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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roadtorecovery
Has anyone used an online CBT program successfully with ED?  If so, can you please give me some feedback as well as the program you used.  The studies are fairly light however the results from the little bit of research out there does suggest about the same results online or in person.  I see accountability as a possible roadblock but if someone is motivated what do you think?
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Foodsupport_AUS
I am not sure which research you reviewed but certainly the bits of research I found can be summed up in this paragraph 

Our findings and conclusions are at variance with those from the two prior systematic reviews.  concluded that “the internet is a promising vehicle for delivering eating disorder treatment” (p. 551) and  stated that “internet-based interventions based upon CBT principles can be assumed to be a good alternative to face-to-face therapies for the treatment of eating disorders” (p. 15). We cannot agree. We have found that if the standards applied to the research on other treatments are applied to e-therapy, then it is impossible to describe the finding as “promising” and there is certainly no basis for saying that e-therapy is a good alternative to face-to-face treatment. Instead, we conclude that the value of e-therapy for bulimia nervosa and binge eating disorder is at present uncertain, and nothing is known about its effect as a treatment for anorexia nervosa. 

Which comes from this article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271736/

I would be very hesitant with using e therapy for AN or BN as I think one of the important roles for the therapist is to challenge the thinking styles and challenge the behaviours. Even motivated people struggle enormously and few people recover from their eating disorder without assistance. I couldn't really comment on BED through lack of exposure. 
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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roadtorecovery
What do you do if there isn't a good option anywhere close?
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tina72
Skype sessions with an FBT specialist. What about Tabitha Farrer or Eva Musby? Both do skype sessions. For YOU.
She does not need other therapy but food at the moment. CBT does not work until they are full nurished and brain recovery has started and they are back to normal and have some insight that there is a problem that they need to learn to avoid.
Keep feeding. There is light at the end of the tunnel.
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sammspiess
You need to get in contact with Tabitha I have her info, she is amazing my daughter didn’t eat for 17 days and wasn’t planning on eating I convinced her to speak to Tabitha and that night she ate pizza for the first time in three years and ever since we spoke to Tabitha she’s been eating every day🙂
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roadtorecovery
We are working on the eating.  She's gaining and doing well on that end.  There are just so many powerful voices telling her bad things right now.  Her body dysmorphia is really bad.  I was hoping to give her some tools to help fight the voices.  
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scaredmom
Some have found that the thoughts and behaviours get a lot better with more food and time. We found that here. 
your child may not yet be in a place where she can engage with CBT. 
If you could share where you are with respect of her illness ie WR or close to it. We may be able to give some ideas/information to help.
Therapy may not work if her brain is still under nourished.
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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tina72
We are working on the eating.  She's gaining and doing well on that end.  There are just so many powerful voices telling her bad things right now.  Her body dysmorphia is really bad.  I was hoping to give her some tools to help fight the voices.  


It is normal that the voice gets stronger in refeeding and with gaining and also body dysmorphia until she comes to that point when brain recovery starts. You might not be able to help her more than feed her. ED is a terrorist in her head and no tools help with terrorists. You need to eliminate them 🙂.
Keep feeding. There is light at the end of the tunnel.
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debra18
A lot of distractions and involvement in activities has helped my daughter tremendously. She learned to do this herself after some time. Playing piano, writing in a journal, writing poems, crafts, reading, etc. I make sure she has what she needs and she learned to utilize them.
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roadtorecovery
I thought she was WR or close to it however probably not because her mental state isn't good unless this is an extinction burst...who knows?  I'm so frustrated and angry at this disease and it taking my daughter's mind hostage.  It is seriously like she is possessed.  When she speaks, it is like a demon talking.  She doesn't want to recover.  She's basically told us that and we can't do anything about it.  However without prompting, she did eat a great lunch today.  I prompted a bit at breakfast to throw some fats and protein into her oatmeal.  She did do it without a fight.  I'd say she added about a half a cup of walnuts and 1/4 cup shredded coconut. Lunch was good.  Probably 1-1/2  cups of diced sweet potatoes, at least two cups of a whole grain salad (quinoa and whole wheat berries with mandarin oranges, nuts, olive oil, balsamic and honey and blueberries) and a banana and whole fat greek yoghurt.  We talked yesterday about trying to eat fat, protein and carbs in every meal to keep her blood sugar level.
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scaredmom
It is a horrid illness that is for sure! I am glad she ate well for you today.
May I ask how old she is?
For my d at age 12, at diagnosis I felt it best not to include her in any food discussions. I am sure you have heard of magic plate. 
As I am not sure the age of your d, not sure if that may be an option. Time and good weight gain are the best treatment at first.
I acknowledge how hard it is to parent these kids. I know it is nearly impossible to keep positive while being immersed or maybe a better term is submerged, with ED.

Keep strong, you are not alone. 
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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tina72
I thought she was WR or close to it however probably not because her mental state isn't good unless this is an extinction burst...who knows?  I'm so frustrated and angry at this disease and it taking my daughter's mind hostage.  It is seriously like she is possessed.  When she speaks, it is like a demon talking.  She doesn't want to recover.  She's basically told us that and we can't do anything about it.  However without prompting, she did eat a great lunch today.  I prompted a bit at breakfast to throw some fats and protein into her oatmeal.  She did do it without a fight.  I'd say she added about a half a cup of walnuts and 1/4 cup shredded coconut. Lunch was good.  Probably 1-1/2  cups of diced sweet potatoes, at least two cups of a whole grain salad (quinoa and whole wheat berries with mandarin oranges, nuts, olive oil, balsamic and honey and blueberries) and a banana and whole fat greek yoghurt.  We talked yesterday about trying to eat fat, protein and carbs in every meal to keep her blood sugar level.


Even if it is extinction burst around WR it is important to keep feeding and get over the target weight for some time x. Their metabolism normally increases and then she might need more food again. My d is still eating same amount as during weight gain just to maintain her weight now at age 19,5.

So if you can add more fat and protein without big fights keep doing it.
One question - is your d vegetarian? If yes, has she been that long before ED moved in or did it move in with ED?

"When she speaks, it is like a demon talking.  She doesn't want to recover.  She's basically told us that and we can't do anything about it."
Most of us know that "voice". We had that too. She does not need to want to recover to get better. She just needs to eat and gain and get brain recovery started. And you can do something about it, you can insist on regular meals and full nutrition and so help her brain to recover. Then, with more time and brain recovery, she will realise that she is sick and that there is a life outside besides AN that is worth to fight for.
Keep feeding. There is light at the end of the tunnel.
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roadtorecovery
She is not a vegetarian but she was last summer when the disease took hold, she eats meat now.  I try to compare things to life before ED.  We haven't eaten much meat as a family outside of dinner ever.  This is not an atypical lunch. Lunch when they were in school was a sandwich etc (sometimes with lunchmeat, sometimes with peanut butter/jelly or almond butter jelly)  and then fruit etc.  That's obviously not enough now.  So, it's a lot of time, leftovers from dinner the night before and she likes whole grain salads which I will happily make because they are very nutritionally dense.  The quinoa in particular is a complete protein which is good.  
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tina72
" I try to compare things to life before ED."

This is a very good strategy, we do it the same. We also do not eat much meat, about 2 times a week, but it is important to get rid of all these AN rules and have a great variety in food.

Try not to talk that over but simply serve more fat, protein, carbs and also sugar with every meal and snack. It does not help her to talk about it and to need to think about it. Just do it 🙂.
Here it also help to check the glycemic level of different food to keep the blood sugar level constant. Some food does push the blood sugar up quickly but let it go down again very fast. These food should be avoided and go for food that keeps her blood sugar level constant for a long time. My d for example could not eat cornflakes for breakfast. She said then she needs to think about food the whole morning. When she eats whole grain muesli she has no problems. This is different in every patient but sometimes it helps to keep a diary what was eaten and how was the mood (keep that for yourself and do not let your d make that diary) and so seek for food that causes bad mood.
Keep feeding. There is light at the end of the tunnel.
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