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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Our 13yo daughter was diagnosed with atypical AN a few weeks ago.  I had been reaching out for help since Feb as it was evident that she was losing weight and restricting food choices.  From my own reading I had identified that she fit a lot of what I was reading about Orthorexia.  She is obsessed with “healthy” eating but has never seemingly shown an interest in weight loss or any body concerns. After trying to support her through lockdown, we reached out to her school who told us about the CAMHS Eating Disorder Service and told us to ask our GP to refer. Wish I had known earlier that we could self refer.  We went to our first CAMHS appointment and didn’t come home for 3 days as she had Bradycardia and was hospitalised for 3 days to monitor her heart. We are now doing FBT at home under CAMHS. 

We have implemented meal plans and she is eating 3 meals and snacks and gaining weight (6 lbs since she was diagnosed). What we are struggling with is that she only wants very plain food and is very resistant to any fat apart from avocado. I was adding butter, cream and oil to things but she found out and we had a very distressing for all meltdown where she screamed like a wounded animal for 2 hours, while punching herself in the stomach. Now I am finding it hard to plan meals. I know that if I plan something plain - dry pasta, veg and chicken or salmon - she will eat it. If she thinks something has ‘hidden’ fats then she refuses to eat. She does eat avocado and a cauliflower soup recipe which she knows has cheese in,  but is resistant to any other cheese, oil, butter etc. Is it just early days and should I just give her what I know she will eat to get the weight on? 

She is generally compliant with her meal plan but her mood is low and she is constantly anxious and depressed and I just don’t know how best to help her. CAMHS are very supportive and keep telling me I am doing all the right things but I can’t help but feel that I am missing something. 

Welcome to the forum. Sorry that you have had to find your way here. 

It sounds like you are doing all the right things. Firstly you have got help for your daughter as needed, secondly when home you are getting her to complete meals and snacks and she is starting to gain weight. Right now these are the most important things to be working on. 

Your daughters fear of "unhealthy" fats and certain foods is normal and expected. Her reaction is also normal and expected. How you deal with this is up to you, you know your child best. At some point she is going to need to eat all these foods, but right now getting her brain to heal and regaining the lost weight is the most important thing. Learning how to deal with your child's distress is an essential coping tool for this illness. It will happen no matter what. Her tolerance for distress and yours will vary from day to day. Ultimately you don't get over a fear without facing it but whether you do this in tiny steps or do it all at once is a very individual decision. https://www.feast-ed.org/distress-tolerance-is-a-parental-superpower-not-a-lack-of-caring/
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.
Hello and welcome from a mum of another "healthy" eater that fell into a rabbit hole.
Some children are predisposed to eating disorders and we only find out when there is a trigger, such as trying to eat "healthy". Your instinct was right, you spotted the problem early!
I think it's great you have found a way to get your child's weight back up, and are bringing her out of danger. Keep the momentum as much as you can, though tantrums and meltdowns will come and go. In fact, if there is a reaction from the ED, you know you hit the right spot. 
Fats are the fear food for your daughter, for others it's sugar or fast food (mine still tries to "drain" the sauce from the vegetables, so I know we are not out of the woods yet). You have a choice to tackle them later and prioritise weight gain at the moment - or insist all is eaten from the start. I agree that weight gain is more important at this stage, especially since your daughter had to remain in hospital for 3 days.
In the meantime, you can try to sneak oil into some dishes. I learnt on this forum that aubergine can soak up so much oil, which was my d's favourite. From there, I got creative. 

For ideas, here are some popular threads from this forum:
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
Well done so far. Establishing the 3 meals and 3 snacks and her eating and gaining are really  positives points. 
How you get the weight on right now really does not matter. As she gets used to the way things are going you can start adding those fear foods. It really is up to you. For us, at the beginning here, everything was a fear food. Knowing there will be a melt down and learning how to just watch it happen with less emotion really is what I learned to do. I know it is awful and we want to save them from the upset. The link that Foodsupport_AUS has posted is amazing.  
It took me awhile to realize that they have to go through that part to understand that food will not really hurt them. I know it can be agonizing to watch them suffer, but when you think about it, it is so irrational to be fearful of food. We are desensitizing them over time 6 times per day. It does get better. 
How are you holding up?  It is so early. I saw real changes at about 2-3 months in, where I could breathe a bit. 
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)

Thanks so much guys. It really helps to hear the experience and tips of others. I will read the forum with interest. 



I have a supply of coconut oil and avocado oil hidden away that I regularly add to soups and sauces that I make while my d is asleep. If I make pancakes or crepes, the batter is mixed up late at night with lots of oil and cream and then it just comes out of the fridge "ready made" when we are ready to cook it. I do the same with home made protein balls - lots of coconut butter, nuts and dates, but I keep them small so she doesn't feel overwhelmed by them. 
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.
We did the rip the bandaid approach, and fortified meals with canola oils, coconut milk, WHC, etc. She was 13 at the time, she was definitively orthorexic (no junk food, no meat, no sugar). Read read read on the forum and Eva musby's book for strategies. It is a long road but the sooner you get the weight back (we overshooted a bit to have a cushion) the sooner thing will get better (after getting ugly first!).
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