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

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Yael826_
HI, my daughter after about 2 1/2 months in now weight restored. Yeah! mood considerably improved. Rages gone, still intermitintly lowish/depressed but psychiatris doesn't think medication is indicated.  We are in FBT with a great therapist who feels my daughter should now start one one one therapy with her, we are continuing with our family sessions and she would like to start preparing us to move to phase II. For some reason I'm so anxious. Read stories about relapse. I so don't trust my daughter to take in 4000 calories on her own. Why would she, it's so much! She never ate like that before her anorexia. I realize that I will still be doing lots of monitoring and that we will be moving into this stage slowly. Allowing her to make some food choices with us continuing to monitor proper caloric intake. When do you cut back on 3 meals three snacks after weight restoration. Our therapist would like to see her about 5-10 lbs over her "target weight" for cushioning. She is also starting High school and is mortified that I will continue for awhile to monitor lunches. It's an open campus as I feel it will be pretty manageable but she is so craving to have her independence back. Any words of advise for those who've successfully been through this phase. 
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Enn
Well done! 
A couple of things and I don't wish to burst any bubbles but I wish to impart that WR for a 14 year old does is not a one shot deal. She will need to gain appropriately on her growth curve until her 20's. At 2.5 months it is still early days. They don't have switch where they hit the right weight and then they can feed themselves. That takes a long time. It took us about 6 months to get to a good weight, the first WR the team gave me, it took another 6 kg for my d's brain to get better and at 10 kg more from the first WR where she was more comfortable. We did not give her much control at all when she hit her first or second WR. We gave her choices, like flavours of yogurt or cookies or a clif bar, orange or apple juice. It took a long time for her to order on her own at restaurants and at 2+ years after dx and over 1.5 yrs of WR and chasing growth, I still am in control for most meals and caloric intake. Many teams give control back to early and one needs to establish stability for a while prior to handing back control. I have seen here too often that when control is give back to early there is a higher chance of relapse. I think one thing I tell most at this stage, is keep going and only give some choices like a mentioned above, but not every day, do it slowly. You want to make sure the "teaching" you do about food sticks. 
There is a good thread on timelines and how they set us up to fail that is a really good read, if you wish. 

During times of stress, we found that d would restrict more due to anxiety. It is unconscious and so we still have to remind her to eat properly during exams, and transitions. My D too is going to high school in Sept, and I am very wary that this may be a time where she may restrict so I will be speaking with the guidance counsellor in the first week to ensure everything is in place to give my d the  best shot at a successful grade 9. 
My d is 14 and she needs 3500+ cal per day just on average days and more on active days. She still is eating 3 meals and 2-3 snacks. Right now 3 snacks to gain more weight prior to school starting


Good job! Great that things are going well now.
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

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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Enn
This is a popular thread. 
https://www.aroundthedinnertable.org/post/stages-and-timelines-and-how-they-set-us-all-up-to-fail-7917698?highlight=timelines&pid=1304173472
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

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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Foodsupport_AUS
Great job on getting your D back to where she needs to be. As you have identified there is still a lot of work to be done, it is normal to feel anxious about it, and also pretty typical for teens to be insisting that they can do this for themselves. She will need high intake for some years to come and is likely to long term to need to eat more than she ate before, after all that is how she fell down the rabbit hole of ED. My D still eats three meals and two snacks a day, we are 9 years in. For her it is now a way of life. Part of moving to phase 2 is "returning control to the adolescent". I have to say I hate that term. For me it is more about learning to eat more independently in accordance with age and stage and development, after all this is what kids with ED struggle so much with. You are the safety net underneath her as she tries to navigate learning how to do things. So going slowly, little bits at a time, with her being aware that if she is struggling that you will step back in because she is not ready to do what she is trying to do. They are often very keen to manage lunch at school to avoid the embarrassment of parental attendance. They cannot learn independence if we do things for them. So trying, take back if needed, then try again in a while is the best way forward. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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Mamaroo
I would suggest starting slowly. My d moved schools close to being WR and didn't want me to monitor her recess and lunch meals, so that is where we started. I told her the scales would tell me if she's binning the food, but we had no problem with that. She did come home on occasion not finishing the food, which I just added to afternoon tea (her non ED sister did the same, so I didn't see that as a relapse, since it didn't happened often). If that goes well for several months, you can tell her to pick her own snacks, but continue plating the main meals. I still plate most meals, but do the same for non ED d, so she is not singled out.
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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ValentinaGermania
Most therapists want us to start phase 2 too early and too fast. Do it VERY slow. Start with allowing her to chose one snack and see if she is able to chose a good one and a good amount. Then when this works the next one and so on. It took us 1 year to get from phase 1 to end of phase 2. We are 2 years after WR and I still plate lunch (biggest meal here) and my d is required to eat most meals at home so we see what she choses. It works. She maintains her weight for 2 years now and is in good mood. She choses all meals and snacks with good amounts and I still plate the warm meal. She can have lunch at university for example but not eating out 7 days a week. That would not work because she still has no hunger cues.
Keep feeding. There is light at the end of the tunnel.
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Hope42019
We started phase 2 with giving our D (age 14) control in making her breakfast with us eyeballing it and letting her know if she needed more. Did that for a month. Gave her options for her side at lunch after that. We were WR mid June. She just started Freshman year 2 days ago! We mapped out her lunches and help her pack them. She is aware that if she doesn’t eat them (scale won’t lie) then counselor will be notified. Our saving grace right now is that we do a shake every night (900-1200 calorie). I adjust this based on her intake. We are working hard on the ED behaviors so we can improve her intake to food alone and no shake. It’s taking forever but we are trying to be patient because we know we can’t fix it all overnight. 
Phase 2 is such a slow process. If your D is craving that independence it can start with just one meal/snack and her showing you she is applying what you have trained her to do. Sounds like you are doing amazing getting 4000 calories in so you are on the right track. We have such a long ways to go but we are with you on this one. 
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