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

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strawdog
Hi - apologies this is probably a topic that's been over a million times but my d is starting to rebel against foods where she's getting a general vibe that I add 'bad' things to - creams in the mash, extra oils, cheese etc. We had our biggest scare yet last night of a full blown refusal. Having eaten everything we've given in her so far she suddenly flew off the handle when she asked what was for dinner - it was twice baked potato  - bake them, scoop the insides out and mix with cheese and a little bacon. For some reason this gave her massive anxiety- dad will just pit lots of cheese and butter and stuff in it!! She told us half an hour before that she wasn't eating it no way and told us to prepare for that. As you can imagine the next half hour was just filled with utter dread for us! BUT she did come down and did eat it but was in a filthy mood. I feel ED won in some way as I was so fearful that I just wanted her to eat the meal no matter what. So i had changed normal potatoes to sweet potatoes because I know that;s her preference and I gave her half what I think she ought to have had (hard with meals like this to know exactly how much she needs).

So now I'm really apprehensive over the next couple of meals. Ideas for calorie dense food that isn't going to appear too oily, creamy or cheesy for her?
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Foodsupport_AUS
It is not unusual for resistance to eating to get worse before it gets better. She knows she is gaining weight and she knows that it is what you are feeding her. 
You did an amazing job getting the food in, even though you compromised on the type of potato and quantity. Complete food refusal was common for us, so if she said she wasn't eating it she didn't. That always left a problem in that the only way to get her to eat her food was to compromise some way, but if she didn't eat at all she would be hospitalised sooner - we had a lot of them. 

Many parents here would not agree, but I found for us that eating foods that "appeared" to be safer was easier to get in. For us adding a greater quantity was not as much a problem as adding loads of melted cheese on top. Oils/fats had to be well soaked into the food otherwise she seemed to find a way of leaving it on the plate as some sort of liquid (never worked out how she got the oil out of pasta sauces). Things like potatoes, rice and pasta soak up oils very well, use them in cooking. I also soaked many of the vegetables in butter - steamed but allowed melted butter to cook in too. We also had a meal roster - she knew up ahead of time what was for dinner - it relieved a lot of anxiety for her. 

If she does refuse hold fast. Nothing else is more important than getting it into her. You  get to decide when she gets up and leaves the table, and don't forget that supper still comes even if she is still not eating dinner. Many kids will back down at this point but not all. 
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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Ronson
Refusal and resistance increases after the first few weeks.  I think in the first few weeks they are so hungry that they will eat then a realisation will kick in that this is long term and resistance will pick up.  Stay strong in the face of being told they won’t eat.  Use all leverage necessary and remember to fake confidence that she will eat. 
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tina72
strawdog wrote:
Hi - apologies this is probably a topic that's been over a million times but my d is starting to rebel against foods where she's getting a general vibe that I add 'bad' things to - creams in the mash, extra oils, cheese etc. We had our biggest scare yet last night of a full blown refusal. Having eaten everything we've given in her so far she suddenly flew off the handle when she asked what was for dinner - it was twice baked potato  - bake them, scoop the insides out and mix with cheese and a little bacon. For some reason this gave her massive anxiety- dad will just pit lots of cheese and butter and stuff in it!! She told us half an hour before that she wasn't eating it no way and told us to prepare for that. As you can imagine the next half hour was just filled with utter dread for us! BUT she did come down and did eat it but was in a filthy mood. I feel ED won in some way as I was so fearful that I just wanted her to eat the meal no matter what. So i had changed normal potatoes to sweet potatoes because I know that;s her preference and I gave her half what I think she ought to have had (hard with meals like this to know exactly how much she needs).

So now I'm really apprehensive over the next couple of meals. Ideas for calorie dense food that isn't going to appear too oily, creamy or cheesy for her?


First I want to say that you might feel that you gave in a bit to ED but in total YOU WON. She ate it although she announced she will not. I think you did great not to let the situation escalate by changing to sweet potatoes for that dinner. But I would serve the other recipe again soon so she sees she cannot control that.
She might try to dictate what you cook now, be aware of that. She might also try to see what happens when she refuses completely so be prepared and have plan A, B and C there. She will test the boundaries now.

We also did a lot of meals that we cooked before and just sneaked something in that was not visible. So for example I do mashed potatoes now with butter and cream and not only milk like before. I let oil suck in into rice and vegetarian pattys. I hide cream and oil and melted cheese in sauces where it is not visible. And I always served some alibi vegetables as side dish.
Keep feeding. There is light at the end of the tunnel.
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strawdog
So this is normal - we're not going backwards BUT it is going to get harder then? We thought it might get easier so we're going to have to re-calibrate mentally. I guess this is the million dollar question but at what point might it start getting better again? Tina you say have a Plan B and C for full blown refusal - is there anything else we can do other than insist she eats it no matter what?
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tina72
At the start they often eat just because they are so hungry. Then there is a phase when they realise this is going to be normal now and my parents are making me gain weight and they are serious with this. Then they start to fight it. If you stay strict and go through it it gets easier again. They accept you mean that serious. Then they see that their body changes and you will see some more fight for time x and need to get through it. It is a rollercoaster until they are at a good weight and some time x for brain recovery and then you will see progress.
You ask at what point it starts to get better again. I tend to say at the moment AN sees that you are not giving in. That you are stronger than the ED. That there is no way NOT to eat. That was about 3 months after we started refeeding here.

Plan A, B, C: you need to think through what might happen. If she refuses totally to eat what you serve and insisting does not help.
You could ask her to add an ensure then. You could tell her you will add the missed food to the next meal (if a snack was refused). You could offer another meal that you have in the freezer for such cases that you know has more calories than the one she refuses.
You could think about other consequences (no school when she refuses breakfast, no other things she would normally be allowed to do, bed rest then). You could take phone until she has eaten and give it back when the meal is completed (and if she refuses she does not get her phone back). It might happen that she refuses for 24 hours and longer or that she refuses to drink even liquids. That means you might take her to A&E then.

I do not want to scare you, most things might never happen. But you should be prepared and have a plan what you will do when A, B, C happens. Last thing you need is that she sees that you are helpless and do not know what to do. You must fake that you are super prepared and know what you do whatever will happen.
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
I think you are doing incredibly well Strawdog, honestly I’m in awe of the way you’ve got stuck in. 

There will be many bumps in the road unfortunately, good days, bad days, ok days and dreadful days.   

Did you have a go at setting the expectations in advance in I told you I do on your other thread?  It might help to lay out clearly how things are going to be. 

Youre not going backwards it simply isn’t a straight path, I struggled a few times to not become complacent when things are going well, being on high alert at all times is draining but necessary.
Certainly for me adding a heap of oil, ground almonds etc to things got us over many a bump.   Even a tin of tomato soup got 300 calories of rapeseed stirred in. Same with pasta sauce. 


Ellesmum
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strawdog
Thanks everyone - I think Friday nights are just a bad night! Everyone is tired at the end of the week. Hopefully we will have a good weekend. As I type she's happily tucking into scrambled eggs on toast - but this is a 'safe' food for her,  Ellesmum you talk about setting expectations - can you remind me again what you mean by that?
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Ellesmum
Great news about the scrambled eggs, plenty of butter?

So, expectations yes. I simply would say for example on a Friday night ‘tomorrow we’re going shopping and we’re going to go to Starbucks for lunch (or wherever) and have a toastie and a cake. Then I’d repeat this the next morning. I also made it clear that we’d have to come home if she didn’t comply. In the early days I’d sometimes have to promise a small bribe, maybe ‘finish your cake and then we’ll go get you a bath bomb’  

Basically no surprises...’daughter, at 6 you and I will have a coffee and a cookie while we watch x film’.    It’s just the way I instinctively did things but it helped a lot.   There was a lot of ‘no’ along the way but by faking confidence we got there. 

I did lose the plot spectacularly once in a coffee shop over a slice of cake, not my finest moment for sure but she had the cake and from then I think she knew I would never just give in.  
Ellesmum
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tina72
You can also add some cream to scrambled eggs. And I am sure you buy the big sandwich toast slices 🙂. Compare different brands as there might be one with 50 calories more...if that is safe food think about serving more safe food on difficult days where you can sneak in calories without big stress. Most important is to get the food in and the weight up, no matter how.

We also did great with announcing things that are going to happen before and then go through but I know that there are kids that do better with surprise and not be prepared before. So as always here: try and error. No right or wrong.
Keep feeding. There is light at the end of the tunnel.
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strawdog
Yes plenty of extras in the eggs - double cream and rapeseed oil and a big slice of bread - so about 500 calories I think. Its a tricky one with announcing things as it may give the anxiety time to build up but then surprising things on her is not good either - its a difficult balance!
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scaredmom
You asked, strawdog when it starts getting better. For us it took from diagnosis to about April to July to have a good routine on feeding and weight gain and some fear food etc....
After WR which took us 6 months and then I added another 10 plus kg it was about 9 months since diagnosis then she was much more her old happy self. 
But the early part give yourself a few months. You are studying her ED. You are learning what ED can handle and you are getting tools for your tool box.
You really are becoming a stronger as well.
You are doing very well.
As for the sweet potato,it was a win. If you have to make foods look safe for them to eat and you add stuff to it and they eat, it is all a win.
i used to fry all meats but to make the meal look safe I added in broccoli roasted with tons of butter or oil. It appeased her she ate all the other stuff on the plate.
XXX
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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Ronson
The announcing things should not be too far in advance to allow an anxiety to build up but it’s more the announcing it as a - this is what is happening type action.  So no negotiation or will you manage this.  You are completely in charge of her food and eating. She needs you to show you are in charge.  So for example - we are going to have breakfast now and I expect you to eat all your pancakes.  At the cinema you are having crisps and a drink.  Would you like x to eat or y to eat.  So all instructional clear commands, no room for negotiation or dubiety.  If there is a choice you set the choices and it’s very limited - would you like ice cream or cake.  If there are sides etc no helping herself - plate everything.  Her brain will be a bit confused so the clear direction really helps.  As Tina says have a plan b or c - it needs to be realistic and you have to follow through.  Again directional - I need you to eat now and I am taking your phone until you start to eat.  When you start to eat I will return it.  We are going to eat now - would you like to watch tv or play cards while we do. 

As Ellesmum said completely fake confidence.  I also lost it on several occasions over various food items.  On her very worst day about 3 months in I had to get a friend to sit with her as my energy was gone.  She got d to eat on that occasion (it was a day of lots of smashed plates and food throwing).  I felt that was a turning point for us - when d realised I would let someone see the horror of it all just to get her to eat. 

In our experience it got so much worse before it got better.  We saw big improvements after about 4-5 months of proper refeeding and now another 5 months on mealtimes are relaxed and things are not too bad.  But there are still behaviours and we need to keep so on top of it all.  Just last night she commented on her portion of naan bread which she hasn’t in a while - I just said it was the right amount and she ate it all.  

You are doing a fantastic job so please don’t be disheartned but remember recovery is not linear and sometimes it goes back before forward 
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scaredmom

strawdog wrote:
Hi - apologies this is probably a topic that's been over a million times but my d is starting to rebel against foods where she's getting a general vibe that I add 'bad' things to - creams in the mash, extra oils, cheese etc. We had our biggest scare yet last night of a full blown refusal. Having eaten everything we've given in her so far she suddenly flew off the handle when she asked what was for dinner - it was twice baked potato  - bake them, scoop the insides out and mix with cheese and a little bacon. For some reason this gave her massive anxiety- dad will just pit lots of cheese and butter and stuff in it!! She told us half an hour before that she wasn't eating it no way and told us to prepare for that. As you can imagine the next half hour was just filled with utter dread for us! BUT she did come down and did eat it but was in a filthy mood. I feel ED won in some way as I was so fearful that I just wanted her to eat the meal no matter what. So i had changed normal potatoes to sweet potatoes because I know that;s her preference and I gave her half what I think she ought to have had (hard with meals like this to know exactly how much she needs).

So now I'm really apprehensive over the next couple of meals. Ideas for calorie dense food that isn't going to appear too oily, creamy or cheesy for her?


As I have been thinking about this a few things come to mind. Is she fearful of the type of food? Is this potato a fear food or cheese or bacon? Or is it the anticipation of knowing what is coming anxiety provoking? For my d at the beginning it was all of that. All foods were  fear foods.  So we basically flooded her at the beginning and picked up on the other subtle fear foods, like sweet things, cheese, pastry in quiches, chicken pies.
My D was very suspicious too for a few months. This is common. Telling her it is safe helped my d eat better. Even now if there is a different situation that "pops up" with food, she will look to me to ask if it is safe and she trusts me and she gets the same answer anytime she asks " Yes it is safe, it is fine."  

Some kids tell us their fear food, sometimes we have to glean from their behaviours, Just keep your eyes open and ask in your own mind, is the a fear food or not? It may need to be tackled differently than just a regular meal.
XXX

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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strawdog
Ellesmum wrote:
Great news about the scrambled eggs, plenty of butter?

So, expectations yes. I simply would say for example on a Friday night ‘tomorrow we’re going shopping and we’re going to go to Starbucks for lunch (or wherever) and have a toastie and a cake. Then I’d repeat this the next morning. I also made it clear that we’d have to come home if she didn’t comply. In the early days I’d sometimes have to promise a small bribe, maybe ‘finish your cake and then we’ll go get you a bath bomb’  

Basically no surprises...’daughter, at 6 you and I will have a coffee and a cookie while we watch x film’.    It’s just the way I instinctively did things but it helped a lot.   There was a lot of ‘no’ along the way but by faking confidence we got there. 

I did lose the plot spectacularly once in a coffee shop over a slice of cake, not my finest moment for sure but she had the cake and from then I think she knew I would never just give in.  


How far into the re feeding process did you start asking her to eat cake out? We were discussing this last night and I don't think we'd feel brave enough to try this for many a month yet! There are definitely foods that would have been on her banned list before - obviously cakes is a big one. Others are white potatoes (prefers sweet), cheeses, ham, pizza, chips that sort of thing. There' s a 'healthy' cook book she was obsessed with before - Joe Wicks - She asked could we not cook a few recipes from there next week. So this book is OK with its recipes - it has cream in some etc but it would just say to serve without carbs. If I just added the necessary carbs and snuck some oils in then i could probably get the calories in no problem and it would be safe food for her. I guess the question is are the first couple of months about just getting the carbs in no matter and tackle the fear foods when her brain is more recovered to handle the anxiety or do I hit them head on and serve her a cheese and ham sandwich for lunch??!
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tina72
As always: there is no easy answer to that.
At the beginning I would say no matter how the food goes in and no matter what. A lot of parents refed to WR only with safe food. That is working. Around WR when brain recovery started they often fight fear food less and it is easier.
But: it depends on how long the fear food list is and what is on there. If basics are fear food (noodles, rice, diary) you cannot wait until that because you will not get the weight on.
We did the laddered approach. We had ONE fear food day a week (today looking back I would do 2 to make the period shorter) and on that day we served a fear food. It took us about a year to empty the list totally (some were easy, some were hard work) and looking back I would do that faster as she had big progress after fear food was done.
Keep feeding. There is light at the end of the tunnel.
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Frazzled
We tackled some major fear foods initially to be able to get some good weight gain. Pizza and ice cream were some of the first things we tackled. Weight gain was slow until we introduced a high calorie shake. Meals were hell for a month and a little easier for the following month then we would have a really good week and then a hell week for the 3rd month. After the first three months things improved. We had a lot of freebies along the way with fear foods and new foods as well. In another post a couple days ago I had stated that my daughter ate a piece of chocolate that I gave her the other day without a problem at all. I was freaking out a bit in my head and was more afraid of giving her the chocolate than she was at eating it. So, I would say we started out flooding with fear foods (My H took a month off of work as it was much easier with both parents at meals) and then went to a more laddered approach after that. Whatever works for you. 
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strawdog
We're lucky in a lot of respects - we can feed her around her Fear Foods - she happily eats rice and sweet potatoes and pasta so plenty of opportunity to get the carbs in. It's always been about the snacks for her as that is what she cut out originally - finds them very hard but does eat them. We've come up with a meal plan for the week and pinned it up in the kitchen - she's aware of it but no comments so far. It is a pretty safe menu though with not much to fear - other than macaroni cheese as she seems to be anti cheese at the moment - we shall see. Hope everyone has a good week 🙂 
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tina72
If she says she is anti cheese at the moment that can really mean that she wants to eat that very much but ED voice in her head fights that. SERVE CHEESE!!!
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
tina72 wrote:
If she says she is anti cheese at the moment that can really mean that she wants to eat that very much but ED voice in her head fights that. SERVE CHEESE!!!


Agreed.

strawdog, you asked how soon I asked to eat cake and fear foods, the last few months are a bit of a blur but it was just about as soon as I knew her diagnosis and found this site. I made it my business to learn all I could about the illness and went pretty much straight in (or tried) I won’t say it was easy.   I was aware of issues for a few months then she was officially diagnosed last September, I’d been managing to get 1800 to 2000 calories in by that point and once I learned what I was really dealing with I jumped in. We’ve had dips and rebounds but I’m confident we’re really on the way now. 
Ellesmum
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Ellesmum
I don’t seem to be able to edit. I should add to my post above this worked for us but it is trial and error, our kids are all different and it takes a few approaches until you find what helps. Also what works this week may not next.  Not working and being with d all the time made me become fairly intuitive about what approach to take at the time but I did get it wrong a lot too.
Ellesmum
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strawdog
Thanks Ellesmum -glad everything is heading in the right direction for you. I'm just not brave enough to go in feet first! We had a choc chip hob nob for the first time after school so little steps! She has so much anxiety anyway with exams coming up - I think it's best not to push it too hard. When exam season is over I'mdefinetely going to start ramping things up a bit!
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Ronson
Well done on the hob bob - if you can re feed on high calories/carbs etc then I think it’s ok to bring fear foods in gradually.  Once the weight is up the fear reduces a bit anyway and like you say it is a stressful time for her.  Be aware though that if you get calories in without introducing too many fear foods then you might become scared yourself.  We have got d to a good place eating enough but we are scared now to push things in case the backlash comes again - in hindsight it may have been better just to go for it when all was bad 
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tina72
Ronson wrote:
Be aware though that if you get calories in without introducing too many fear foods then you might become scared yourself. 


Agree with that. If you wait too long you might be more scared of your ds reaction to fear food than she is scared of the fear food herself.
It often helped me to tell myself that it is totally normal to eat chips and ice cream and burgers and that it is NOT normal to be afraid of that.
Keep feeding. There is light at the end of the tunnel.
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tina72
strawdog wrote:
She has so much anxiety anyway with exams coming up - I think it's best not to push it too hard. When exam season is over I'mdefinetely going to start ramping things up a bit!


I do not know what this choc thing is 🙂 but great that she ate it.

Be aware that exams mean a lot more calories and that she might lose weight only because of thinking. My d lost 1 kg due to A level exams. I forgot that the brain needs 500 calories extra to work that hard. When the oral tests came I added more and she did not lose weight again.

Is there a possibilty to delay the exams to a better time?
Keep feeding. There is light at the end of the tunnel.
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