piece of fruit. Clif bars, granola bars, muffins, cheese and crackers. Goldfish cracker and juice or milk. cookies and milk, 
I will post the high cal meal and snacks and recipes threads. You may get more ideas there too. 
What is he actually eating at meals? we could help with some ideas to get more calories in.
 
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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scaredmom
https://www.aroundthedinnertable.org/post/high-calorie-suggestions-696425?highlight=high+calorie&pid=1309311425

https://www.aroundthedinnertable.org/post/high-calorie-snacks-5794369?highlight=high+calorie&pid=1308424146

https://www.aroundthedinnertable.org/post/feast-recipe-book-call-for-recipes-9915329?pid=1309324731
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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Mcmum
You seem to have a steely resolve about you, which is great!  It truly is hell and I remember feeling like we'd landed in the middle of of a version of the Exorcist! 
I agree about the trip unfortunately.  Do the teachers know?  The staff at my son's school still have to supervise snack and lunch (he'd been binning both) and have been really excellent but if you know he won't eat, he can't really go. Best to view it in the same manner as a debilitating physical illness - which it is of course. 
At first snacks were small but calorific and I found I could do this best if I made my own.  Flapjacks looked "healthy " but were mainly butter and almonds.  Small pancakes were good if made with cream and fried. The smoothies were the game changer. Lots of credit and Hagan Daas as this ice cream seems to have the most calories.  My son would freak out about water and toothpaste in the end so we brazened it out and had the same melt down over more calorific stuff.  The sight of your child writhing around on the floor is very distressing but unfortunately not unusual.  I found I had to learn a few Eva Musby mantras then take myself off to a different place whilst I faked calmly dealing with him. My husband and I would bail the other one out when it all got too much. 
You're in the middle of a horrific thing but try to take a meal at a time and try too for you and your wife to do something that is non ed related. Very best of luck! 
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Mcmum
Cream not credit - sorry.  Shopping habits now revolve around butter, cream, almonds, cheese, ice cream etc
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chillsey
Hi again everyone and thanks for all your advice.  S is at school and I have been going and having lunch with him every day as he was binning the lunch previously.  Also we have measures in place with his tutor and PE teachers to not allow him into the gym after school.  His teachers are fully aware of what's going on and they have been very supportive 🙂

S has had a fruit smoothie (with lots of cream in it) to go along with his lunch of boiled eggs and toast today so that is a big win.  
I really like the idea of extra cream in the full fat milk🙂

Generally his meals will be along the lines of..

Breakfast = 2 shredded wheat with strawberries, blueberries, grapes and banana on top.  Full fat milk on the cereal and a glass of full fat milk on the side.

Lunch = Either a tuna salad sandwich / chicken salad sandwich or eggs (scrambled / boiled) and a fruit pot and some mixed dried fruit/nuts.  Although the nuts have been problematic recently

Dinner = Various things like Salmon, aspargus, new potatoes (all with lots of oil on them), spaghetti bolognaise, Stuffed peppers with rice and veg etc.
We're going to try a Sunday roast tonight !!

Also an extra glass of full fat milk in the afternoon.  I'm still struggling to get him to have the dried fruit/nuts with it though.

We also try and do fun things as a family which are not ed related.  S loves walking outdoors but I only take him for short gentle walks as he'd walk 10 miles if he could 😉 

Again thanks for all the lovely replies and help 🙂

Chris






 


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Joe
Hi Chillsey, I'm so sorry you're here, but you'll get lots of amazing advice and support. 
We were where you are now a year ago with our then 11 year old son. 
You need to get CAMHS on board more. We're in Somerset and after 2 weeks of weight loss, our son was admitted to the children's ward for a month last summer. The threat of a tube feed (NG tube) was the only way we managed to get him to eat... 
Speak to your team and ask if there's anything similar in your area. Without that threat, we'd never be where we are now, slowly coming out the other side.... 
Sending hugs and all the luck and strength... Jo
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Dontgiveuphope
Hi there, I feel your pain.Refeeding our 11 yo daughter took her eating 7 snacks and 3 meals (plus extras) before her weight and mental health took an upward turn. She was eating at least 4 museli bars a day + other snacks and measured meals. Then started snacking on fruit as well volunteerily, able to lick fingers etc which was a turning point and the weight came back on. She is terrified of going back to hospital but is having a little relapse now , restricting a bit so back on the meal plan and told not to trust her appetite. Cooking higher calorie meals again, sneaking cream into everything and cheese.
We found every big fight against the ED, helped move her forwards in the disease as horrible as it was we got . Stopping her playing sport was the big turning point  - caused a lot of anguish but enabled her to recover her weight faster. 
Hold onto her hope, keep fighting..
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chillsey
Hi Joe and Dontgiveuphope.  Thank you very much for you replies and advice, it is so appreciated.  Interesting point about stopping playing sport.  CAMHS have advised us so far that S is ok to do 2 PE sessions a week at school but nothing else; he has been banned from the gym after school and my wife and I are not doing any other physical activity with him apart from the occasional short walk (weather not so good now so that's probably a plus).  However I'm a bit dubious about him doing the PE lessons.  His weight is fluctuating just on the border of right at the bottom end of the healthy weight scale and the top end of the underweight scale for his height and age.  So far we have not questioned CAMHS about the PE but I'm not sure if we should.    The LSUYE method of eating seems to be working ok so far although we were 2 hours at the dinner table last night.  Got there in the end though and he ate his dinner 🙂

Chris  
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Foodsupport_AUS
Great that you seem to be making some headway. Keep on persisting with that LSUYE. It is a bit of a balancing act for many trying to work out activity levels. Many do need to stop for medical instability. If that is not the issue, then the next concern is can you get weight gain happening whilst still active. Some parents have found they couldn't others have allowed their child to resume exercise whilst refeeding and have been able to use maintenance of this as motivation. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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chillsey
Thank you Foodsupport_AUS for the reply 🙂.  We have been told by CAMHS that S currently sits in the low risk category for medical instability so that may be why they are allowing him to do his school PE sessions however I will keep an eye on this and if his weight drops more then I guess CAMHS may reduce the PE or stop him doing it altogether.  Thanks for all your fantastic advice, its so nice to speak with others about it, this forum is fantastic ! 🙂

Chris
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tina72
Hi,
I would at least ask cahms to tell him that he needs to eat an extra snack on these days with school sports. My d was allowed to go to her dance class quite early for social contacts and she was told that she needs to eat an extra snack at theses days and is still doing that in year 3 of recovery.
Keep feeding. There is light at the end of the tunnel.
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chillsey
Hi tina72.  Thank you very much for your reply.  That's a very good point about the extra snack, I will certainly get onto camhs about this and ensure that my son does this.  Very useful advice, thank you 🙂

Chris
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