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

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kangamum
Hi, I haven't been on the forum for quite a while as d, now 17, has been in strong recovery. Until last week. I had noticed over the past 4-6 weeks that she wasn't always finishing her breakfast, and some school lunches came home barely touched. However, she would often hit the fridge after dinner, and make herself a large snack so I thought that perhaps it was her appetite returning to 'normal' after many months of feast eating.

Last week she rang her brother's gf and told her she was struggling with eating again. When we talked about it with her she told us she had had suicidal thoughts, had self-harmed and was in a bad way. This followed the trajectory of her previous ED bout. We made the house safe, but she remained in a very low mood. After telling me she couldn't guarantee her safety I took her to the ER. There was no chance she would be admitted due to lack of beds (I did not want this anyway), she slowly brightened up and by the next day said she felt great. Her mood has been excellent since then with no more thoughts of self-harm. Fast turnaround.

Meal-wise she has much more insight than last time, says she no longer has any negative thoughts while eating, but is experiencing the same gagging feeling when eating certain "difficult' foods. Prefers "easy" foods such as porridge and yoghurt. I have told her that is ED driven, and the accepted wisdom (and our course of action) will be to serve those difficult foods regularly. We have also talked about the importance of 'last bite'. She has perhaps lost a little weight, but remains at BMI 22 where she has been since August last year. She has been back to weekly weighings at the GP, put on 500gms last week.

However, she has been asking to eat in her room due to thrush (so needs to be underwear free), or periods (so needs privacy) or catching up with something...etc etc etc She also eats very slowly (like last time) and insists that prompts to eat make it harder, and mostly finishes everything on her own. She is obviously struggling. But soldiers on and I can see she is really trying to eat this time (with relatively less resistance to last time).

Last night I insisted she complete her meal in a timely fashion and she really got upset. She said she regretted telling me, that she could handle things on her own, and I really was making everything worse. She got very upset, and ended up ringing a help line for comfort. 2 hours later she lay on the end of our bed reading us an essay she had written and telling jokes.

This morning she acknowledged my right to voice my fears, and really is showing much more insight and maturity about the ED this time round. She has told us and her doctor that her PTSD from an assault drivers her ED and has agreed to attend weekly trauma counselling with a fabulous therapist.

So, after that very long post, I would like advice on where to from here. How strictly should I push her about her meals? I have told her as soon as she loses weight I will go back to supervising lunches at school. I have told her my intention to serve regular "difficult" foods. Should I insist she eat every meal with us? even if doing so drives her low mood, and self-harming thoughts? Should I talk to her about State not Weight as our way forward? Should we set out some written goals and red flags and consequences? It was easier last time, as she was so obviously so unwell, there was no room for anything but total control over her meals etc.Your expert advice gratefully received.
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tina72
kangamum wrote:

How strictly should I push her about her meals? I have told her as soon as she loses weight I will go back to supervising lunches at school. I have told her my intention to serve regular "difficult" foods. Should I insist she eat every meal with us? even if doing so drives her low mood, and self-harming thoughts? Should I talk to her about State not Weight as our way forward? Should we set out some written goals and red flags and consequences? It was easier last time, as she was so obviously so unwell, there was no room for anything but total control over her meals etc.Your expert advice gratefully received.


My d was also 17 at diagnose and is 19 now. What I learned here from the old rabbits and thankfully listened to was to get the ED treated very aggressive and get her in best state possible before she can turn 18 and close us out from treatment.
Early intervention is crucial, with first diagnose and with a relapse. And agressive and strict intervention.

I would be as strict as possible to make sure that ED behaviour is not tolerated in your house and that you will do everything needed to fight that.
I would insist that she eats with you. That is normal. It is not normal to eat seperate in another room.
I would recommend state not weight as you do not really know at which weight her state will improve again.
Yes for red flags and consequences. We have a contract with our d. We wrote down what we do for her (pay for living, insurances, car, phone, university , everything) and what she needs to do for that (eat 3 meals 2 snacks, go to GP regularly, maintain weight, TALK to us).
If total control is needed again, do that. It is not really different if they are 13, 17, 19 or 22. 🙂 The disease is the same and the treatment is the same.

You know what to do. Breath through, make a plan and act NOW. She can be in a better state again very soon.

We are here if you need us 🙂.
Keep feeding. There is light at the end of the tunnel.
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scaredmom
I feel you are handling this blip beautifully!
You recognized she needs support and supervision and with that has gained some weight!
I think that blips happen and can be from stress/ events that are occurring. Besides the trauma issues is there something else. I have found with my d with school pressures she will try to eat less with stress and now she will discuss it more( maybe a bit of insight??) . Then I know I have to be more strict with her eating and supervise her more and she accepts it. 
I feel your d has expressed she is not doing well and that she needs support. So I think you Should be a bit strict while she navigates the trauma part too.
then she can focus on the counselling as you have the food covered. Hope that makes sense.
all the 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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sk8r31
Sending a virtual hug as you navigate this new phase.  Sounds like you have a pretty good handle on it all; as scaredmom says blips do happen, but you do have knowledge on your side, and it sounds like your d has a bit of insight as well.  Interestingly, I just watched a documentary on trauma-informed care in the foster care system (another of my 'hats' is working with that population).  The care and counseling your d is willing to do to heal her trauma will only help, but in the meantime suggest that you start as you mean to go on...more supervision and scaffolding to help your d move into strong ED recovery.  As tina mentioned a contract, I will say that having one was also a very helpful thing for our then 17-year-old.   And please keep in mind that your d should still be gaining a bit yearly into her 20's.

With warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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