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

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WorriedMum68

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Reply with quote  #51 
Thanks for the update, Toothfairy, it’s so heartening to read these stories of recovery. It’s been an eye opener for me, I had no idea that calorie levels had to be so high for so long, or that such a level of vigilance had to be maintained. Can I ask how your son feels about the time he was in the grip of the eating disorder, or is it something he doesn’t like to talk about? I’m only asking to try to gain a better understanding of how my daughter might be feeling. On a different note, I think it was you who posted an extract from a new book by Lauren Muhlheim? It’s a great book and a welcome addition to my ED collection, so thanks for that! WM68 x
toothfairy

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Reply with quote  #52 
Dear WorriedMum
My Son had a very similar experience to what is described in this video,
Best Wishes

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cm72

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Reply with quote  #53 
This was amazing to read. I understand the length of time this will take but I don't think my husband has any clue!!! I'm going to print it out and show him.
toothfairy

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Reply with quote  #54 
Thank you.
I would like to add that we now have a great relationship, & he has very little memory of being so ill & the re-feeding horror. His lowest bmi was 16.8 & he was only restricting for a few months before we caught it.
He has thanked me for all that I have done & said that even when he hated me, he felt comfort in knowing that “ I had his back”, even though he couldnt show it.
Keep Feeding everybody!


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KLB

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Reply with quote  #55 
Thankyou for this post. It's exactly what I needed to read.
toothfairy

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Reply with quote  #56 
Here are some stats from BEAT UK
https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics

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toothfairy

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Reply with quote  #57 
https://www.verywellmind.com/brain-starvation-and-recovery-in-anorexia-nervosa-1138303
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toothfairy

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Reply with quote  #58 
https://www.kartiniclinic.com/blog/post/avoiding-negative-energy-balance/
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tina72

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Reply with quote  #59 
bump
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Ronson

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Reply with quote  #60 
That’s the one - thanks Tina - I was looking for it and getting ready for work at same time
tina72

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Reply with quote  #61 
I did not want to beat you, Ronson, I just found it and thought I can bump it already in case you have no time now. Please don´t mind.
Have a nice weekend!
Tina72

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Ronson

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Reply with quote  #62 
Of course I don’t mind - thank you - have a nice weekend too
toothfairy

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Reply with quote  #63 
Here is an extract from Dr Muhlheim’s book
“The good news is that once you complete the challenging early phase of parent-directed treatment and establish a routine, holding your teen in recovery generally becomes easier than it is during those first few weeks—that is, as long as you don’t rush to return control to your teen. Some teens may not be ready to take charge of their eating for a few years. Accepting this reality will grant you the patience to hand back control slowly. Return to the stages we discussed in the eating independence continuum in chapter 3. I have known families who have needed to spend an extended amount of time in stages 2, 3, 4, or 5, retaining full or almost full supervision, before starting to return some independence over eating to the teen. As you will see in chapter 9, you can conduct experiments along the way to test and offer your teen the opportunity to demonstrate her readiness.”

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mamabear

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Reply with quote  #64 
I am upping this post. It seems to be a very helpful thread for many many people. Read the entire thread.

This takes just a helluva long time. There is a lot of grey. Everything I wrote 3.5 years ago still holds true today.
Keep feeding❤️

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ACL

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Reply with quote  #65 
Hi Mamabear,
Thank you for all your posts telling your daughter's /your story. Some people binge watch tv shows, in the past year since my daughter was diagnosed with AN
I have binge read your posts.
She is now weight restored and so much better on so many levels but the ED behaviors feel like whack a mole: get rid of one and another pops up. Th e current struggle is over chewing which is making meals take 45-60 minutes...
tina72

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Reply with quote  #66 
How long is she WR? And are you sure she truely is?
Here it changed slowly but constantly about 4 months after WR and with about 1-2 kg higher than target weight set by the professionals.
Did you already try to set a time line for meals?

Tina72

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ACL

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Reply with quote  #67 
Hi Tina72, 

First, let me thank you for your posts as well. I have been doing a lot of reading and not much posting over the past several months but much of what you have written for others has been helpful to me. 

Yes, I do feel confident she is weight restored. We relocated our whole family to Portland for 2 1/2 months to work with the Kartini clinic. She is 12 and has (in hindsight) been ill for 2 years- lost only a little weight instead gradually saw changes in eating behaviors + fell off the growth curve. Goal weight was set on her historical weight percentile + they also did labs to confirm weight restoration. Most of her weight gain was in the 2 1/2 months we were at Kartini - they were able to help us push 3 lbs per week gain whereas in the months we tried to do FBT at home without a great medical team backing us we struggled and made slow progress. 

She has only been weight restored less than 1 month. We returned home last week and she re-started school. So, lots of changes. Kartini uses a meal plan (which I initially had mixed feelings about but which has been a very effective tool in getting her weight restored). She is eating everything on her meal plan. I do have to scoop the last of the keifer in her cup with a spoon, the last of the butter off her plate with a spatula etc and ask her to eat it. She does. She had a ton of ED behaviors in the past- tearing up her food, tiny bites, food hiding, etc etc etc. The over chewing is a new one over the past few weeks. She is (I think genuinely)  afraid she will gag if she doesn't chew so much, gets tearful when pushed. I can think of a number of reasons this one might have cropped up- reflux during re-feeding, another kid in her group with same behavior, past experience of seeing little sister choke on food.  It has waxed and waned so I was feeling initially like maybe we should give her a little grace period on time but I also don't want it to "take root" Her time limits are 30 minutes for breakfast and lunch and 40 for dinner. So, she is over them. Snacks she has no problem with time but they are usually yoghurt or kiefer so no chewing needed. At kartini her doctor pulled boost/ensure as a consequence for not finishing meals and told her the deal was "eat the whole meal plan every day or get an NG tube" So, using boost is off the table. Plus, I think it would be a bad idea as she finds drinking easier than eating and we don't want to give in to her anxiety about swallowing by letting her avoid real food. 
My husband and I talked last night and decided we will start with taking away distractions at meals (not always helpful for her as they make it too pleasant to take overly long eating), make sure he too is being clear that she is expected to stick to time limits (so far he has mostly been being sympathetic trying to calm her anxiety) and make sure to be very consistent with time cues at meals. 
tina72

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Reply with quote  #68 
Quote:
Originally Posted by ACL
Hi Tina72, 

First, let me thank you for your posts as well. I have been doing a lot of reading and not much posting over the past several months but much of what you have written for others has been helpful to me. 


Thanks for that. Please come and post more often, it helps you to keep your own sanity and you can help others to read your story.

Quote:
Originally Posted by ACL
Yes, I do feel confident she is weight restored. We relocated our whole family to Portland for 2 1/2 months to work with the Kartini clinic. She is 12 and has (in hindsight) been ill for 2 years- lost only a little weight instead gradually saw changes in eating behaviors + fell off the growth curve. Goal weight was set on her historical weight percentile + they also did labs to confirm weight restoration. Most of her weight gain was in the 2 1/2 months we were at Kartini - they were able to help us push 3 lbs per week gain whereas in the months we tried to do FBT at home without a great medical team backing us we struggled and made slow progress. 


So other question: Did you cut back food intake after WR? Is she still eating 3 meals and 2-3 snacks? I ask that because a) I could not cut back intake here until now, my d still needs to eat more than me just to maintain her weight and b) she still needs to eat very regular to keep her blood sugar level up. If your d is only 12, are you sure she has not grown in the last months? Then you would need to add more weight again.

Quote:
Originally Posted by ACL
She has only been weight restored less than 1 month. We returned home last week and she re-started school. So, lots of changes.


O.K., that is really early. So brain recovery will not have started up to now and that is why you still see so much AN behaviour. Is she doing school full term? What about lunch?
What surprised me a lot was that my d needed much more food when she was back in school. The brain needs about 500 calories extra to work. So learning might mean more intake now. Be prepared that she might lose weight because of learning.

Quote:
Originally Posted by ACL
Kartini uses a meal plan (which I initially had mixed feelings about but which has been a very effective tool in getting her weight restored). She is eating everything on her meal plan. I do have to scoop the last of the keifer in her cup with a spoon, the last of the butter off her plate with a spatula etc and ask her to eat it. She does.


So this is positive.

Quote:
Originally Posted by ACL
She had a ton of ED behaviors in the past- tearing up her food, tiny bites, food hiding, etc etc etc. The over chewing is a new one over the past few weeks.
She is (I think genuinely)  afraid she will gag if she doesn't chew so much, gets tearful when pushed. I can think of a number of reasons this one might have cropped up- reflux during re-feeding, another kid in her group with same behavior, past experience of seeing little sister choke on food.  It has waxed and waned so I was feeling initially like maybe we should give her a little grace period on time but I also don't want it to "take root"


You are right with that. It is ED behaviour and so it has to stop. Can you give her a number of chews that is "allowed"? Maybe 10 times and then swallow? Is there something she is interested in that you could use as incentive? Maybe "if you can eat within your limit we will go and buy that nail polish you want to have"? At that age incentives work very well normally. Can you think about a point system where she gets an incentive for every meal she eats within the time limit?

Quote:
Originally Posted by ACL
Her time limits are 30 minutes for breakfast and lunch and 40 for dinner. So, she is over them. Snacks she has no problem with time but they are usually yoghurt or kiefer so no chewing needed. At kartini her doctor pulled boost/ensure as a consequence for not finishing meals and told her the deal was "eat the whole meal plan every day or get an NG tube" So, using boost is off the table. Plus, I think it would be a bad idea as she finds drinking easier than eating and we don't want to give in to her anxiety about swallowing by letting her avoid real food.


I do not really understand why you thing ensure is out now at home, but I understand that you do not want to replace food that needs to be chewed with liquids.

Quote:
Originally Posted by ACL
My husband and I talked last night and decided we will start with taking away distractions at meals (not always helpful for her as they make it too pleasant to take overly long eating), make sure he too is being clear that she is expected to stick to time limits (so far he has mostly been being sympathetic trying to calm her anxiety) and make sure to be very consistent with time cues at meals. 


Taking away distractions might be worth a try but can also increase anxiety. You need to try. I have really no experience with over-chewing here, I hope someone else will come with more ideas soon. 

Tina72


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tina72

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Reply with quote  #69 
Another thing I forgot to mention:
I would suggest you open your own thread on this. Use the "new topic" button on the right and copy and paste your question from this thread. You will get a lot more replies to your own thread.

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ACL

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Reply with quote  #70 
She got through all her meals within set time limits today. Actually asked at dinner how many times each bite needs to be chewed. Still chewed more than others do but was trying.
Of course she pushed other boundaries instead-came in kitchen while I was prepping lunch, when asked to leave pulled chair so technically she wasn't in kitchen but still able to watch me. Finally complied when I told her to go sit on couch.Then outdoors wanted to go without her sweat shirt despite it is cool out. Told me it's normal, other kids don't wear a coat either, you're a dictator blah blah blah. It's a bit funny if I keep a sense of humour and remember my job is to be mom not friend. I will definitely take a little sass and boundary pushing over the level of distress, anxiety we had a few months ago.Although it does wear to constantly be pushed against.

3 meals 3 snacks still but doctor took 2 benecalorie off her meal plan once she got to weight goal. She did some school work while at kartini and was released to normal activity once she was weight restored. So, back to school is not a huge jump in activity compared to last few weeks. But, I agree, we will need to watch her very closely and be ready to increase food or cut back activity i f needed. She was weighed last week ( with weight up but first weight since leaving kartini so different scale so who knows if really gained) and will go back to doctor next week and be weighed again then. Lunch at school is with teacher or counselor who all know about illness so monitored.
tina72

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Reply with quote  #71 
Great that she got it in the time limit today. Keep on fighting for that.
Get her out of the kitchen. If she does not accept it, can you lock the door?

If she wants to go outside without coat or does shower cold or does not use her blanket in the nights check her phone and PC for those pro-ana-sites because that are common "tips" they get there to lose weight...

"remember my job is to be mom not friend"
YES! That is the change in parenting that is needed.

Tina72


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