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.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

Need to talk with another parent? F.E.A.S.T. parents offer peer support via:

GTAMom
My 15 year old daughter is currently an in patient on a pediatric ward in a hospital, working on weight restoration.  She was admitted initially due to a low heart rate because of AN.   She is currently eating 3 meals and 3 snacks per day as required but sometimes she refuses/is unable to complete her meal and she has Ensure instead.  She's probably having a couple of Ensures per day, sometimes because she won't eat any part of her meal and sometimes because she's eating only part of it.    Her heart rate is improving and   but we've been told that she can't go home while she is still refusing some food and requiring Ensures.   Is that a standard requirement?  From everything I've read, we can't really work on her mental health until she is fully weight restored so I was expecting that she would need some supplementation for a while longer until she can spend more time working on her mental health. Obviously our goal is to have her eat all of her 3 meals and 3 snacks once she gets home but I was expecting that she may need Ensure sometimes.   I should also mention that we've been told that while she needs to gain more weight, she could go home at her current weight so once her heart rate is acceptable, the only thing that would keep her at the hospital would be her need to have Ensure to replace food once or twice per day.   Thoughts?
Quote
Enn

Welcome ! Sorry you needed to find us and hope we can help support r you.
Some programs will send home and tell the family to supplement as required. We were shown that if she did not eat all her food she had the choice to finish or have ensure. She ended up eating her food always when given a choice. We were told to have ensure as back up at home if she did not finish her meals and we did use it a few times. She hated it so she ate. My d was only 12 at the time.
i actually think it is good that they won’t let her go until she eats all meals to be honest. You can say when she gets home that she ate everything in the hospital and so she can at home too.  It may take months to get to WR  depends on her current weight and then after that  a few more months for the brain to start to heal where she can get mental health support.

Interesting that they say her weight is good but the heat rate is not. That I disagree with. The weight is NOT good if her heart rate is low. That is why her heart rate is too low because her weight is too low for HER, individually. How have they determined her WR range? Her historical growth ? Or an arbitrary population norm? 

please ask all the questions you have we all wish to help! 

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)
Quote
Foodsupport_AUS
Welcome to the forum, sorry that you have to find your way here. 

Certainly it was an expectation in the inpatient hospital program my D was in, that all meals and snacks were being completed with food prior to discharge. I also think that is a good idea. I am not sure how long that would continue if all other parameters were met for medical stability. Beds are very tight as they are in many places. i think the biggest concern would be that if she was using supplements in hospital and was to be discharged home the likelihood of readmission is likely to be higher as it indicates she may struggle even more to complete her intake at home. 
One thing that my D found easier in hospital was that she truly had no choice, if she could not complete meals she was given a supplement and if that was not completed a NG tube was used. At home there was no NG tube, if she couldn't complete meals she never took a supplement either. The hospital for its own reasons would not offer back up with a NG tube, so we ended up cycling in and out. 
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.
Quote
GTAMom
Thanks for the feedback.  Her goal weight is based on her growth charts from her pediatrician, she is still a few kg from her goal weight.   Her heart rate has improved a lot at night -- it was 39 when she was admitted and is in the 50s and above now, but there is still too big of a difference between her lying down and standing heart rate.   This all started during COVID, she lost the weight very quickly.  She is a competitive athlete and was very fit and strong before she lost the weight.  We went from discovering she had an eating to disorder to hospitalization within two weeks.  She's been there for over 3 weeks now.  Right now she has to eat everything and if she doesn't she has ensure.  If she won't eat the ensure, she has to take it through an NG tube.  She had the tube once and hasn't repeated it but sometimes she can't get through her meals.  Yesterday at dinner she told me that she was trying to eat everything because she wants to go home but that the amount of food was very overwhelming for her. She actually ate the most difficult part of the meal but couldn't/wouldn't finish it.  She wants to be physically in school when it starts up in September (our province just announced that high school students will be physically in school 50% of the time) so I'm hoping that will help motivate her to eat when she gets home. 

Enn, where in Canada are you?
Quote
Enn
I am in Ontario. One hour west  of Toronto.😊
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)
Quote
GTAMom
Have you heard good things about the outpatient program at North York General?  We are at a different hospital now but I think we will be connected with NYGH when we are released.  
Quote
Enn

Yes I have. I have worked with a therapist (research project)that moved from NYGH to my city. She had good things to say about them and she herself really understood ED and my perspective very well as a mother with a child with ED. She also promoted FEAST! 

I do hope that they are a good fit for you and your child.

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)
Quote
GTAMom
Thank you!
Quote
Enn
Hi there thought this might be helpful for when she comes home:

Helpful Re-Feeding Tips From fellow - shared with author’s permission.

 

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 re-feeding 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!

21. Learn from others. I found stories of other parents journey through recovery to be extremely helpful.

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.

26. Make sure all weighing scales are removed from the house.

27. Lean on us - you have 24/7 support here as We are International .

28. In some cases FBT isn't an option, generally if there are co-morbid’s such as ASD and BPD (Borderline Personality Disorder) . It may just be that FBT needs to be tweaked, or that a different approach is needed. There are many here who have found ways to

work around those co-morbids.

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)
Quote
Enn
I have posted the above for you and anyone else to get some ideas.
This may not be for everyone at all. One thing I learned was that EVERYONE, each family and child, has to find what works for them. If it were so simple as to follow A-->B --> C etc, well then it would be fixed in a heart beat. Sigh, it is not the way it goes. It takes trial ,and not error, but learning what the ED in your home needs and what YOU need to do/figure out as you move through. 
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)
Quote
GTAMom
Thanks.  
Quote

        

WTadmin