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

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BxMom

I wanted to pick your collective brain.

My 14 yo D was diagnosed  5 months ago with restrictive AN.  She did not have any medical issues related to her weight loss and never lost her period.  We have been in FBT since her diagnosis with a psychologist and occasional visits with an adolescent specialist.  She has been weight restored for 2 ½ months and is back to school.  She eats lunch on her own.  Admits to not eating lunch every day.  Other meals, she eats with supervision.  She probably skips 1 meal per week and needs 2 ensures to replace unfinished meals per week.  Her behavior continues to be difficult-eats dinner with us but is on her phone the entire time. Barely speaks to me or her dad. And when she does it is nasty. Often up at 1am talking to her friends on the phone.  She’s been posting videos on tiktok which are more suggestive than I would like.  In our last session, her therapist suggested that part of the reason her behavior continues to be difficult is because we as parents aren’t setting firm consequences.  It feels very not FBT. Curious to hear your thoughts.  My sincere gratitude to all of you.    

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mid73
I’m not sure I’ve got any advice other than to say my daughter has broadly been the same throughout our 3 years and counting Anorexia experience.  I don’t think our daughter ever really got to the “ right weight” for her although until recently she had maintained 100% weight for height on the charts. 

I would say though , it’s still very early days post WR and ED thoughts are obviously still very much there. If you can I would say those school lunches need to be supervised for a long time to come. Try not to take the behaviour too personally. There will be teenage stuff going on too! What a difficult minefield. 
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greekdude
IMHO Take her phone away. Sleeping late is a classic for missing breakfast the next day and also a cause of more unneeded fatigue and anxiety. One of the things they did in the hospital was to cut him (S) off from the internet. I wish all parents might get the strength to do the same, at least for certain periods/day.
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MKR
Well done on weight restoration!! And for over 2 months and counting! 👍👍

I still think your family deserves manners, like joining the conversation at the table (I know it's hard to come up with something interesting and engaging every time) and having house rules, like phones off at 8pm (blue light disrupts our sleep for some time afterwards).

Once our child was weight restored, we were given a contract to write for her. We used the University of California San Diego sample. I have attached it to another post on this forum, let me know if you can't find it.

Neither our expectations nor the rewards nor the consequences were outrageous, just back to normality.  Normal weight, normal manners, for consequence we used increased supervision. You should design your own. We found the structure really helpful at times, when we lost our bearings after a battle. 

Severe weight loss is a kind of brain injury so it takes at least a year to recover from the trauma. 

All the best!

Z ❤❤
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Enn
Hi and welcome!
BxMom wrote:

I wanted to pick your collective brain.

My 14 yo D was diagnosed  5 months ago with restrictive AN.  She did not have any medical issues related to her weight loss and never lost her period.  We have been in FBT since her diagnosis with a psychologist and occasional visits with an adolescent specialist.  She has been weight restored for 2 ½ months and is back to school.  


Good for you for getting this far! That is the hardest part of this!
You are still very early into this and it takes MONTHS at least 4 months to see her brain to start to improve. 

BxMom wrote:

She eats lunch on her own.  Admits to not eating lunch every day.  Other meals, she eats with supervision.  She probably skips 1 meal per week and needs 2 ensures to replace unfinished meals per week.  Her behavior continues to be difficult-eats dinner with us but is on her phone the entire time. Barely speaks to me or her dad. And when she does it is nasty. Often up at 1am talking to her friends on the phone.  She’s been posting videos on tiktok which are more suggestive than I would like.  In our last session, her therapist suggested that part of the reason her behavior continues to be difficult is because we as parents aren’t setting firm consequences.  It feels very not FBT. Curious to hear your thoughts.  My sincere gratitude to all of you.    



She may need more weight and "wait" (time) for the brain changes. She is missing lunch at times and may need more supervision at lunch. How do you know she is missing only one meal per week? Could it possibly be more? I think the missing of ANY Meals has to stop pronto! How do you think. you can do that? Is the school able to provide proper supervision? Do you need to be there  or take her home?
The sooner you act, it will be better. The longer you wait, the harder it is. 
And I do agree with Greekdude, it is time to set limits on her phone. That part may not be ED but regular teenage behaviour. Don't let ED allow them to be treated any differently than if she did not have ED. Normal parental rules still apply.

Please ask all the questions you have. We all do wish to help. 
Parenting is hard enough and throw ED into the mix and BAM! It is harder still.
Sending my 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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ValentinaGermania
BxMom wrote:

I wanted to pick your collective brain.

My 14 yo D was diagnosed  5 months ago with restrictive AN.  She did not have any medical issues related to her weight loss and never lost her period.  We have been in FBT since her diagnosis with a psychologist and occasional visits with an adolescent specialist.  She has been weight restored for 2 ½ months and is back to school.  She eats lunch on her own.  Admits to not eating lunch every day.  Other meals, she eats with supervision.  She probably skips 1 meal per week and needs 2 ensures to replace unfinished meals per week.  Her behavior continues to be difficult-eats dinner with us but is on her phone the entire time. Barely speaks to me or her dad. And when she does it is nasty. Often up at 1am talking to her friends on the phone.  She’s been posting videos on tiktok which are more suggestive than I would like.  In our last session, her therapist suggested that part of the reason her behavior continues to be difficult is because we as parents aren’t setting firm consequences.  It feels very not FBT. Curious to hear your thoughts.  My sincere gratitude to all of you.    



You are still early days and I would like to bet she is not on a good weight up to now to get brain recovery started. A lot of ED behaviour there. Close the loopholes with lunch in school, that is really important. Supervise lunch there or take her home for lunch. Skipping one meal means to open the door wide for ED coming in. Keeping her blood sugar level constant and let her feel no hunger in between meals keeps the ED voice low.

No phone in the bedroom at nights. She is 14 and needs her sleep. No phoning up friends at 1 a.m.!!!
If she posts videos that are problematic on tiktok you need to control and stop that. She is 14 - again! You are in charge for what she is doiing in the internet and should control that.

"In our last session, her therapist suggested that part of the reason her behavior continues to be difficult is because we as parents aren’t setting firm consequences.  It feels very not FBT."

Parents being in charge and set boundaries and consequences IS FBT. You must decide wether those therapists are right that you need to be more firm or not. We can help you brainstorming ideas how to set boundaries and consequences if you like.

It is like a drug addition. You would take away the heroin materials if she would be doing that - for sure.
AN is a life threatening disease. You are the parents. You are in charge. You need to help her to stop that.
Keep feeding. There is light at the end of the tunnel.
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Mamaroo
Welcome from me as well, and sorry you need to be here. Like the others have said, brain recovery only starts from 6 - 12 months after WR. My d was still mentally as sick as she was 6 months after WR than at before WR. Only after 6 months did she become more her old self and d more affectionate. 

My other non ED d becomes a very grumpy person is she doesn't get enough sleep, so I have to ensure she gets into bed early and ban all screen times after 8pm. We have a parental internet control device which you can set to internet time on and off and restrict social media sites,  works great (I don't want to sound like an advertisement , but we used Circle with Disney until it became incompatible with our new router and then switched to KoalaSafe dome). Worth every penny! Children flourish with strict and consistent boundaries, yes, they'll be unhappy at first, but they'll be happier in the long run.
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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ValentinaGermania
I just checked that tiktok thing, I do not know how it is in your country but here that is allowed from 13 years old WITH THE ALLOWANCE OF THE PARENTS. So if she uses that a wrong way you simply need to stop your allowance...
Keep feeding. There is light at the end of the tunnel.
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ValentinaGermania
Ronson wrote:

I found I almost became scared to parent for a bit - in case she didn’t eat - but ultimately, whilst allowances needed to be made for her illness she still needed boundaries like any other teenager.   I stopped being scared she wouldn’t eat (or pretended I was) and asked for a basic level of respect. 



It is really hard to set boundaries first, Ronson, I totally agree with that, because you fear they will refuse to eat totally then. But in fact in many cases (my hands up) they are not eating enough anyway in this state so we should not let them blackmail us.
And I agree totally, we should ask for a basic level of respect.
Keep feeding. There is light at the end of the tunnel.
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Torie
It may be useful to focus on one problem behavior at a time.  First on my list would be lunch supervision.  One way or other, that meal should be supervised.  Sometimes the school can do the at.  Other times you can join her in a special room or she can come outside and eat in the car.  It can be a tough nut to sort this one out.

She is probably pretty miserable with all the ED battles.  Can you plan a special treat to look forward to - a day trip or weekend or something?   Or a favorite relative can visit?  That might help in working up a plan for improved behavior.

I wonder what would happen if one of her friends joined you for dinner.  Likely she would not be rude with a witness.  Part of the challenge is interrupting the habit.

Please keep us posted. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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BxMom
This really resonates...the idea that we have become scared to parent.  D has maintained weight (a few pounds above the target) with independent lunch for the past few months.  So, she gets to keep lunch. We are going to work on putting the phone away during meals.  I think we forgot how screwed up everything is in our house.  One thing at a time.  Thank you all...
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ValentinaGermania
BxMom wrote:
the idea that we have become scared to parent


This is really hard. You do not dare to say x or y or insist on anything because you are afraid that they will stop to eat then. Imagine all that was need to do with a 17 year old - take away phone and freedom and lock doors in the car or at home. Horrible but necessary to keep her safe. And only an episode. After WR it was not needed any more. We could take all guards and boundaries down slowly and now only have a relapse safety net on place.
Try to remember that you are in charge and you decide and you do not need to let you blackmail by ED. You can help her with that. ED hates rules and boundaries...
Keep feeding. There is light at the end of the tunnel.
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BxMom
I am adapting the UCSD contract for my D.  While the behavior outlined seems reasonable, it is far from what is happening in our house.  Any thoughts on graded implementation?  Grateful for your assistance
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sandie
Perhaps you need to decide what the priority is  for you to tackle. You can move onto the next priority once first is sorted. 
For example, we had horrific behaviour of all sorts but the first priority we agreed was to tackle violence against me. My husband wanted the door slamming to stop at same time but we agreed to focus on one thing at a time. And this worked. 
It is whatever is the biggest issue for you at the time. 
You could amend the contract every few weeks. Xx
Courage is not the absence of despair; it is rather the capacity to move ahead in spite of despair
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sandie
Using phone at table would not be my top priority to tackle here although I am starting to address it now. My D needed the distraction and still after a year often needs tv during dinner if ED strong. 
Courage is not the absence of despair; it is rather the capacity to move ahead in spite of despair
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BxMom
Very helpful advice.  Thank you....
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Torie
I don't know about everyone else, but I know I kicked myself a few times for making what sounded like promises that had to be walked back later.  For example I (eventually) learned to say "If you do a, b and c for x length of time, I HOPE you will then be well enough to do d, e, and f.  Of course, many of the contract items really are clear cut and do not merit this caveat, but I wish I had been more careful to hedge the "promises" I wasn't 100% sure of.  I hope that makes sense. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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BxMom
It does make sense...so hard with the concrete thinking of ED to be transactional
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