Originally Posted by toothfairy
I am so sorry to read all this.
Yes you are right to be worried, his BMI is only 15.6 .
He needs to be re-fed and we will try and help you with that.
Here are some tips another parent shared , I hope you find them helpful.
1. You prepare meals
2. Do not allow your child in the kitchen during meal prep
3. Your child should not go grocery shopping.
4. Toilet before meal and no toilet for at least an hour afterwards.
5. If purging is suspected, use an open door policy in the bathroom, or have them count or sing whilst in there. And no flushing
6. Do not negotiate - whatever you serve has to be eaten
7. Use whatever leverage you have - phone, Internet, tv - whatever they hold dear is to be removed if they refuse to eat, until they have eaten. If they're older and are not financially independent, this is your leverage
8. Separate the two - Your child is not the ED
9. Detach yourself from the situation during meals. Do not get drawn into emotional discussions. THIS IS NOT UP FOR NEGOTIATION
10. Remember that your child wants to recover - the ED is stopping them
11. Your child needs your permission to eat. They need you to stand up to ED as they do not have the strength to do so themselves
12. 3 meals and 3 snacks per day (supervised) - do not deviate from this. Add time limits to the meals (as a guide/goal!). Ours (and the hospitals) was 30 mins for meals and 15 mins for snacks. In the early days this could extend A LOT. I made my Ds meal times the same as they'd be at school so that when she transitioned back to full time it would be easier and less anxiety provoking.
13. High calories are needed throughout refeeding with lots of full fat dairy. Some need as much as 6,000 cals with hyper metabolism, but the norm would be minimum 3500-4000 cals (for you to track not your child)
14. When they know you will not negotiate, I promise you will see the weight lifted from their shoulders... If only for very short periods
15. BE THE CAGE that keeps ED away from your child
16. When food is eaten be mum / dad again and have cuddles if they'll let you
17. 24/7 supervision - I slept with my D for 4 months - this will protect against them purging through vomiting or exercise. Many patients will exercise alone at night for hours on end when nobody else is awake.
18. All sport may need to stop in the early stages, and
for those who compulsively exercised this could be long term.
19. Be consistent, consistent consistent!
20. Don't congratulate them after a meal or say 'well done' - just cheer inwardly! Likewise when (for girls) their period returns!
22. Recommended reading: 'Brave Girl Eating' by Harriet Brown
23. Be prepared for resistance, and lots of it! You will find your own way to manage this, but NEVER back down. Any compromise is a win for ED. Remember, you have to see the beast to slay beast!
24. Making decisions / choices is extremely difficult for them (painful to watch). This is true in areas outside of food too. If you've tried to hand over some control of a meal or snack and notice that they are struggling, that is an indication that it is too soon and that you need to be making those decisions for them.
25. Sometimes distraction helps during meal times. That can come in the form of games,TV, music. Whatever it is you control it and it only continues with eating.
Hope this helps! Best of luck!