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

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We have been on this journey for 18 months and have hit a very low point. My D’s rigid thinking around wanting to lose weight and be skinny is exhausting.  She has never been underweight, but behaviours and thinking are very strong. BMI 21
I don’t know what to say to her now, she seems to turn all conversation towards food, being skinny and losing weight.
I manage to get around 1200 calories into her and then the fighting starts as she feels she has had enough food for the day.  She is 17 so not easily distracted. I think I get around 1800-2000 calories daily, so not enough for weight gain.
Our kitchen is open plan and she watches me like a hawke so very difficult to add extras to smoothies and sauces etc. I know she is not supposed to watch any food prep. I do try to pre prepare food, but she is so suspicious of what I might have added.
ICAHMS have referred her for residential inpatient care and we are currently waiting for a bed to become available. I am really concerned for this and it worries me the other patients will be very underweight, and this will reinforce her need to want to lose more weight at any cost.
So, how long does it take for rigid thinking to decrease, how do I steer conversations away from weight loss etc, has anyone had any experience with inpatient care when D is not underweight?
Any help/advice much appreciated
Personally I've adopted the approach that it's not about food it's a coping strategy for her anxiety, Low self esteem etc. I'd start by having an honest and open discussion about what's driving it. Let her talk or it will just go round and round in her head. 

Ask why do you feel the need to do this? What's going on for you? 
Trying to have an argument with ED and convince ED of anything is a one way trip to nowhere. Her arguments probably even sound more "normal" given her apparent normal size and weight.  As you say her eating disorder thoughts are very strong and hence her using any strategy to get out of eating more and the continued drive to lose weight. I know how hard it is to put a stop to the conversation. My D was also very persistent. Firstly just letting her know that you are not going to discuss this with her is appropriate. She may keep  on trying to raise the topic but the trick is to then just keep on ignoring it. Hmmm, becomes a good statement. For a while it may become a battle of wills. The more you cannot discuss her food, again, the better it is likely to be. What can you do to insist that she eats what you prepare?
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.
My d was never underweight for her height, but having lost a significant amount in a period of months meant that she had to be hospitalized for medical stabilization.  It is not always true that those who are very ill look underweight. 
As regards the challenge with the open plan kitchen, and having your d watch like a hawk, do you have a partner or anyone who could distract your d & keep her occupied while you are preparing meals?
Rigid thinking can take a long time to disappear, and really the only way out is through.  With nutritional rehabilitation, that will hopefully lessen in a few months.  Hang in there!
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Thankyou all for your responses. I am
mostly doing this on my own but do have friends and family who are a big  support in other ways.
She lost 30% of her body weight and at times has been medically unstable. No hospital admissions yet.
Yes I know the only way is through, no light at end of tunnel yet!
It is definitely a marathon & not a sprint, so taking care of your own physical and mental health, in order to help your d as much as possible, is so important.  Please do take care of yourself on a daily basis, no matter how briefly, to recharge your batteries, and hang in there for the long haul.
Sending warm support to you.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
I found it helpful to listen to podcasts and read books by people who have gone through recovery so that I could develop a better language for having conversations with my d so that I could tap into what she may be thinking. Like Pingu says above, ask questions. If the response you get is, "Because!" then mix empathy with more questions, "I can see this is really hard for you AND that you think not eating more is the right thing to do. Do you not feel safe eating more food right now?"

I learned a lot of good communication tactics through the Emotion-Focused Family Therapy website (there are links to webinars that discuss how to have more effective conversations. The big point is to use "AND" instead of "BUT" in your statements.


Hope this helps.
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
Thanks, I checked out that website last night, it’s very good, some good ideas, these will be helpful, Thankyou so much