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

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Yael826_ Show full post »
mamabear
If you feel we are criticizing the “ entire field” I will reiterate what I already posted. There ARE some GREAT dieticians out there. Some people here have had huge help from a great dietician. But they are very few and far between who actually truly understand ED. 

My beef with the ENTIRE  field is that there is zero education in their college curriculum on Eating Disorder treatment. How can a field literally be about nutrition and food and exercise and disease and yet not even have a class about eating disorders? It’s different even than a general family doctor because they have to know a little about everything and a lot about some things. And that’s why I have given talks and met with local health care providers to EDucate them. 

Thats what needs to change. There should be at least mention on FBT in all dietician training. 
Persistent, consistent vigilance!
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graceforthemoment
@debra18 I know you took your post down. You do not know what kind of Healthcare person I am. I am also a parent who knows from experience that best helped my family.  Good FBT programs do use dietitians. I am very happy my daughter had a specialised one.
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Ellesmum
We saw a dietician yesterday who I was told had great experience in ED, was the best possible choice for my girl to guide her to full recovery, did incredible work in fact  (d is doing well, eating everything but still needs nudging) I asked lots of questions before I agreed for her to meet d then sat and listened to her undo a year of exceptionally hard work.  furious doesn’t begin to cover it. 
it was rather like hearing a therapist tell an alcoholic who hasn’t had a drink for a year but admits it’s hard that a couple of beers a week would make it easier, yes it was that bad. 

My view is that while I’m sure there are fantastic dieticians who can really be valuable, services in the uk aren’t best placed to choose them as many CAMHs are simply not fit for purpose due to outdated training and time constraints due to cuts. 
Ellesmum
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debra18
My understanding of FBT is that parents know how to feed their children and therefore do not need nutritionists. The problem is getting them to eat, not what to eat. Is this different in the UK? I am not sure. 
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Ellesmum
debra18 wrote:
My understanding of FBT is that parents know how to feed their children and therefore do not need nutritionists. The problem is getting them to eat, not what to eat. Is this different in the UK? I am not sure. 


I think broadly yes that’s the idea, so we had a dietician present at our assessment to ask questions of and could give advice if required.  We were never offered one again until yesterday, the idea being she would be able to reassure d that it’s fine to eat everything she wants and needs, and just nudge her on after a couple of wobbly weeks. Unfortunately she started banging on about healthy eating, weight ranges and pulling back to make it easier on d, everything I feared and had checked in advance wouldn’t happen.  Dangerous, I lost my temper I’m afraid. 
Ellesmum
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Hendrixt
Same here ellesmum. Don’t get me wrong, I would never generalise and criticise a whole field of medical practice. I am sure there are many families who have benefited from a great dietitian and I’ve no doubt the vast majority of clinicians come to work to make a difference in the lives of their patients. 

I will only offer my experience just so that others can learn from it in case they are unlucky and get a dietician who’s methods are not going to help. 

Just make sure that if you are going to see a dietician you speak with them privately first to be fully aware of exactly what messages they are going to give to your D. 

We had been refeeding for about four weeks and getting nowhere, just about stabilising her weight loss but not gaining any weight. Then on one week she gained 1.4 kg and we were delighted. In response to this the therapist recommended that our D needed to see a dietician.  I insisted that the dietician should meet with ourselves in private before she meets with D. During the meeting the dietician expressed concern about the amount of weight gain saying that 1.4kg was too much - of course we did not accept this argument. She also said that D was almost Completely wait restored, which was just not true. She also said that D should be resuming physical exercise and doing PE at school, this really concerned us as compulsive exercise had been a big part of her ED.  She also kept talking about eating healthily and she warned that we should not be adding calories by stealth as our daughter had every right to know exactly what was in her food. 

Yes you can guess - we did not allow this dietician anywhere near our child.
 
I am not saying that all dieticians are like this, I am just saying that this professional could have caused a lot of damage to our daughters recovery had we not been careful about ascertaining what she intended to say to our D. 

 It’s up to you whether you allow your D to see any medical professional





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kazi67
As a mother you know what a “normal” meal looks like 
I managed to get weight on my d myself by plating 3 normal meals and 3 normal snacks 
With a glass of milk at each meal, of course if you d is not gaining you add more to each meal, many count calories (we never did and still don’t)
i thought  my d would benefit from seeing a dietician WRONG!!!
once we saw a dietician and she asked my d about her meals for the day, dietician then said no need for all that milk ???? wtaf!! I asked myself 
my d took “the professionals” word to gospel and ever since milk is an issue for her she refuses smoothies now which were once a great nutritious snack 
so in our experience the dietician wasn’t helpful at all 

THEN once my d relapsed and lost all her weight plus more she was so entrenched in ED it was scarey  and d though the exhaust out of cars had calories and she would inhale them so she would hold her breath when passing one😳

once she got an specialised ED dietician (by this point admitted to a specialised ED hospital) she is now again eating it has been a very long and scarey journey and we nearly lost her

please be careful who you see and go by yourself, then you can hopefully gauge their level of knowledge of ED
but be aware as others have said above the dietician may in fact say something  to make matters worse (if not ED specialised) as the patient can be so rigid in their thinking whilst sick and take things so literally 
ie: oh you don’t need all that milk = I’m never drinking milk ever again as it will make me fat 

you are her mother, you CAN do this, it’s not easy but you d at an age here you have control, ie: you shop, cook, pay the bills, etc etc 

so much harder once they are older 
still doable but omg so much harder 
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ValentinaGermania
Unless there are no medical needs like celiac disease or diabetes I think a mum knows what her child needs to eat and most of us fed their kids with great progress for years or even decades before ED moved in. If you have problems with getting enough calories in because your kid has a super metabolism YOU could see a dietitian but there is NO reason why a kid should see one. Just yesterday a mum here posted that her dietitian told her d to eat 1700 calories and maintain the low weight (she has lost 10 kg!).
The dietitian here in hospital told my d she would be healthy at a BMI of 18,5 or when her periods return. Then periods returned on BMI 17 and my d thought she was healthy now!
As long as these mass of black sheep exists in that job please be VERY careful.
Keep feeding. There is light at the end of the tunnel.
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