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.

qwpo10
Hello, after a very stormy time including prolonged hospital admission for anorexia, our 18year old daughter has been doing extremely well. She has been eating a meal plan devised and provided by us, and was getting back to having a social life again. Then she became overambitious and went on a 3 week tour of the country visiting friends. Because she was feeding herself her eating went out of control - restricting and bingeing. Since her return she has been desperately depressed, not wanting to be seen by anyone because her weight has gone up. After around 4 weeks of this she has emerged with a plan which is to restrict her eating to around 1100 calories per day so she can lose weight. Her theory is that once she reaches her target BMI (18.5) and feels better about herself she will go onto a maintenance meal plan and will be able to engage with her therapist and see her friends which will strenghten her to fight the eating disorder. She thinks this is her tricking the eating disorder rather than the ED tricking her, and is currently on a high with this plan. We are desperately worried, as is her ED treatment team. We know that she must avoid a low calorie diet. She is still able to rationalise to a certain extent and is talking to us. Is anyone able to give us anything that might help her gain insight into the fact that it is the illness and not her being clever which is making her do this? A personal experience? An account of a similar experience from an ED sufferer in the family? Any written material we can be directed to? I have been unable to find anything specifically on this topic myself. Thank-you. 
Quote
tina72
Hi qwpo10,

I am not really sure what you are searching for. As anosognosia is very common in ED she will not understand that in that state. You can try to explain to her what anosognosia is but I am not sure this will help.
https://en.wikipedia.org/wiki/Anosognosia

I suppose it was to early to allow a 3 week countryside tour with doing all food decisions. How long has she been WR before?
You will need to go back to phase 1 for some time and not allow her to restrict and to lose weight. It is a dangerous idea to only eat 1100 calories and she should know that 18.5 is not a good target weight at all as it means just not underweight. Patients with AN can never go on a diet and lose weight once they reached a healthy weight without risking a relapse.

I know it is harder when they are legally adult but you have some power left, I suspect she is living with you and you pay the bills so you set the rules.
You could have a contract with her to set boundaries. What does her ED team say?

" Her theory is that once she reaches her target BMI (18.5) and feels better about herself she will go onto a maintenance meal plan and will be able to engage with her therapist and see her friends which will strenghten her to fight the eating disorder. "
She should know with her experience in ED that this will not happen. She will not feel better about herself at 18.5, she will get depressed and see all the bad consequences of a malnurished brain again. She will not be able to maintain her weight but set a new target to feel better of maybe BMI 17. Then 16. You know what will happen.

There is no logical reason for that. It is ED talk. And it is lost time to discuss that with her. Say NO and stay strict. No diet and no weight loss. If she had really gained a bit on that trip her body would come to normal soon just by eating normal portion sizes and regular food.
Keep feeding. There is light at the end of the tunnel.
Quote
qwpo10
Thank-you, I know I probably sounded a bit vague about what I am looking for. I think I am searching for the impossible which is something I can give her to read while her brain function is still reasonably intact which she will think about rather than just dismissing it as parents not understanding. The point which she doesn't get is that she can't go on a diet without a high risk of relapse.  I wonder whether a personal account of someone who has tried this (or cared for someone who did) and failed, might help. Because of her age we have not used a contract with her or set absolute rules, but we might need to rethink this. Her ED team has said they are worried and we must not agree to it, but haven't given us any concrete strategies. 
Quote
scaredmom
Tabitha FArrar has been a good resource for many.
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
debra18
I was going to say the same as scaredmom. Maybe a recovery coach that can tell her that this plan won't help her recover?
Quote
Kali

Hi Qwpo10,

We had a very similar experience at one point. Our d. went on a trip for a few weeks with friends and clearly restricted heavily at the same age as your daughter. She too had been doing well before that. 

When she returned it proved to be difficult to get the weight on again. But at that point I just kept serving meals and got as many calories as possible into her. I don't think that trying to reason with someone in that state can really effect any change, but if you can get her weight up she might have just a little more volition. That was our experience, anyway. The one time I tried to have her read a scientific study about why weight restoration in Anorexia indicates a higher likelihood of recovery, she ripped it up into tiny little pieces and scattered them all over in my bedroom. While I was picking them all up I decided that was the last time I would try to reason with her about weight. Just keep feeding her is what I would say. You could try going back to the meal plan you had devised for her if you think that would help.

warmly,

Kali

 

Food=Love
Quote
tina72
qwpo10 wrote:
Because of her age we have not used a contract with her or set absolute rules, but we might need to rethink this. Her ED team has said they are worried and we must not agree to it, but haven't given us any concrete strategies. 


I would definitivly rethink that. An ED patient needs strict rules and boundaries for a long time. She is adult on paper but does not behave that way. She cannot care for herself properly.
It is very normal to have a contract with young adults with ED and a lot of clinics and outpatient teams offer that.
Talk with her team about that, I think they already want you to get into that direction with saying "you must not agree to it".
My d is 19 and 2 years in recovery now and we have a contract and it is working very well. No relapse up to now.
Keep feeding. There is light at the end of the tunnel.
Quote
qwpo10
Thank-you, Tabitha Farrar's blog looks interesting, but D said she want interested in 1:1 coaching with her. I can see that a strict contract is a good idea. I would be very grateful if anyone was prepared to share their contract with me so I can get some ideas.
Quote
Foodsupport_AUS
It sounds like your D is already in relapse to some degree. A normal thinking brain would not think a BMI was a healthy goal weight - as that is unlikely to be a healthy weight for her - less than 3% of the population are going to be healthy at that weight. If she was maintaining that weight before then she is likely to have been underweight. It is normal of course for young adults to increase their weight until their mid 20's with most women needing a BMI above 20 to be healthy and many significantly higher than this. 

You can search for contracts by using the search button on the forum and typing in "contract" Quite a few ideas come up. 
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.
Quote
tina72
qwpo10 wrote:
Thank-you, Tabitha Farrar's blog looks interesting, but D said she want interested in 1:1 coaching with her. I can see that a strict contract is a good idea. I would be very grateful if anyone was prepared to share their contract with me so I can get some ideas.


I think Tabitha makes skype sessions, please ask for that.
Keep feeding. There is light at the end of the tunnel.
Quote
tina72
qwpo10 wrote:
I can see that a strict contract is a good idea. I would be very grateful if anyone was prepared to share their contract with me so I can get some ideas.


Our contract is quite simple:
We pay for living, insurance, holidays, university, car, cellphone, everything.
She has to eat 3 meals 2 snacks, maintain her weight, go to regular weighings and see the GP when we think it is needed.
And she has signed a paper that we get information from hospitals and doctors here and that we are in charge if she needs to be admitted against her will. (There is a paragraph here that allows the gp to get her case to court to save the patients life if needed).
She knows that refusing to eat regularly will mean to lose the car keys (she is a danger for others when on low blood sugar).
She knows that losing weight (more than 2 kg) will mean to cut back university or take a gap semester if needed.
She knows that refusing to go to the weighings and to see the GP will mean to lose the car key and if needed the phone.
She loves her car 😅...

So although it is in some parts harder with young adults you can have great incentives as long as they are financially dependend.
Keep feeding. There is light at the end of the tunnel.
Quote

        

WTadmin