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

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bonny Show full post »
bonny
And if we are basically saying that the doctor doesn't know what she is talking about, what is the point in continuing to go for sessions?

The reality is that we NEED to get some sort of support - it is way too much for me to do on my own. My husband cannot be at home during the week due to the nature of his job, and we can't afford for him to be unemployed.

Plus he needs to be in school and learning, given his age. And I need to be back at work, partly for my own sanity, but also so I don't lose my job.

So what I am saying is, you are all saying make him eat more and gain more weight, and I am obviously going to try to get that to happen, but it might take a long time before he really gets with the programme?
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EC_Mom
Bonny, different people may have different views on whether it is realistic to imagine that a kid will go from leaving some food to eating it ALL.

For me, something clicked, after we had come home from a week of IP. Before that we had struggled, negotiated, gave up after a certain amount of time, and let ourselves be deterred by smashed plates, punching, her refusal to pick up a fork, and other things.

Then it clicked (and my D gave me a big clue, actually, hinting that I needed to not give up, but not saying it directly). I had to make her EAT IT ALL, no matter what, and do the absolute maximum to make it happen. I crawled all over her in her bed, with the fork and a noodle, for hours. I gently talked to her about what she didn't want to miss that was coming up. I talked for hours with the fork in hand, about how her friends would miss her at the party. I did not berate her but focused on things that used to matter to her--her friends, a party, a dance, a boyfriend. I replaced food she threw and dodged a few punches. And a few hours in, she opened her mouth a tiny bit and I tucked a crumb of pasta in. I fed her that way for 6 hours, to get her to eat a plate of pasta. In her bed, against resistance, crawling all over her. She was falling asleep because it was 1am, but I shook her back awake to get the bites in. She finished it about 2am.

I decided that from then on she would eat every bite unless I were dead. I did allow for some exchanges--but only if the switch added calories. I fed her for hours in her bed. After awhile we were able to get out of her bed and on the sofa. 

I had read on here that you have to prove to the ED that you are stronger than it. And that's what I said to her over and over as I crawled around her in her bed, while she kept turning over to avoid me.

She's had other bad stuff come up lately, and so we have plenty going on. But she eats. On her own, with friends, etc. She asks for stuff. 

I think it might be helpful to shift your mindset to: "I am stronger than ED and I will do whatever it takes for however long it takes to get ALL food eaten. No negotiation with ED terrorism."

Good luck!!!
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EC_Mom
Bonny, you posted while I was still composing my last post. I was fortunate to get family leave from my job. Can you? Can you get relatives to help out? It sucks...maybe others will have ideas for you because the economics of treating ED are awful, no matter what.
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bonny
I have already been off work for nearly 2 months. We have no relatives nearby/able to come and stay and make him eat.

If things do not improve, or get worse, I will have to try to get leave of absence from my job, I guess. But my son is in his exam year (I know many of you are American) and he does need to be in school anyway. Unless it gets worse, in which case he will have to give up on doing his exams and I will have to stop working altogether.
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Sotired
It takes as long as it takes.you wouldn't look at any other illness and think "this illness will be finished on march 2 2017'.just as your son is focused on eating as little as he can get away with and exercising off what he does eat, you want end times.we all do, but it does take years.
Like you, my child got this as a teenager and it is hard to get them to co operate.a lot of the behaviour is guilt inducing.the anorexia uses that behaviour to get you to back off-and that's what it's doing.your son is going to be sad and make you feel guilty when you take away his exercise.but right now restoring him to true health matters.if he keeps pushing food away you have to sit at the table for a long time to get him to eat.
If that doesn't work offer ensure to replace the calories he didn't eat.if that doesn't work then in front of him write down all the food he isn't eating-everything he left on the plate and everything he refused for snacks.explain that you need to give the team a much better idea of what is happening with his eating.
My d was passive until.until I wrote things down.until I caught her exercising.until I found the food hidden in her room.until she discovered the extra calories I added.
Then anorexia really went to town and we experienced every bad thing that anorexia makes them do.but I have no regrets about the fact that I pushed.none that that we sectioned her over and over.nothing mattered more to me than we showed anorexia that no matter what it tried-guilt,tears,anger,violence,self harm, avoidance,...-no matter what, we fought and found a way through.
There's no easy way.it requires pretty draconian parenting.it has to be your way-because their way will keep their mind sick.you have to harden against the guilt feelings for now and just be as matter of fact as you can.he eats what he needs and you decide that, not him.
Also watch out for food hiding and water loading before weigh ins.my d was a chronic water loader before we found out.it meant her weight appeared the same each week though it wasn't.they also put weights in pockets and underwear.no animals in the room at meals.
And expect that if you are getting where you need to go,you will see an escalation in behaviour.its part of the illness, but you will need to have outside help (the police visiting)if he tries to hurt you or your h.i hope he won't, but always best to be prepared.
There are no magic answers and no easy fixes.you can't go along to get along-because there is no gettting on with anorexia.
Good luck,
Sotired42
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bonny
So re sitting at the table to make him eat (or following him upstairs, or whatever!) - how long till you stop, given that his next snack/meal is in 2 hours? Do you forget about that one whilst still trying to make him finish, or add it on or what? 

We sat at the table for an hour this morning trying to eat a slice of toast (had eaten the other stuff) I eventually stopped, making it clear that I wasn't happy. He did go and have his morning snack and he did have his lunch. Should I have done differently? 
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EC_Mom
Different forum people will have different angles. From what I read, your son currently weighs 9kg less than he was before you knew he was ill. That is a LOT to still be regained before you can start letting him do sports and make any eating decisions. And most parents here report that after the illness, the kid needs to weigh substantially more than s/he did to begin with. 

As I reported, in my case the reframe of my own mentality--that it will ALL get eaten, no matter what--ultimately and slowly and at great cost to my own sanity and health seemed to show ED that I was not giving in, and ED slowly gave up. And for awhile the meals and snacks did all run into each other, and most of what I did all day long was feed (or lead up to feeding, or comfort after feeding when the self-recriminations came). And people on here reassured me it was normal (Thanks Colleen!!!). And then I got some tips on how to speed up meals and then my kid got more of her life back and then it got better very slowly. 

While in the thick of it, though, there were some options: Can he replace the toast with an Ensure/Boost drink? Can you replace the toast with a calorie-dense alternative? Be sure that it is NOT a negotiation with ED, but frame it as YOU deciding that there is an alternative that you would accept.

In my case, I realized that if ED knows I'll stop after x hours, it will keep resisting for x hours. Others on here have paused a meal/snack and added the item to the next one. My problem with that was that things could add up a lot and make it harder. But it did work for some here.
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Kali
Hi bonny,

You could try this: don't look at your son eating. Eat with him, look at your plate, look out the window, look directly in his eyes when you talk with him, try to lighten up the conversation as much as possible, tell stories, talk about things you or he are going to do but don't look at the food on his plate and don't watch him as he puts the fork/spoon in his mouth. One of the symptoms sometimes is that someone with an ED just can't stand having other people watching them eat and it makes it even harder for them. That has actually worked well for us. 

Not sure if it will help or not but we all need to try what will work for our kids and figure out how to do that.

Kali









Food=Love
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Sotired
I'm sorry Kali I disagree.in our house, if I took my eyes off my d for a moment,that food was hidden and disposed of later.the whole point of sitting with them is that you ARE watching every mouthful going in.
This is not a time to respect boundaries like you normally would.thats why I called it draconian.
My d would have-and did-use anything like not watching her as a way to not eat...my dog got fat...her room was full of food she hid and put in bags.so no, keep your eyes on your son when he eats bonny.
I gave you a couple of thoughts already, but I know how hard it is to take all advice in,so I will say them again.
You stay at the table until the food is eaten Or have a time limit inside your head.when that time limit is reached you can offer a replacement milkshake-I am refeeding smallboy right now and he has a milkshake with three scoops ice cream,milk,I let it melt a bit, add cream and then whizz it up in the milkshake machine.
He has gained a kilo and a half in two weeks with this.
If there is still refusal you can talk to him about needing to go to hospital or residential for refeeding-because if he is 9kg away from his previous weight and not gaining for growth as well, then he may need a higher level of care anyway.
One thing we did say was "it's never your choice not to eat.you either do it here or in hospital, but those are your only choices".
For our d this led to full refusal ,but that had advantages-we could then put her in hospital,get some Ng feeding done, some support around refeeding and know that she was actually safe.hospital is how she found out about her heart dipping very low overnight.
If he eats very minimally or has a day where he eats or drinks nothing, it's a lot more serious for him than it can be for other children who don't have anorexia.one of the sayings here is that you can't be afraid of what the anorexia is afraid of.i would extend that a little and say you can't be afraid that they stop eating entirely, you put a plan in place for if that happens and push on.if you worry too much about them stopping eating anything, sometimes anorexia reduces what they eat because it knows you are too afraid that hospital will happen.
It's not a big deal if it does need to happen-just the same as any other illness, sometimes a higher level of care is required.so push forward, get some clear consequences going-and keep a food diary of what you see going in.if you don't see it going in-at this stage, it probably isn't.
I hope this helps?
Oh the rule is 24hours no fluid or 48no food-unless he weakens rapidly in which case,take him to a&e anyway.make sure they take his obs orthostatically-this MUST be LYING TO STANDING as many places do it sitting to standing and it gives incorrect obs for an anorexic person.
That's just if you need though, but I found the more I challenged, the more hunger strikes we had, and I had to have an effective plan b.

Sotired42
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mjkz
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But my son is in his exam year (I know many of you are American) and he does need to be in school anyway.


The least of your worries with 9 kilos to gain is his school attendance.  It makes absolutely no sense for him to refuse a piece of toast, go to school, ace his exams and die from a weakened heart a week later.  This really is life or death. 

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I eventually stopped, making it clear that I wasn't happy. He did go and have his morning snack and he did have his lunch. Should I have done differently?


If making you happy mattered, he'd have eaten the toast.  You are the one in control of what he gets at meals and the meal plan-not him, not his eating disorder.  With my daughter she ate what I gave her. If she ran over the time limit or refused something, then she was given a supplement.  If she refused to drink the supplement, she was on complete bed rest until the next snack or meal. That meant laying in her bed or on the sofa until the next meal-no reading, no internet, no phone, no TV, nothing.  Her life (and mine) stopped completely until the next meal.  We did the same for every single meal and snack.  Every time something goes uneaten, his eating disorder gets stronger.  His ED is still very much in control at this point.

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You could try this: don't look at your son eating.


My daughter would have died if I tried that.  Just like Sotired, not watching mine constantly led to hidden food, dead plants, stopped up drains from food hidden in there, fat pets, etc.  If I hadn't lived it, I would not have believed the places she stuffed food trying to hide it so she didn't have to eat it.  I think once her son is weight restored and has some time of eating 100% of everything given to him no matter what that might be a good experiment but with 9 kilos to go-that is a lot of weight.  The more you clamp down, the more his ED is going to kick up and that is actually good because then you know you are winning.
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grumpylostlittleboy
Hi Bonny, I'm so sorry to hear what you are going through. Your story sounds similar to mine.

I was wondering if a contract which focusses on positive reinforcement might work? We are currently using this approach with our son (13 nearly 14). He gets points for completed tasks (meals, timing, any anorexia behaviour he controls). The points add up to a monetary value (or privilege) & he choses what he is working towards. This way he is directly responsible if he does not get to go to pe.The feeling of depriving them of something often feels like a punishment & I often wonder whether it enables anorexic feelings....This approach changes the angle.

Also....we often see our health professional separately and then together. It helps setting targets from both ends & then she mediates.

Lastly....I still add heaps of extra calories. Everywhere. Boys need a lot of food to ensure they grow to their potential. Anorexic boys more so. At the moment fortisip is a life saver. He is still underweight thanks to a horrible decision by our psychologist 3 months ago, but he has stabilised.

Just a few thoughts...
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OneToughMomma
bonny, I didn't think my d had a compulsion either. But looking back she begged to exercise and was distressed if she couldn't. After she got better Sha actually said 'I'd rather stick a pin in my eye than go to the gym,'.

My guess is if your son gets anxious if he's not allowed to exercise then he's got a compulsion.

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

Sorry, I think that I didn't make myself clear in my post. I probably should have explained it better: I do sit at the table with d. for every meal. What I don't do is to stare at her eating and that is what I was suggesting. Does that make more sense? I am very aware of what is happening on her plate. But when I see her hesitate and know she is having a hard time taking the food and placing it in her mouth I don't stare at her. The plate of food is always within my peripheral vision. We don't sit across from each other we sit at a 90 degree angle so I can also see what is going on at the edge of the table and if something goes underneath. I guess this is a little hard to explain. D. had a really hard time, almost a phobia about people watching her eat and this is how I was able to make her more comfortable eating with others, by not making what was on her plate the centerpiece of the meal and her difficulty eating the center of attention. Instead there is a firm understanding that she must eat the food and she does. I hope I'm explaining this better this time. For example when she hesitates and I see she wants to leave some food over, (this happened this evening for example) I ask her to finish what is on her plate in a firm but kind voice and then she does it but I don't stare at her doing it because I can see that it is hard for her. And I change the subject and talk about something else. But I see the food go in. Does that make more sense? I was never suggesting that we should not eat with our kids or not be vigilant or let them go off and eat on their own. I am totally up her b***hole, as d. says, but this method is working for us. She is eating.

The dog has not gained any weight by the way [smile]

Kali



Food=Love
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Sotired
Thanks Kali, yes that does explain it better thanks.for my d though, I had to watch directly, she was a magician in training I think!lucky you re the dog-ours gained a kg and that's a lot on a little dog!
Sotired42
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BattyMatty_UK
It was fairly obvious with my son because he used to exercise round the clock. He just couldn't stop and was hating it. Rugby, gym, swimming, running, situps, pressups, the lot. He'd make himself late for lessons at school just so he could run between classrooms - and much more besides. He was also exercising in secret. In my experience boys tend to have issues with exercising more than girls do (that is boys and girls with eating disorders). Having said this, there are of course exceptions i.e. boys that aren't compelled to exercise in order to purge calories and girls that are. Maybe just keep a close eye on things to ensure it doesn't become a purging thing because, obviously, exercising does burn calories and this can be tricky when we are trying to get our children to gain weight...
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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Kali
Hi Bonny

When we were first starting with serious anorexia and d. was not eating and I was grappling with how to feed d. I ordered the video from this website:

http://www.thenewmaudsleyapproach.co.uk/Home_Page.php

It has different scenarios about feeding someone who is resistant. 

I also read Eva Musby's book about anorexia, Anorexia and other Eating Disorders, How to help your child Eat well and be well. She has the best suggestions for practical feeding. 


Kali
Food=Love
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mamabear
I found the book "Brave Girl Eating" was my "light bulb" moment. It became my Bible. It empowered me to truly own that WE could fight anorexia. That it was going to suck and be the hardest thing we had ever done, but we could do it. I also have given that book to many many friends and family to help them to understand what was going on in our home behind closed doors. Our house truly became a mini-treatment center. 

We did take our daughter out of the hospital against medical advice. There were a multitude of reasons but one of the primary ones was the snail paced weight gain. My daughter was at 2800-3000 cals and not gaining and they just could not believe it. I kept BEGGING them to give her more FATS specifically. They had her on this stupid "meal plan" and 1 little tiny teaspoon thing of butter counted as "1 fat". It was ridiculous. When we got home we jumped up the fats and cals and put more weight on her in the first 10 days than they had in a month. The meal plan was torn up. We fed her like my grandmother fed the big men that worked on their large farm. Full fat dairy, area, butter, breads, pasta, potatoes, oils, nuts.....We told her "we will never give you too much or too little. Food is your medicine. Trust in our love for you." That is why I told you that my hubby is a doctor and I am a nurse- because a "bad" professional can be worse than none. They are not all created equal. I am not saying you should fire everyone on your team and go it alone- but just that you need to FIGHT for what you know to be right because YOU are in charge of this. YOU are the one who has to do the nitty gritty work of sitting there and cooking and cleaning up and dealing with the constant abuse of the beast known as anorexia. You are the consumer. 

I also had to tell you this- I have a 13 year old non-ed son. Right now I have been doing a little bit of calculating his daily intake and I would say that on most days he is hitting the 3500-4000 calorie mark all on his own instinct. He is TIRED and hungry all of the time and is growing fast. So it is not surprising that a teenage boy who has been in starvation mode and needs to gain a ton of weight will need a ton of calories and fats.

Don't negotiate with the terrorist. Know that no matter what comes out of his mouth- it is ED talking. You have to learn to put up a shield of armor and let things bounce off as much a possible. My daughter would tell us she hated us and punched her dad in the face and screamed and spit and threw plates.....but if she spit out a bite, another bite was put on her plate. If she threw a plate, I pulled spaghetti out of my hair and got another plate. If food was not eaten- then ensure was drank. If we had to sit at the table until 1 am- then so be it. It was hell- but it WAS WORTH IT in the end. It DOES get better but those first few months are really really hard.
Persistent, consistent vigilance!
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Torie
Bonny, First I want to say that you have done a fantastic job getting your s off on his way to wr at a nice clip and also finding the forum so early on!  Well done, you!  You're off to a great start.

I feel so bad when new people come here and we flood them with all manner of overwhelming, scary, and otherwise bad news and opinions of which you've already had plenty.  Ugh.  But - regretfully - I'm going to have to pile on with more ...

You wrote: "It sounds easy to make him eat everything, but in practice, this is not going to happen overnight (as I am sure was the same for all your children) or even in a week or two. That's why it has taken lots of the children on here 2/3 years or more to be recovered?"

My d only restricted for a very brief period of time (thanks to a super awesome friend of hers who saw the problem  and made sure I got word - repeatedly - that she needed help).  She never lost more than 10 kg and she was never technically "underweight."  We are now three years in, and only just the other month, I realized that she is (finally) her old self again.  (Yay!!!) So it took three years to recover from 2 - 3 months of restricting.

OTOH, it was relatively easy to get the weight back on her.  (Relatively being the key word in that sentence of course.)  But yeah, she ate every bite of every meal from the get-go.  When it looked like I might not succeed with a particular meal, I explained that if I wasn't able to help her enough to finish, I would need to take her to the experts who could offer better help.  Thank heavens I never needed to follow through, but if I had, we'd have been off to A&E with the meal in hand.  Many find their Ed-kid is able to finish in the hospital parking lot; others have to go inside.  Often, the "help" is thoroughly unhelpful, but some do get lucky and find helpful help at A&E.

I once read a study about rewarding animals, and then stopping the rewards.  If the situation is black and white - first there are always rewards for behavior A and then suddenly there are never rewards for behavior A - the behavior is dropped pretty quickly.  But if the rewards are sometimes on sometimes off so that the animal never knows whether to expect reward or not, it takes a lot longer for the previously-rewarded behavior to go away when the rewards are stopped.  I think AN is like that - if bad behavior is rewarded by reduction in food - even once in a while - it will take that much longer to beat this vile illness.  I know that is not always possible, but I think it is worth going to great lengths to strive for: every meal, every bite.

I sympathize with your difficulty in figuring out if what you're seeing is exercise compulsion or if it's actually something your real s loves.  We were lucky that d's extracurriculars are non-athletic so she didn't need to stop them.  I thought it was a real plus that she was able to have the distraction and spend time with her friends and peers.  So I understand your reluctance to put a stop to something that may be positive. 

I agree with whoever noted that one clue about exercise compulsion is what happens when a day must be missed because of bad weather, flat tire or whatever.  For normal people, that is a disappointment but not a huge deal.  If it is a huge deal, well ...

Have you considered putting an air mattress or something just outside his door (or half in half out) so you can monitor his nighttime activity or lack thereof?  Some here have been very surprised by what they found. 

I also agree with whoever said it seems that exercise compulsion might be more common among male sufferers (and also the very young).  

(Abrupt transition to next topic follows) One idea I read here was to try holding the utensil for them and feeding them like we did when they were very small.  I was really surprised me that my d let me do that, but I think it made it easier for her.  Worth a try?

One final tip I learned here: Normal is a fabulous word.  As in, "It isn't normal to cut a sandwich into 340 pieces," or, "I really look forward to you getting back to normal so it isn't so hard for you to eat a piece of toast."  (Many here - raises hand - fall into the trap of saying the word healthy, which is inevitably converted to mean fat in their disordered minds. I don't think you used that word; it just occurred to me to mention that.)

Oh - oops - I guess that wasn't the last tip after all.  Someone here is good at reminding everyone that we are the best experts regarding what our kids need to eat.  Perhaps it would help if you explain to your s that you respect and value the opinions and advice of the paid help, but you are the one who knows your s best and loves him most, and you are the one who actually makes the decisions (after taking their suggestions into account).

I really will stop now.  Sorry for the information overload.  It's like trying to get a sip of water our of a fire hose, I know.

Keep up the good work! xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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BattyMatty_UK
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Someone here is good at reminding everyone that we are the best experts regarding what our kids need to eat.  Perhaps it would help if you explain to your s that you respect and value the opinions and advice of the paid help, but you are the one who knows your s best and loves him most, and you are the one who actually makes the decisions (after taking their suggestions into account).


So very true, Torie. I have always said: Never underestimate your gut instinct as a parent; you know your child best.
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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Kali
Hi Bonny




This video on youtube has some good suggestions for how to handle mealtimes.

Kali
Food=Love
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Dobbin
Hi Bonny

My D was referred to the Maudsley team just under two years ago at 15.5 and in year 11 and for a long time I was intending posting the question "how do you get the best from your CAMHS team" because I found it all so bewildering......It sounds like you've probably made quite a break through with your Dr and your son's treatment so maybe my comments are now a little redundant. And apologies in advance for any longwindedness but just incase our experiences help...!

I was slow to realise that I could relatively easily get to speak to our Dr on the phone and could at any time email - always via the administrators but they were incredibly efficient and i always got a response. The Dr would not email me in response other than very basic or generic information because of governance and confidentiality rules but would phone me.

At first the family sessions felt slow and unproductive. Our Dr was also relatively inexperienced in ED but behind these front line Drs there is a support network of experts who provide advice and guidance in between appointments. We had a couple of reassessments and sessions which were videotaped for others to view when progress stalled. Once weight is restored and state improving, then you may find that others are brought into the direct treatment process, for example the excellent art therapist.

Once I worked out that these professionals didn't have a magic wand, I adopted a position with my D that these experts were there to guide and advise me (us) in the fight to get her well, For me, one of the most important things the Dr said to my D was "trust your mum". I also remember sitting in the car outside explaining to her that whilst it might feel that I was betraying her confidence/privacy in the family sessions, this was essential if I was to get the advice I needed to support her through this illness and that I would only talk about things which I thought were important to her recovery. We first challenged our Dr when our D just kept losing weight when we moved into stage 2, after several weeks of weight loss he asked her to turn it around by the next weekly appointment or she would have to stop her dance classes. This might sound reasonable but knowing our D, I knew it wouldn't work, she would give up any hope of ever dancing again rather than be able to rise to the challenge so after an anxious weekend and with a lot of trepidation , i emailed to tell him that I didn't think it would work and that we were taking control again to get her weight back up higher than previously. And in response I got his wholehearted support....From then on her Dad and I became less passive in the sessions and, although our D remained as unresponsive as ever, we started to get a lot more out of them. Another thing I did was to find opportunities to let my D know that I had spoken to or emailed the Dr about something and received advice, I felt it was important that it wasn't kept secret from her that we were communicating and to share some of what we were communicating about although of course not all the details.

Another thing to keep in mind is the change once they turn 16 in the UK, there will come a point when the Dr has to reveal to your son that at 16 he can exclude you from his treatment (and even discharge himself). We were able to gloss over this a little and keep her attending and must admit that there was a fair bit of coercion and manipulation going on from our side which I didn't reveal to the Dr. It's a very tricky dance as parent.

Returning to the dance classes for a moment. Even at her lowest weight we didn't stop her going, this was out of ignorance because we had no idea how ill and fragile she actually was. However, I quickly worked out that it was impossible to get her to eat after dance class so very early on I was insisting that she ate a full meal before a class, this meant having dinner at 5pm to be at class at 6pm twice a week. Initially, many classes were missed but as eating became easier, dance class night became a good night for fear foods and larger portions!

I know exercise is a contentious and important topic so I will also add that I did stop all the out of character exercise - the trips to the gym, the crunchies and star jumps in the bedroom, I disappeared the skipping ropes and I took her everywhere she needed to go in the car. I also pulled her out of PE at school and arranged for her to spend the period studying with a teacher she liked who was free at the same time, as she wasn't a fan of school PE there wasn't any motivational ground to be won on this front.

Finally, my advice is to read all the advice on here about closing loopholes and interrupting behaviours and act on as much of it as you can. Even if you don't think your S is hiding food, deliberately vomiting or doing 100s of sit-ups after you go to bed, make sure you are checking for and devising ways to preventt these behaviours.

I wish you all the best and hope that after reading all this there's maybe something useful to add strength in this battle.

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anotherbite_CAN
Hi Bonny-  Such a good job you are doing!!

Don't know if anyone has mentioned checking out "trusttheprocess"' old posts.  She had a son, who played soccer and and fed though the teen years-  her posts are a wealth of info.  

Here is a link to one about how she managed the early days of referring (a check list if you will)-  http://www.aroundthedinnertable.org/post/show_single_post?pid=1276762308&postcount=25#gsc.tab=0

Here is a link to an early one when she was just getting going --- with lots of wisdom in the responses:
http://www.aroundthedinnertable.org/post/looking-for-support-5087151?pid=1267260215#gsc.tab=0

It's hard work to wrap our mind around this topsy turvy world (where we move them into (and through ) their anxiety rather than help them avoid what they fear.  Know that you are doing the right thing.  The only way out is through-  we can't be afraid of what the ED is afraid of.  We have to stand firm and fiercely love though their fear and resistance.  We can get them (drag them kicking and screaming -  sometimes metaphorically and sometimes not [smile])  through to the other side.

You got this mama!! keep reading and asking questions.  We have all been there.   




D dx at 10 years old in June 2011. She is now 16 and happy and healthy.  We were IP for 8 weeks and then refed at home for what felt like forever.  We chased vertical growth for years...as is typical for the age.
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bonny
Thanks so much for everyone's advice and links, etc. I have been reading and forwarding to DH. We are a bit overwhelmed, but better informed, and now have to decide on our own plan of action, whilst continuing to get him to eat it all.

DS is (like all anorexics, I'm sure) extremely stubborn. We are staying at the table trying to get him to finish his food (eats 3/4 or maybe more of most meals) but are not having much success in persuading him to eat more once he has eaten what he thinks is the right amount for him. He has done no sport and is unhappy about that, but is not trying to exercise - he has chosen to sleep on the floor in our room and is with one or both of us at all other times. We are being extremely vigilant. We go back to the ED clinic on Tues, so we will make sure he doesn't water-load or anything before weigh-in and then see where we are. I feel certain he has lost weight, but perhaps I am wrong.

Dobbin, I was so interested to read your post as you were at the same clinic and also because it sounds like your D loves dance like my S loves footy. I keep reading posts from people who say LSUYE, but they seem to be able to immediately involve the ED inpatient service, etc to take over feeding if their teen refuses to eat the whole meal plan. This just doesn't seem to be an option here - is that your experience? And how did you actually get your D to eat more? How did you manage it in school and did she eat all her snacks as well as her meals. My S HATES the afternoon and evening snacks and rarely eats any of either.
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mjkz
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And how did you actually get your D to eat more? How did you manage it in school and did she eat all her snacks as well as her meals. My S HATES the afternoon and evening snacks and rarely eats any of either.


What else can you use for leverage?  Does he like and want to go to school?  If he doesn't eat everything you give him, he doesn't go to school. Does he have a phone or use the internet?  If he doesn't eat everything you give him, then he doesn't have access to his phone or internet.

Do you add things to his food?  What I started doing with my daughter was adding extra calories everywhere I could and made sure she got all the calories she needed to keep gaining while working on making sure she finished everything I gave her.  My daughter literally spent a week laying on her bed doing nothing but coming down to eat and when she refused to eat everything was back on her bed on complete bed rest before she was willing to try eating everything I gave her.  It was a miserable week for both of us but that was what it took to get her to eat every meal and snack.  On complete bed rest, she did nothing but rest.  No phone, no TV, no reading, no anything.  I would follow her up with the food and sit on her bed with it in front of her until the next meal or snack.  It really was one of the worst weeks of both of our lives but she finally learned she was going to have to eat what I was giving her in order to do anything.
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bonny
Thanks - that is all good advice.

Yes he likes and wants to go to school. We will start saying no school if not eating meal plan from Tuesday if he has not maintained. But then it's the Christmas Holidays at the end of the week.
Also DH has said, if he has not maintained and S can't turn it round immediately, he will stop paying the football fees. 
He is getting a new phone for Christmas, so we could definitely use that as leverage.
Happy to say complete bed rest as and when it's necessary and we can definitely do that in the holidays when both of us will be around, although it would be difficult over Christmas itself.

Can I ask how low your D's weight was (and anyone else who would like to comment!) when you were saying eat or nothing happens? Was she in the danger zone?

I really hate BMI as a measure, but my S is not currently underweight, and infact, he was on the 55th percentile for his age according to BMI at weigh-in last week. However, he is definitely anorexic and his normal weight (he was very muscular) would have put him on the 79th percentile for his age. He also passed through puberty at 12/13 and has been the build, etc of an adult male for 2+ years. 


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