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.

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fcuked
Hi, my 13 year old D has been diagnosed in July. Since then we have been with Child and Adolescent Mental Health Services team in UK. They have been challenging her and us to face and tackle the problem. I have been trying the Magic plate as well as anything I find online. So far there is no progress. Weight comes on and off. It's like us against her. If the team finds something positive she stops it completely (coping mechanism or smooties etc). Now she refuses to be weighed. Also has been selfharming in the last week. Still in school. Don't know what to do. Taking her off the treatment is not an option I guess. Or is it?
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Torie
fcuked wrote:
It's like us against her.  


Oh gosh, it does feel like that, doesn't it?  But really, underneath the layers of ED, your real d is counting on you to be stronger than this vile illness because she. just. isn't.   Although they fight tooth and nail in the early days, later on your d will likely thank you for saving her.

Hang in there.  It's worth it.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Kali

Hi,

I know that many families arrive here confused and scared and unsure about what to do, and with many questions.

One of their questions may be:
What is FBT?

True Family Based Therapy is a manualized program of therapy conducted with the family and the sufferer under the care of a trained professional who has been through the Train to Treat training. Here is a list, from their website, of qualified professionals:

http://train2treat4ed.com/certified-therapist-list/

If anyone wants to read more about it here is a book you could take a look at:

https://www.amazon.com/Help-Teenager-Eating-Disorder-Second/dp/146251748X/ref=pd_lpo_sbs_14_img_0?_encoding=UTF8&psc=1&refRID=HSYNKZ504XVFX6J267WA

In most cases, the treatment has three phases over a period of 6-12 months, and involve the entire family in hour-long weekly sessions.

The three phases of treatment are:

  • Parents take responsibility for decisions of what, when, and how much the ill patient eats as well as behaviors around food.
  • After weight restoration is nearly achieved, control is carefully given back to the patient.
  • Finally, the therapist and family work to restore normal and age-appropriate lifestyle and relations between family members.
It is evidence-based, meaning that there have been studies done to show its efficacy. 


The list that Toothfairy has posted is really great as a description of what parents can try doing at home while their child is in treatment, but I just wanted to point this out.

warmly,

Kali

Food=Love
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BattyMatty_UK
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Oh gosh, it does feel like that, doesn't it?  But really, underneath the layers of ED, your real d is counting on you to be stronger than this vile illness because she. just. isn't.   Although they fight tooth and nail in the early days, later on your d will likely thank you for saving her.


Tooth is so right. I'll never forget the day when my (recovered) son handed me a greetings card just before he left for university. Inside it he'd written: "Thank you for being the one who never gave up." This was referring to the long months/years when he appeared to be fighting against us, yet it was the ED and not the real boy that had been fighting us. Underneath it all he was desperate for me to continue fighting on his behalf to get him well yet the ED wouldn't let him show this - quite the opposite, in fact...

Now that he is recovered he often tells me this - and one day it will happen to you, too. I know that it's easier said than done (to put it mildly) to ignore the ED's venom and see through it to the 'real child', but if you can view it like this it might be a little easier for you to push for what your instinct says is right?

Bev xxx
Bev Mattocks, mother of 24-year old male DX with RAN 2009, now recovered. Joined this forum in 2010 - it was a lifesaver.
 
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fcuked
Our day starts with a light breakfast. A toast and fruit. I pack her lunch and snacks for school. She has supervision for snacks but eats with friends. This was the first full week at school so don't know how much of it is consumed. A snack of cereal bar aftee school. A plate of pasta with cream and chicken or equivalent at dinner and lots of fruit in between.
She definitely fears the weight and each meal time is argumentative. My 3 year old is seeing all this. I hope she's not aware of the battle we are having. My husband is losing his nerves already. I feel like I am the last man standing.
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mjkz
You are the last man standing and thanks goodness for your daughter you are!!!  I am a single parent so I can truly appreciate how you feel.  A couple of thoughts.

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Our day starts with a light breakfast.


I used breakfast as an opportunity to pack in the calories.  My daughter wanted to stay in school so she knew she was only going to school after she ate her entire breakfast.  You can easily get 1000 cals in a breakfast if you make oatmeal with heavy cream, sugar, add dried fruits and nuts.  I made muffins that had over 1000 calories per muffin so I got in around 2000 calories just in breakfast alone.

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She has supervision for snacks but eats with friends. This was the first full week at school so don't know how much of it is consumed.


If she has good supervision, then you should know.  I had to go to school to eat with my daughter for lunch and she ate snacks with the guidance counselor.

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A snack of cereal bar aftee school. A plate of pasta with cream and chicken or equivalent at dinner and lots of fruit in between.


You can add a smoothie in there as a snack rather than the cereal bar and add over 1000 calories in that.  The faster the weight gain the faster you will get to weight restoration and brain healing.  Don't be afraid of what ED is afraid of.  Yes, she will fear the weight so make sure you do blind weigh ins.  Being weighed is not an optional activity that she can refuse.  I once stood there for over two hours waiting for my daughter to get on the scale.  She knew we'd stand there until she got on.  Require it of her.

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each meal time is argumentative.


Don't allow it to be.  When my daughter started arguing or negotiating, I simply said I was not going to talk to her eating disorder and refused to engage in the conversation.  Talking about food and weight is not going to help her and only beat you down as well as terrorize your 3 years old and husband.  If my daughter continued arguing or negotiating, I simply ignored her.  I found distraction was the best thing because no amount of discussion will help.  It may take a few days but she will realize that you are not going to argue or negotiate and move onto other things.

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rose08
Hi there, and so sorry to hear of your battle with this. My D is 12 and also recently diagnosed. As some of the other mom's have said smoothies are a great way to pack in nutrition. Although my D fights and complains about them, they are just not negotiable at this point. I find using full fat yogurt, mixed with double cream and canola oil (right into the tub so no telling the difference) and adding frozen chopped banana, berries etc as well as future life powder has been a real lifesaver in terms of her nutrition. She has one approximately 250ml one with a muffin before school and another in the late afternoon. Combined total about 1000 calories. Hang in there, It is tough. Re weighing, we blind weigh our D which helps take the anxiety out of the number vs her self worth. Some days are better and some worse, just keep at it and know you are not alone xx
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melstevUK
fcuked, 

Welcome and sorry for the diagnosis and the hell that has landed on your family.

Personally, I would phone the psychiatrist or psychiatric nurse at CAMHS and ask them to back you at every meeting.  Tell them that you understand what needs to be done and that all you want them to do is to back you and express confidence that you know how much to feed your child.

You say that they are 'challenging' you and your d.  They should not be in any way 'challenging' - if that means giving her things to do and to ask her to try them - they should be laying down the law with her on what she needs to eat and about weight gain, and about getting weighed.  They can be sympathetic - but ultimately they have to back YOU against the eating disorder while ensuring that your d is compliant with what needs to happen with regard to eating.  If they are at all expressing things in a way that suggests she has CHOICE - this will absolutely not work. They don't appear to be using FBT and this is maybe something you can explore with them.

In no way should your d be putting on weight and then losing it  - this is indicative of a lack of understanding by the team.

I hope you can start moving things forward in the way that they need to go.  You have landed on the best website on the internet here - and you will get lots of advice and encouragement from some very knowledgeable parents. 
Believe you can and you're halfway there.
Theodore Roosevelt.
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fcuked
Thanks to all of you FEAST videos and another night thinking about it, I told her that it was not negotiable to be weighed. At the point where the argument was escalating I took the dog for a walk. She has put on weight (sigh) , but I didn't make any encouraging comments to make her feel worse.
I let her have a light breakfast as I read somewhere you intend to eat more during the day if you don't fill up at breakfast. Muffins have not entered her acceptable menu yet.
I have a limited amount of fight in me and I save it for after school and evening.
But I wouldn't be able to survive today if I didn't get guidance from you.
My only fear was after what I read, it felt like I hadn't fed her enough. As she is so petite, I personally can't see her eating more at this point without taking it out on herself.
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Foodsupport_AUS
Getting the hang of parenting a child with an eating disorder takes some getting used to. It is not normal parenting for most of us. The tips about how to get more in are well worth considering. It may also be worth reading this information about weight goals from Julie O'Toole. Your comment about her being petite resonated. It may be that she is not meant to be petite. Either way getting a gain is a start, but it will need to keep on happening and the trick for you is to work out how to best achieve it. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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Torie
fcuked wrote:
I let her have a light breakfast as I read somewhere you intend to eat more during the day if you don't fill up at breakfast.


I can't say I agree with that.  For most, breakfast seems to be the easiest meal, with things getting harder as the day progresses.  So breakfast is often the best time to pack in the calories and get the day off to a good start.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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mjkz
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I let her have a light breakfast as I read somewhere you intend to eat more during the day if you don't fill up at breakfast. Muffins have not entered her acceptable menu yet.


Actually breakfast should be a big meal because she has not eaten for 6-8 hours.  As for muffins not entering her acceptable menu yet, make them and serve them.  You choose what is acceptable, not her.
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EDAction
Hi fcuked,

While refeeding my D I kept a log (privately, I did not show it to D) of the food I gave D at each meal and snack and the approximate calories.  I also kept notes as to how the meal/snack went and about any other happenings of note that day (e.g. anything extremely bad and/or any small good thing).  It helped me to see patterns over time, to make sure I was giving her as much nutrition as I thought I was, to see small improvements, to keep track of variety, etc..  I also kept track of her weight checks here.  Sometimes during refeeding things felt so chaotic and out of control and I felt so exhausted and depleted that keeping a log helped me to keep refeeding on track and to know I was actually working the plan, not just flailing about.  

Thinking of you, your D and all your family.  

DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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EDAction
Hi again fcuked,

You mentioned that your D started to self-harm.  * This could mean a lot of things, so I have to start by saying if you think she is suicidal you must take emergency measures.*  My D started cutting while refeeding and it scared the living *** out of me.  (She was seeing a T weekly and I talked to T about it.  Her medical doctor has talked with her about it too.)  But I know there were times when I was afraid to push my D with refeeding because I was afraid she would cut.  In the long run she stopped self harming (knock on wood) after being weight restored and put on prozac and staying stable for many months. 
DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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