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

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mulberry
Hello, our daughter is 12, and diagnosed on 14th Dec with anorexia.  Weight for height (or whatever it's called) is 81, and it has been ongoing for about 3/4 months, took a nosedive once we had visited the GP.

At the appraisal session, (NHS ED clinic following FBT) we were sent away with instructions to feed 3 meals, 3 snacks and a pint of milk per day.  We are failing so far to do this.  Best was probably yesterday when we managed 2 snacks (small creamy milkshake and a biscuit) about 20% of lunch and 80% of dinner.  Everything else refused, screaming, shouting hitting.  

She is very anxious around food, very anxious sitting with the whole family (4 of us, mum, dad big brother aged 17) and so she is sitting with me (mum) just now, but it means it's all hanging on me, and I am not managing to get her to eat once she has really dug her heels in.  Sometimes, she does better, but it all depends on her frame of mind before the meal.

What I want to know is why the ED clinic send us away telling us to do this with not a word that it was going to be next to impossible.  Is this anyone else's experience?  We are feeling so disheartened that it was a "simple" instruction, but we were given no advice or support or strategies at all.  Just told that our daughter would try to negotiate and we must be firm.  Do you think this will be improved on at the next meeting? (our first with the named counsellor).

Well, I am feeling that I must the crappest parent alive as we are not managing to stick to 3 meals and 3 snacks a day, maybe half that.  I don't know how to get her to eat.  And, yes, we are reading Eva Musby.

Anyone able to advise?



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rose08
Dear Mulberry
No, you are not the crappiest parent alive, you are probably all of us when we first started out!  First off, well done on even getting to where you are now, finding out the info you need to know and heading off into the unknown... as much as it feels like uncharted territory, and some of it is, a lot of it is "normal" eating disorder behavior. 
My daughter is 12 and we are 8 months into this process, her diagnosis was restrictive anorexia and it felt like we were transported into some kind of B rate horror movie.  Our beautiful, funny, super intelligent daughter turned became this sullen, grey waif with vicious outbursts when faced with food.  We were in shock.  It takes superhuman parenting and then some.  My humble advice, read and learn as much as you can (Eva's book is a great), this forum has a wealth of information, ask lots of questions, there is always someone there to give advice or even just to understand what to most is inconceivable.   

Anyway, concrete advice when starting out and what helped us:
Find what works for you, if this means scrapping the meal plan, do it. 
Start with a small "footprint" that packs the most calories, Ie Smoothies with double cream, full fat yogert, nuts, bananas etc
Separate the illness from your daughter, be really firm with the Anorexia but compassionate with her - easier said than done, but I do believe it is sheer hell that our children go through.
Keep coming back for more.  This is tough, especially if you have had a meal thrown back at you, or horrible insults thrown at you.  Its the anorexia, not your daughter. 
Take a break, I know as the mom this can be virtually impossible, but if you feel like you are about to loose control - get dad or big brother to tap in, sometimes a change of face can actually help.
Nutrition is key, each mouthful is small victory and it can and will get easier, but it does get worse before it gets better. Keep at it, and keep coming back for more - you can do this! 

If it helps at all, my D tried to climb our 6 foot property gate to "escape" her food, tried to get out of a moving car as she knew I had bought one of her fear foods, shredded up countless meals, told me she hated me about 1048 times (you get the idea) and made me rethink everything I thought I knew about parenting and my sanity.  3 meals, 3 snacks and 2 smoothies a day literally saved her life and caused every gray hair on my head but we have her back, not completely recovered yet, but enough that she can enjoy outings and have her friends over (she went on her first sleepover since this began!), and family dinners are actually enjoyable again and there is much greater flexibility in her thinking  She still sees our GP weekly for blind weigh-ins as well as  her therapist who is working on body image issues and helping to normalize her relationship to food.  There is hope - much love from South Africa, Rose xx


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Foodsupport_AUS
Welcome to the forum. You are doing really well. Even better you have found us here. Yes, what you are experiencing is entirely normal, including your experience and feelings about FBT. There is no one way to get that food into your daughter, but it does need to go in. It may not feel it, but the idea is that this is empowering you as you really do know what needs to happen. The only thing is, at the moment you don't know how. 

If you haven't yet, read through the Hall of Fame for ideas on getting started, as well as looking at the FEAST learning center and the booklets for some ideas. I would also suggest watching Eva Musby's video  which is really helpful to get the idea as well. 

The screaming, tantrums and fear are all normal, further it means you are on the right path.

try these too
http://ceed.org.au/sites/default/files/resources/documents/FamilyLedRefeedingRecoveryResourcePartA_Nov_2017.pdf
http://ceed.org.au/sites/default/files/resources/documents/FamilyLedRefeedingRecoveryResourcePartB_Nov_2017..pdf

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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seaglass
I remember feeling that bewilderment and frustration and shock at being told to feed my daughter 3 meals and 3 snacks a day and sent home with no advice or help at all. It's like madness isn't it? I remember feeling totally shell shocked and fragile and unsure.

It's hard. It's so so hard.

Make each meal or snack as low key as you can. It might help to eat together in front of the TV, it might help to plan an activity (jigsaw etc) right after ... Each of us had to find our own way through. The hardest thing is the resistance and fear (and anger/tears/running) from each meal. Your job is to require her to eat. Every bite counts. Some meals will be easier than others. Are drinks easier? If so then smoothies and soups will be your friend. Are there any easier meals/snacks that she can handle now while she is fighting her toughest fight at the start of refeeding? Have you heard of Ensure/Fortisip? Meal replacement drinks that you could require get to drink if she won't eat a meal. Worth a try.

You'll get tons of support and advice here. Keep posting and for every issue you face there will be ideas to try and suppport.

As for you. It's so tough. You CAN do it but you also need to find bits of time to cry/breathe/reset your batteries. Even if it's just a short walk when she's snuggled safely with a family member or friend. It's hard when you're so frightened and shocked to make time for you. But try as you need it.

I used to use BEAT and ABC phone helplines a lot in the first weeks and months. Just to talk through each meal, each thing that I was struggling with and just to talk. It really helped me.

Read Eva Musby's book. It's fab. Full of practical strategies and things to try. And full of understanding.

Take one meal at a time. If one is a nightmare dust yourself down and the next might be better. If you need more help from
CAHMS ask for it. If you need support and help here post anytime. Night pr day there will probably be someone to reply.

Be kind to yourself. It's hero parenting. It's hard. And it's so hard for our children too.

Let us know how you're getting on. I know each day lasts a lifetime. Take as much care of yourself as you can xx
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seaglass
Sorry - meant to say if you've been given a specific meal plan - I found it easier to
Just go for 3 meals and snacks, an idea of how much I wanted my d to eat per day and then kind of ripped up the meal plan and just fed her. I went with not really minding how the calories went in. So my d eats much better at teatime and so it was easier to pack more calories in then. She struggled with mid morning snack but could manage a drink at nbreakfast with equivalent calories. So maybe you'll find a way that works where you find your own plan?

Hot water bottles after meals helped as did crafts and TVs. And lots of hugs and baths.

Also add rapeseed oil to whatever you can to boost calories and cream. So if she'll drink a small hot choc boost it with cream and oil so a small cup counts more.

Don't feel like you're crap. You're amazing. It's the most bewildering and scary thing and you're doing it.
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Mamaroo
Hi Mulberry, it takes time to get onto a mealplan or just getting all the calories in. I've attached our weekly mealplan. I would print this out and place it on the fridge. It is fairly monotonous, but it lessened the anxiety. Note the times of the meals. My d could eat better if all the meals and snacks were given at the same time every day. She would not follow this plan initially, but every day ate more and more until after 7 weeks she could follow it. She lost weight the first couple of weeks, then stabilised and eventually started to gain weight. I used incentives to get her to eat. She could play on the ipad after each meal and if she completed the mealplan for the day I would giver her some money, which she used towards ipad games.

Best of luck!! Click image for larger version - Name: mealplan weekly.jpg, Views: 62, Size: 173.39 KB
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
Hi and welcome!
First: you managed 2 meals and 2 snacks yesterday. She might not eat enough at that point, but getting anything in to her is a good job!
"Everything else refused, screaming, shouting hitting"
That is quite normal ED behaviour and it will get less if she eats enough. So you have to stand that now and try to stay compassionate and firm. Safety first, so hide scissors and knifes and everything she could use to hurt you or herself. Take away the keys from doors so she cannot shut herself in. Be sure that she cannot get out of the windows or run away.
It is hard to say all that but that is all normal. They are so afraid about food that they would do ANYTHING for no eating.
Try to feed her separatly as you did and if she refuses to eat with you it would be great if someone could take over (hubby, brother, family, friends???).

"What I want to know is why the ED clinic send us away telling us to do this with not a word that it was going to be next to impossible.  Is this anyone else's experience?"
Yes, nearly everone here experienced that. FBT wants you to find out yourself how to refeed her because then you will be able to find it out everytime you will need it in future. That gives you some power when you see that it works but in the beginning you feel very lonesome, so if that is the case come here and vent and ask for help.
You are not alone and we are all here to help you and we know how you feel at that moment.
You got already great advice and reading Eva Musbys book is helping a lot, you will see. I learned all the good working sentences from her. She has made some great videos, too.

And no, you are not the crappest parents alive or we are all [smile].
No one without ED in the house can imagine how difficult refeeding is. It is a war, and it is a marathon.
You will need a lot of power for a long run so try to get some distraction and care for yourself. Get family and friends into the boat if possible.

A warm welcome from Germany,
Tina72
Keep feeding. There is light at the end of the tunnel.
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EC_Mom
. I spoon fed my d in her bed because she refused to leave it, climbing back and forth over her as she kept rolling away. You need to as much as possible reduce what obstacles there are to eating, as you discovered that eating with everyone else is too hard.

Also very short term leverage is important: “as soon as you’re done with lunch we will go see aunt jane’s new puppy!” Or “now that you started eating, here is your phone back, maybe you can find out who asked who to the dance next week”. We found it important not to be punitive about taking things away but instead framed it positively around what would happen once she ate.
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Torie

Hi Mulberry, so sorry you needed to join us here.  It's really the best place, though, for information and support to help make your way through this hellish journey.

Although it is maddening (and scary) that no one can give us a roadmap for our family, it's true that we each have to find our own way.  One of the few "good things" about this vile illness is that we do know what needs to happen - food is your d's medicine, and she needs enough of it to get back to a healthy weight, meaning, whatever weight is healthy for HER.  Getting her there, though, is the hardest thing you will ever do.  And however hard it is for you, it is much, much harder for her.  Ugh.

Hard as it may be to believe, many here (raises hand) have initially found "professional help" that was much worse than you are describing.  It is great (!!!) that your team expects you to refeed your d.  I'm among the many who were told not to.  (Unbelievable, I know, but true.)  So please try to have an open mind about them.

It's whatever works.  In the Torie Family, that included a lot of bribery, what felt like superhuman patience, and watching like a hawk for years.  "As soon as you have finished your breakfast, you can go to school (or watch that show, or phone a friend, or whatever is motivating at the moment)."  I think we all have found hidden food at some point, in spite of feeling like we are supervising closely  - it's like this illness turns them into magicians at disappearing food in the blink of an eye.

Another thing that helped us was to say, "Here's your meal; you need to eat this," and when her reply was that she couldn't, I would tell her that my job was to help her eat, and if I couldn't do a good enough job of that, I would need to take her where the experts could do a better job helping her.  I wonder if it would help for you to say something similar, but end with, "or we will need to let your dad be the one who help you with this meal."

At times, spoon feeding her like a baby helped.  (Yes, she was a teenager.)

Separating my d from the illness helped.  By that, I mean keeping in mind that my d wasn't acting like this as a choice or because of a character defect - she was being impossible because her brain had been hijacked by an illness that was trying to kill her.

So here is my advice:

Watch her like a hawk.  If she has the opportunity to slip bites into her pocket, up her sleeve, to the dog ... she will.
Keep her with you for at least an hour after every meal.  The LAST thing you want is for her to start purging.  (Before the meal starts, ask her to use the restroom so she will be able to stay with you after.)
Remember that however hard this is for you, it is a hundredfold worse for your d.
Come here often to ask questions or just to vent.  We've all been there.
Watch this video by forum member Eva Musby - it was a huge help to me:



Hang in there, and please be sure to keep us posted.  xx

-Torie

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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mid73
You are doing ok. She’s eating more than she was. It’s horrible and it’s difficult. It took my daughter weeks before she’d eat snacks. I did find letting her watch t v whilst she ate useful. Try not to be put off by her reactions. They mean you are really getting to the anorexia! Stand firm and keep going. Don’t be afraid to ask to speak to your team between appointments if you want advice it’s often better to talk to them without sufferer present in my experience !
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HopeNZ
Hi Mulberry

I'm so sorry you've had to join us here, but you're in the best place for support.  You've already had great reassurance and advice from the wise folk above.  We're about nine months down the track from my 14 year old d's diagnosis of restrictive AN and, while we have a long way to go, I too can promise you things do get better.

A couple of things that helped us in those really early days of refeeding:
* We found having the whole family present at meals helped.  I could not have done it on my own, meal after meal, day in and day out.  When things got awful, we encouraged my d's little brother to leave the table to minimise the impact on him.
* We revived all sorts of family games and played them at every meal.  Dominoes, pick up sticks, chequers, backgammon, card-games.  The more fast-paced the better.  Now that we no longer need them as tools to distract my d from the terror of eating, both my d and her brother still ask to be able to play at the table sometimes.
* I put away our nice dinner service.  I wish I had done it sooner.  It took a few smashed plates for me to overcome my disbelief that this was really happening.  Seeing cheap plates hurled to the floor made those inevitable scenes slightly less painful!
* In preparation for each meal, I made a hot wheat bag for my d to help with stomach pain.  Not having to get up to get one for her half way through the meal meant one less disruption and showed ED we meant business.  On bad days as well as the hot wheat bag we also gave her ice to rub on her skin as another sensory distraction.
* From the beginning, on advice, we insisted every last mouthful was eaten.  We didn't always succeed, but we really did find that "ED lives in the last mouthful".  The worst scenes were always about that final mouthful of food on the plate, or gulp of smoothie or fruit juice.  Setting this expectation from the beginning meant one less thing ED tried those desperate negotiations about.  Another version of this advice I've heard is aiming for one more mouthful than ED wants your d to eat.  It's about showing ED who's boss.
* Another fabulous saying we picked up on this forum was "If you're getting flak, you're over the target". 
* I recommend Maria Ganci's "Survive FBT".  It's a short, easy to read summary of the whys and hows of FBT, and a great way to get yourself, your hubby and any helpers up to speed on FBT.

Hang in there, things WILL get better.
x
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