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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GerMom
Hello lovely Forum members,
I am a worried mother from Germany. My „child“ is a 18 y o girl. I was a silent reader up until now...googled topics about anorexia and its effects on the body and found this page. Maybe some of you can help me (I also hope that you can understand everything I write, my english is a bit rusty and german autocorrect does not help [wink])

My daughter always was on the „chubby“ side throughout her childhood and in her teens. She liked to eat all my home cooked meals and took some snacks with her as soon as she left the house. We never had „junk food“ around or went out to eat very often (every three Weeks a pizza/fast Food dish)
But always had nuts, dried fruits, „healthy“ nut bars, juices, some chocolate, bread with different spreads, yoghurts,... around for her to take at any time.
She never was the most athletic Person. Only cycling to places, playing batminton or swimming( just with Friends) or 1-2 a week horse back riding. I didnt want her to start a competitive sport (she has a Mild leg disability)
When she was around 16 she got a gym membership and started to go there every 2 days doing zumba, pilates and some „Weight training“ - still ate good in the beginning. She told me her body role model was one of the trainers at the gym (very muscular, not so skinny) and i told her that she was/is beautiful the way she is. But in the following month she started to go to the gym every day and also doing hours of cardio there. Lost around 5 kg (Starting Weight was 65-68 kg and 168 m) from age 16.5 - 17. I thought nothing of it.
Then the stressful time of the a-levels „Abitur“ started and she (a perfectionist) started to freak out quite a bit. Didnt eat her dinner and supposedly ate before I came home in her room so that she could learn more :/. In 6 month she lost another 10-12 kg which I only really noticed when I wanted her to step on the scales in Front of me. I was shocked but she insisted that it is because she is training a lot and changed her eating Habits in a healthy way. Now cooks lunch and dinner herself mostly always oil free vegs, some tofu/lentils/other protein and fruit as a dessert. She finished her a levels (yeay), had a good time with her friends afterwards but talks about her „healthy“ lifestyle and doesn’t go out to dinner with the rest of the family any more [frown]. She said that she’s glad that she has changed because she secretly hated being „chubby“ all her life. Her gp told her that she needs more iron/potassium in her diet after her blood work was done. She takes two pills for that. Also encouraged her to gain weight again - she does not want to. Told me that her mens did not return after she stopped taking contraception (from age 15 - 17,5) but then gyn says it’s a normal thing to happen after stopping the pill. Also I noticed there is a lot Hair in the shower/brushes.
Currently she wants to start studying law in October but seems already a little stressed about it.
What is going on with her?(How) Should I encourage her to gain weight (around 48-50 kg and 169 m) ??
Thank you all!!
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Foodsupport_AUS
Welcome to the forum. Sorry that you have had to find your way here.

You mention much that is very concerning.

Your D has lost a lot of weight and is not at all concerned about it.
She does not have her period
She is underweight - BMI around 16 -17
She has various mineral deficiencies 
She is very restrictive in her eating

I think you have already guessed she has an eating disorder and although we cannot diagnose I think you have good reason to be concerned. Firstly I think you need a diagnosis and confirmation that she is not medically unstable and in need of hospitalisation. It appears that some of the people your D has seen have no clue about eating disorders so trying to find someone who understands may be a good first step. 

Please read around the FEAST site  for ways to get started on re-feeding your D. 
Although this website feedyourinstinct is in English it is a good website to help moving towards a diagnosis.

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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GerMom
Thank you sooo much for your quick response. I really worry about her, she seems so fragile and small. Everyone else just complements her effords/athletic looks. The thing is ... she tells me she does not want to change and is really happy about her body (like she has never been before) also she hates it when I „make“ her go to a specific doc because she says she is „an adult“ now and make appointments herself when she thinks she needs them. How do I convince to go to somebody who would diagnose her (a psychiatrist)?? Thank you, Foodsupport!!
Also „hospitalisation“??? Is it that bad 😨? She does a lot of sport - I think she is stable enough to gain at home??
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Enn


https://www.nationaleatingdisorders.org/blog/why-your-teen-probably-won%E2%80%99t-want-do-fbt-and-why-you-should-feel-free-do-it-anyway


Hi I welcome  you too here.
Tina72 is German and has posted many resources in German please search under her name all her topics and you will find it.
Your D is ill and I feel too as FoodSupport_AUS says above that she has and ED. All the physical and mental signs are there. I am so sorry.
Tina72 's D was 17 I think when it started. Please read her posts.

Please get her to the doctor for a check up and remember that the doctor may not understand EDs at all. She may need to stop all sports for a long time.

Does she live a home? Is she dependent on you for money/cell phone (a handy)? etc. If so you have leverage there and you may need to insist and just get her the help she needs.

We are here to support you. Please ask all the questions you have.
There is always someone here who has been through it and can help.

XXX

Food+more food+ time+ love+ good professional help + ATDT+ no exercise= healing ---> recovery(----> life without ED)

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
There is hope, there is treatment. We just have to get her to accept it.
With you in spirit and sending you support.
XXX
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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GerMom
Thank you scaredmom - I also hope that everything will be alright with your Child. :)
I will read Tina’s posts and see if I can come up with a plan to get her to gain some (how much would you suggest to start with?) weight.
She lives with me and I pay everything ...so I guess I need to tell her that, but I also respect her privacy and probably won’t take her phone ?? If I tell her to stop doing sport she will probably have a meltdown [frown]
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Torie
Hi GerMom,  So sorry you needed to join us here.  I'm impressed by your excellent English.

It's really unfortunate that TIna72 is away right now.  I know she will be glad you found us, and she is a terrific support and source of information.  So that is one thing you can look forward to (having her back).
In the meantime, you might want to check the thread she started for German resources.

It's a very good bet that you have a number of meltdowns in your future as you require her to regain the weight she has lost.  (There is very broad agreement that teens should not lose weight.)  If your d has anorexia (as seems likely), it will be a tough battle to defeat that, although very much worthwhile.

In the meantime, I suggest you try not to make any promises to your d (about how much weight would be enough, about if she can keep her cell phone, whatever).  This illness is very counterintuitive, and the learning curve is steep.

I will try to find Tina's thread and bump it for you.

Please feel free to ask all the questions you like. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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GerMom
Thank you, Torie! I really need to train my language skills - I work with english speaking clients. Which is my next problem: I am divorced and the only one who provides for the both of us. I don’t know how much sport she does or what she eats when I’m at my job (which also takes a long time to commute to?) . So I can‘t really know if she eats her lunch (which I still prepare) or just throws it away. I found some „Reibekuchen“ (Potatopancakes baked in oil) in the trash t other day. She said they went bad. But I don’t really know.
Another habit of hers is weighing all of her food?? It drives my boyfriend/partner mad „can’t you just eat a stupid piece of Brokkoli without using the scale?“ (He is kind of like her „Stepdad“ and very direct but says she has to figure everything out on her own and I worry too much :/)

So - Torrie: You say she shouldn’t have lost any weight in the first place? I suspected that ... but the first few kilos flew by. She just moved more and ate a lot [frown]. If I tell her to go back to that she will def hate me. Right now she trusts me a lot and listens to my opinion - even said, she wouldn’t mind gaining some „muscle“ and wants to contact a trainer at the gym to make her a (sadly) vegan meal plan.
I also noticed she freezes a lot. It is summer here (21 degree celsius) and she wears a long top and comfy socks - her feet are cold all the time. She uses a hair dryer to warm them 🤦🏼‍♀️
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krae
Hi GerMom, all of those symptoms sound very similar to my d. She wasn't particulary 'chubby' but was by no means slim. She started using our treadmill, weighing food and restricting intake and lost weight very quickly.

My d has now been diagnosed with AN. 4 months down the track and she is still losing hair, although not as much as she was. D was alway freezing but after gaining some weight is now at a better temperature. 

It's a daily battle trying to get enough calories in. 

Sad that you had to find your way here, but this forum has fantastic information and support for us all going through the ED battle.

Hoping you can get your d to accept she needs help and that it's not her fault that she has this awful illness.
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Kali
Dear Germom,

So sorry you have had to join us here but I hope you will find support.

It does sound as though there is a problem.

You don't need to wait for a diagnosis in order to start upping her food intake.
You can do that today. If you meet with resistance you can be sure there is a problem. 

You will want to keep her out of the kitchen and prepare and plate her food for her. Her only job will be to eat the food. Are you able to take some family leave from your job in Germany to help with weight restoration? 

Perhaps when Tina gets back from her vacation she will have some good advice about how to find providers in Germany. I'm attaching the AED medical guidelines for you to take a look at. Not trying to scare you but low potassium can be a sign of purging. 

As far as getting her to the dr. I also have a young adult daughter. I didn't ask her if she wanted to go to the doctor. I simply mentioned that we had an appointment for a check up and then brought her. This requires a more directive sort of parenting. If you ask her whether she wants to eat, go to the dr. etc, you are giving her to opportunity to say no, which she probably will. I don't ask questions for her to agree or disagree with, I just calmly state facts. We are having x,y, or z for lunch. We have a dr. appointment on tuesday, etc. 

Also if you haven't already, visit Eva Musby's excellent website where she gives practical advice about refeeding. 

https://anorexiafamily.com/

warmly,

Kali
Food=Love
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GerMom
Thank you Kali! Everyone has given me some very needed and helpful advice so far.

I want to call a Eating-Disorder-Hotline on Monday to be able to reach a Professional in my area. Then I just want to take her as soon as possible because my instinct tells me that what she does and how
she acts is just not right. Getting a check up will be a thing she can’t refuse!

Sadly her „routine“ has become to count macros/calories...so I m not so sure how to prevent that and to stop her from going in the kitchen/weighing her food. She also doesn’t eat my more calorie-dense dishes as she thinks that oil is carcinogenic

All in all I would describe her as excessively health driven - only wants to buy organic food, takes supplements, washes her hands every other second and is kind of afraid of bacteria. Does any body else experience this? How can I reassure her she want be ill if she stops doing that?
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Enn

GerMom,
Go with your gut. There is no harm at all getting her assessed. 

GerMom wrote:
my instinct tells me that what she does and how
she acts is just not right. Getting a check up will be a thing she can’t refuse!
 


All the best
XXX

 

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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Torie
scaredmom wrote:
Go with your gut. There is no harm at all getting her assessed. 


Actually, there might be.

Everywhere in the world, there is a danger that the medical "professional" will tell our kid everything is fine, even when in reality they most definitely are not fine.  At the time our kids most need us to intervene, the medical "professionals" often tell us - and our kids! - that we need to back off.  So I hope you will be able to speak with Tina before getting your d assessed.  She will be able to give you good advice about where to go and how to speak with them.

I love Germany and am more than 1/2 German myself, but from everything I have heard, mental health care in Germany tends to be very outdated and less effective than in many other places in the world.  (And it is actually pretty bad in a lot of other places, too.)  Sorry, I hate to be so negative.

In the meantime, I urge you to put your foot down, and do not allow her to become vegan.  If she ate meat in the past (before she started losing weight), she should eat meat again.  I realize that will be very hard for both of you.  I think it is normal for everyone in the household to eat whatever the mom cooks.  Does your partner eat what you cook?  If so, you could say that is now a house rule.  There is no point in arguing or "discussing" things with someone who has anorexia (AN) because AN is a brain-based illness and they simply cannot process information about food/weight/shape/calories/fats rationally.

It is very common that they want all the advantages of being an adult without being ready for adult responsibilities.  (They want to pick and choose so that they have all the advantages of being an adult, all the advantages of being a child, and none of the disadvantages of either.) If she still relies on you financially, you have a lot of leverage you can use to require her to regain the weight she has lost.

I'm really glad you are here.  xx

-Torie


"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Enn
Well I hope you get good help no matter what. I hear you Torie, some have had really bad experiences... 

XXX
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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GerMom
Now I don’t really know who I should contact or what I should do. Hopefully Tina will give me someone‘s contact details. I‘m anxious and really want to do everything right and also act immediately .

I read old threads about refeeding and will give that a try. Has anybody a got good balanced mealplan (including portion sizes) ?

Because I usually only prepare Lunch and a smaller Dinner (mainly for myself) and let my partner have some take away for dinner (which he eats very often, always is „on the go“). I‘d love for the three of us to start eating together and the same food.

I‘m also happy she wants to start eating more (but probably not enough?) on her own since she noticed that it leads to a better performance while weight training.

She‘s always been a vegetarian (since she accidentally saw a documentary age 6) but lately took it to an extreme and stopped eating everything I prepared with even organic milk, eggs etc.

I just want her to stop worrying about everything and start enjoying her normal „teenage“ (which she still comes across as) life.


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teecee
GerMom
Warm welcome from the north of England.
Tina will give you lots of info but if you have read about refeeding then you can start right away. Eva MUSBYs ebook and YouTube videos were invaluable for us and gave us the necessary skills when we were in your position.
I don’t have a meal plan to send you but as an example of how the day went I can say that we had the following:

Breakfast - full bowl porridge made with full cream milk+ 2 slices toast with peanut butter+ banana+ glass of fruit juice.
Morning snack - bagel with cream cheese and smoke almon
Lunch 2x sandwiches (4x slices whole meal bread) with filling (tuna mayo or chicken mayo or ham and cheese etc) + full fat yogurt + crisps/cake
Afternoon snack - 4 x crackers with topping (mackerel pate)
Dinner - a dinner with a third carbs (rice or potato or pasta etc) a third protein (chicken, meats, fish etc) and third vegs + pudding (cheesecake)
Supper - bowl cereal plus 2 x slices toast with butter/jam/chocolate spread topping etc
In addition glasses of water with each meal/snack.
Please no semi skimmed milk or low fat dairy or low anything intact. She needs the fats/calcium to recover and undo damage to bones that restriction can cause. Osteoporosis is one of many issues our children can develop through restriction of nutrients.

It may seem a lot but can I say my daughter restricted for a relatively short time (6 months) however she would eat huge volumes of the above for many many weeks. She did damage herself in that short time and was struck down with viruses as a result. She had issues with her liver due to restriction. I would really get your D checked out ASAP.

Please ask lots of questions and we will always help. Be brave...we are all in your corner supporting you.
Virtual hugs. Xx

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teecee
I forgot to say that a portion size is a good handful. When I say a third/a third/ a third I mean in terms of your dinner plate. Make sure the portions cover a third of the plate to make a full plate.
Also no caffeine drinks as they affect absorption of nutrients.
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krae
Nice tip about the caffine, not that mine drinks it, but I had no idea they affect absorption of nutrients.
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Torie
Here's what I would do:

I would pick a doctor or practice, and call them.  I would tell them what you told us, and ask if they think you should be worried.  I think Tina called a LOT of places and asked them questions and then picked the best one.  I think she wrote about that on one of her threads.

WHen you take your d to the doc, it's important that they check the orthostatic blood pressure.  That's something you could ask about when you call.  Here is a sheet from the U.S. CDC (very respected government agency here in the U.S.) so you will know what they are supposed to do:

https://www.cdc.gov/steadi/pdf/Measuring_Orthostatic_Blood_Pressure-print.pdf

In the meantime, I would start feeding her the same as your partner eats, if your partner is male.  Maybe very slightly less.  You would very likely need to ramp up to this, and start with just a small increase for your d.  Then increase the calories gradually.

It is best if she stays out of the kitchen when you prepare the meals.  THen you can add lots of butter and oils.

I'll try to find Tina's post about how she found the doctor she used.

Keep swimming. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Torie
Here are a couple things Tina72 has said:

"We had to change the GP, too, because our pediatritian did not know anything about ED and told my d that it is puberty and stress from school and will fade away. She did not even weigh her and told me she would eat when she gets hungry. Total bullshit.
I wrote emails to about 20 GPs in our region and asked them directly wether they know something about ED and told them what we would need. 2 wrote back. One to say he is retired now and one to invite us to come for an appointment. That is the one we are with at the moment.
Try to be informed about the illness as well as possible to be able to talk to them on the same line.
A good medical control is important. With this disease patients can look quite well and be an emergency case next hour. I would try to get a better one.
Tina72"
https://www.aroundthedinnertable.org/post/show_single_post?pid=1305014937&postcount=5&forum=136439

"I phoned some up and asked direct questions about EDs. After reading around here you might know more about that than some GPs. Ask about FBT. If they do not know FBT, they normally do not know anything about ED because FBT is the gold standard in ED treatment in 2018."
https://www.aroundthedinnertable.org/post/show_single_post?pid=1305224508&postcount=13&forum=136439
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Torie
The timing is so unfortunate.  Tina is a very valuable member here and a very regular poster.  I know she will want to talk with you when she is back.  (It is really rare that she is not here.)  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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GerMom
Wow - so many replies, thank you lovely people!
I’m wishing you and your familys all the best! Thanks for your support scaredmom and krae !

Teecee: I’d love to visit „your“ country (and the US or Australia) in the near future with my daughter when she’s feeling better 🙂 Sadly she refused to go on a trip anywhere due to her „strict“ rules (the last 2 years) I made a list of groceries which I will buy tomorrow when the shops are open. Thanks to your mealplan I have an idea of how much food she might actually need . She definitely doesn't eat as much or vas often. I also never really cared to buy full fat milk products or certain oils (some people said canola - I usually used small amounts of olive or sunflower). But I‘d do anything to make her feel better. She drinks green tea (mildy caffeinated - should I make her stop??) I read about symptoms girls can suffer from when they don’t have their periods [frown] Now I‘m scared she develops osteoporosis [frown]

Torie: You are a lifesaver! That is a brilliant plan - which I could not have come with myself! The p should be „on board“ with this method here and should I insist to let him/her tell me her results after she got for example her blood work done again or her pulse/blood pressure and everything from the sheet checked? Because she usually talks to every doc alone and they have „confidentiality“ :/ It is really helpful to read those resources about what to look for or how to achieve weight gain together as a family. Now she only has to eat !!!!!

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GerMom
Im already in preparation for a family „meet up“ at our house today. Really happy about it - they bring cakes, pasta salads, different kinds of meats etc. First try to make her eat whatever I put on her plate while saying „you should sit with the rest of us and eat something your grandma made“
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teecee
Morning GerMom
I certainly didn’t mean to scare you! We have lots to cope with during this time but sadly the body needs calcium to lay down dense bones so we don’t get brittle bones when older. When my D found this out she was devastated. We don’t have issues with we drinking whole milk and eating calcium rich foods now 😁 Tina’s thread is very true. My D was a high performance athlete one day running round a sports hall...the next day couldn’t walk up the stairs. She ‘looked’ fine apart from some weight loss which exposed her muscles but she was seriously ill. The mind is a very powerful thing to break through the pain barrier of starvation. I suspect your D is a very smart girl with a tendency to want to do things well?
Re the green tea...we switched to decaffinated and she still drinks it.
We definitely didn’t eat as much as the food on the example meal plan. In fact for the first couple of weeks before we met the dietician we just fed a ‘normal’ family amount which we found from the dietician wasn’t nearly enough. This shocked us. The meal plan ensured she could last the 8/10 hours through the night without waking. Complex carbs are needed (whole meal bread...pasta etc) to ensure they can last the whole night ... so whole meal toasts etc....
It was a big life change for us too as we always had semi skimmed milk but no more now. The fats in the milk, butter etc are needed by the brain as the brain is mostly fats. Without those essential fats it doesn’t work correctly hence the irrational thinking with ED patients.
Patience in abundance is needed along with tons of compassion and confidence (feigned if needed!) to deal with EDs. Any anger you see from her is extreme anxiety so do your best to reframe it and treat her as you would when she was a toddler experiencing a frightening world for the first time. That will be how she feels around food - IF she has an ED (which I have to agree looks possible).
Virtual hugs xxx
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Torie
GerMom wrote:
should I insist to let him/her tell me her results after she got for example her blood work done again or her pulse/blood pressure and everything from the sheet checked? Because she usually talks to every doc alone and they have „confidentiality“ :/ 


I don't know the laws in Germany, but elsewhere it is the patient's choice if the parent has access to the information (after the patient is a certain age, which would include 18, unfortunately).   You could ask the potential doctors if they are willing to encourage your daughter to sign a release so that you have access to the information.  What you DON'T want is a doctor who actively encourages your d to keep the information from you. xx

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