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

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2.5 years into this, which I know is not long but we are at such a standstill.

I really take all your advice and experience to heart. I hear you all say to try increasing the weight. But she is gaining weight appropriately, her numbers look good, she looks good, she eats anything I ask, she transitioned to high school this year and has made friends, she plays soccer and dances. And I see the change that she does these activities for fun and social and not with the "exercise compulsion" she had 3 years ago. She does NO exercise on her own or at gym.

From the outside she looks and behaves like a normal and healthy almost 15 year old. BUT I am still so heavily involved in EVERYTHING she eats. I make breakfast, pack snacks and lunch. I make dinner. When she is home to choose her own snack she still has a really hard time and prefers that I just bring her something (and I explain over and over again that she needs to be able to choose a snack). She will never initiate a snack (and again I remind her she needs to do this on her own.)

On her own she can't eat enough. She went away for 2 nights with a youth group. Lost weight and was upset about it. Picked up where we left off and she ate everything I asked and was determined to put the weight back on. No problem. 

I know she is only 15 and still living at home and we're "only" 2.5 years into this, but what can I do so she can learn to eat on her own and not be so dependent on me. 

Unless I back off completely for a few days (like when she was away) I won't see a drop in weight. She eats without me few times a week with friends, at sleepovers and her weight is never effected. (I'm sure she doesn't eat enough then but since it's only a meal or two here and there it doesn't effect the big picture, and I weigh her weekly, blindly.)

I challenge her with every type of food. She eats it.

What more can I do??

She goes to therapy, usually twice a month. I don't know if or how it helps. She doesn't mind going but it's hard to find a time that works. 

Just feeling really sad for her, tired and frustrated.

She never wants to talk about ED. And when I try to have a conversation, I'm the worst and always get emotional so there's that.

Hi hopefulyetscared,

I hear you and empathize.  It takes SO LONG.  UGH!!!!!!!

Can you sit down with the therapist separately and ask what the plan is?  Ask what the therapist is working on and what he/she expects to accomplish and how and how long it will take?  And ask the questions about how to help your D take the next steps.

Does your D seem to want more independence around food, or not at this time?
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)
Dear hopefulyetscared,

You are doing great, and you just have to keep going.

EDAction is right, and I think the best place to start is with d's psychologist.  Maybe together you can come up with a plan.

An idea I did have is to try having d set an alarm on her phone telling her when to snack.  Have a selection of, say, 3 different options for her.  Alarm goes off, she chooses and eats all.  It might only be on the weekends, or whatever works.  She may need tiny baby steps laddering towards independence.

You could have a discussion about what it will look like when she goes off to college (or wherever she might go), and start working towards that. If you wanted to take the emphasis off of food, you could add a behaviour like washing her own clothes. 

When my d was at this point she had very few independent behaviours.  WR and recovery was more important than chores around the house, and she had to learn how grocery shop in addition to loading the dishwasher at 17. 

You are both doing great.


D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]

I really hear your frustration, which ultimately is driven by anxiety about 'full recovery' - and you probably fear that you will never get there.

Unfortunately it seems as if you cannot 'rush' it - for whatever reason your d's hunger cues are still not developed/returned to a position whereby she eats spontaneously enough to maintain or increase her weight.  Why? - your guess is as good as mine.  Some kids seems to return to gaining appetite and start to eat without prompting earlier than others.

I can understand your frustration that you still have to be so involved with ensuring d eats enough and with what to give her.  But I am not sure it's fair to be placing the onus of managing her illness on d at this young age.  This will not be a popular view - but it is very much mine.  She is doing well at school, has friends and appropriate activities for her age and is independent enough to be able to be away for a couple of days without the illness taking over again.  She is upset if she loses weight - that is a huge step in recognising that she needs to keep her weight up to stay well and she is compliant around everything that you give her.  She will have the burden of managing her intake later if she moves away from home although by that time her appetitie mechanism will probably have 'kicked in' - why does she have to worry about it now?  

You have both done fantastically well to get this far - well done to you both.  What if you just carry on doing what you are doing for the next six months without any thought of trying to make changes?  So that you get a rest from the demands you are placing on yourself?  If you are not careful you will lose sight of seeing your beautiful d growing up, progressing, developing, enjoying life and will be spending all the time thinking about nothing but her illness.  The fact that she seems to be progressing without social anxiety or issues like self-harm is a HUGE bonus.  Are you still doing nice things together?  Girlie shopping or going to the cinema?  Something that gives both of you a break from the worry.

What strikes me is that there is still anxiety around decision-making when food is involved.  Maybe if you go to a cafe and choose one of the cakes or scones and you model that choosing can be enjoyable - selecting what things you really like and then picking one, she can 're-learn' that part of eating which is still a fearful process.  I think that the decision-making around food choice and quantities are the issue here - so maybe you can also teach her when she is away from you, to take more than she thinks she needs to ensure she doesn't lose weight.  She needs really practical help to be able to move on to the next stage, it seems to me.

You are doing great - celebrate how far you have come rather than be daunted by the next stage!

Believe you can and you're halfway there.
Theodore Roosevelt.
but what can I do so she can learn to eat on her own and not be so dependent on me.

My daughter was at this stage for a long time because she never gets hungry.  She never recovered her hunger cues.  What she did (and still does some days) is take what she thinks is enough and then adds to it.  Your daughter is probably still going for the lowest calorie stuff so she will need more.  The other thing she did was take what she thought I would give her rather than what she would normally pick.  I got so sick and tired of serving her that I stopped.  I would let her serve herself a meal and then we would work together on what she needed to add.  She hated it but it was the only thing that moved us forward.  She would pick what she would normally eat or what she thought was enough.  I would eye ball it and say okay so what can you add now?  If the answer was I don't want to add, then it became what low calorie thing can you trade in for something higher?  It was a heck of a lot of work on both our parts but it really started her moving forward towards more independence.
SInce your d is still nice and young, I would just go s-l-o-w with food independence.  For example you could ask her to try pouring her own milk.  Not enough?  THant's fine, we can try again tomorrow.  Not enough tomorrow either?  That's okay, we'll try again the next day.  Third time, if it's still not enough, that's okay, you're just not ready yet.  We'll try again in a while.  

WHen she can successfully pour the correct amount of milk, she can take the next teeny step.  Maybe serving her own vegetables or some other thing that isn't too scary.

There's no rush.  She will get there.  I promise.  xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Hi there,
yes, it is sooo difficult to be patient and wait for progress all the time...but as Torie said, there is no rush. You cannot do things too late, but you can do them too early. Every patient needs his own time in recovery. Weight gain is the start and than it takes a lot of time to heal the brain. To feel hunger again and to choose things and to plate themselves a good amount are things they have to learn again just like a stroke patient.
We did it with small steps:
Filling her own juice/milk in a glass.
Choosing a yoghurt out of two taste directions.
Choosing a cookie out of two similar ones in a bowl.

What we are doing right now (and I cannot say wether it will work long time) is to let her fill glasses or plate for other family members. I have discovered that she doesn´t know what amount would be good for herself but that she is able to plate for me on a good amount. I hope her brain will learn by seeing a good amount regularly on my plate what would be o.k. for her. The brain needs to do a thing a lot of times in repitition to get it "normal". So maybe it might be a good start to ask her to choose a joghurt for dad out of the fridge...

It is all try and error. Little baby steps. Try to make a list what you want her to learn and choose one thing and think about what strategies could help her to get there. And than work on it like you worked on fear food. She will learn it by time and she will be independent again at one time, I´m sure. But nobody knows how long that takes. Some times there is only small progress and some times there are big steps. For example we had one fear food a week up to now and on the last weekend we had one fear food and did some christmas bakery and she ate 2 different kind of cookies from that without any problems. And than there will be days again when eating just the normal amount will be difficult because of a "bad" school grade or an argument with a friend. Step by step. It takes a lot of time, but as long as you see small progress, that is o.k.
Keep feeding. There is light at the end of the tunnel.
Thank you all for the encouragement and suggestions!!
It really helps to be reminded that for most kids this is a really s-l-o-w recovery process. I like the idea of adding one small step. I'm going to start with pouring milk at dinner. We've tried this before and then after a few days we just go back to me doing it because it's easiest for all (and sometimes it feels like, does this really make a difference? But I get it, it does make a difference. If she can't do this how can she move on?) So that is my goal for now, insisting that she consistently pours an adequate glass of milk at dinner. Once she masters this on her own, we will tackle the next step of independence...pouring a drink at breakfast! 

And thank you melstevUK for reminding me... 
"If you are not careful you will lose sight of seeing your beautiful d growing up, progressing, developing, enjoying life and will be spending all the time thinking about nothing but her illness."

Feeling more optimistic today...

This is a good idea. One step after the other. One day after the other. Pouring milk, than juice on breakfast, than maybe choosing a joghurt. You will get it.
I often must remind myself that she has to learn it again like a stroke patient. Often it is easier or more quickly done if you do it. But their brain learns on the slow way and she needs to do it very often until she gets it. And today it is less stress for me that d can put the plates and the cutlery on table and pour all the drinks for the whole family while I am cooking. She enjoys to do this for us and she often decorates the table quite nice with pretty napkins and a candle. Maybe your d will enjoy something like that?
Optimism is what we need most. It should be sold in the grocery...[wink]
Keep feeding. There is light at the end of the tunnel.