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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Turnbulltj
Good Morning friends.

Well It's been a traumatic weekend, but by the end of Sunday and a pleasant evening bowling with D's friends she was very upbeat last night and drank her milk with no resistance.

This was a million miles away from the swearing, lashing rampages at breakfast, lunch and snacktimes.

Unfortunately after a nights sleep and no doubt 10 hours of 'Ed' re-hijacking the brain we were back to square one. It seems that mealtimes and snack times are such a lengthy trauma that they jist merge into one and we spend what seems all like all day, preparing food, fighting, fighting, winning and then starting all over again.

CAMhS have now introduced a new diet and D is freaking about the quantities and totally refusing to eat things like jam on toast, biscuits, crisps, chocolate, all of which are on the new regime.

D is obsessed with knowing the calorie value before she eats anything but CAMhS have told us not to discuss calories or grams or anything similar, just reassure her that she is having exactly what she needs.

But we are really concerned about getting more calories into her for refeeding purposes and wondered how others have managed to overcome it.
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mfab12
Hi

I would also be interested how people include those foods. We are 10 days into FBT. My 15yr old has done the lashing out, screaming, head butted a wall, all very distressing. We have made progress on many foods, mainly full fat milk (but still refuses milkshake), nann bread, yoghurts and cereal. No tears for 2 days and I have full control of what she eats. Its really difficult beyond belief!
Chocolate and cakes have been a complete refusal and I get the response of 'of course I am not going to eat that'. Do I enforce this? or continue to do gradually, I have introduced biscuits which are 'cereal bar biscuits', its difficult as nuts have more calories than a lot of the cakes. Or I just pandering to the ED?

She has always been very sporty and concerned of the impact on her health! I know a complete contradiction to her starving herself to be 'healthy as possible'

I have just found this site, I wish I had known about it 10 days ago. I was not prepared for the first week and as a parent it is a lonely battle.



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Enn

Turnbulltj,
Fear foods and high volumes of foods are really scary for our kids. There is no one way to do this and over time you will do it.
You are very, very early in your course, as I recall. From our experience, everything was a fear food at the beginning and always "too much" for her. So, I found that letting her know that one meal per day would have the fear food and she could settle a bit. Yes, there were still fights and I mean throwing, swearing and breaking things. I would just give it again and again AND her dad would sit with her as she was mad at me ( I plated and cooked so I was the bad guy). H would sit quietly with her and calmly say she could eat it. We found too that by not saying anything or looking at her worked a bit better. She would gobble it down and she would feel so guilty. The repeated exposure is the real "therapy" here.

Some have started with one bite of the fear food. For example, adding one spoon of mac and cheese with another safe food then increase in the next few days until a whole serving was eaten. YOur is only 13, did the team discuss the diet with her? We found it helpful that D did NOT know the calories. And I used the team to support my efforts to add in new things. I would call the team and tell them that I would add in smoothies that week for three days per week and they would tell D that so the team took the blame and I could say that "the team decided and we are doing it."

Some had a jar of fear foods that the child picked and they did it that day. Some listed in order the fear foods and tackled a few times in the week or so.
Please look up fear foods in the search, and you will get more ideas.
Have you added in calories with oils, cheese, cream, etc.. once the weight goes up with the smaller volumes ,I found it was easier to introduce more voluminous foods AND fear foods.They learn to trust you too over time. It is a different type of parenting and  you may need to go against everything you thought, but you have to do it and you can do it and you have us. We have been there, in the same place you have and the same anxieties.
I know others will be here shortly with their hard won knowledge.
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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ValentinaGermania
First goal is that they eat what you serve and that you get enough calories into them for wait gain.
Be a broken record, like cams said. Do not engage in calorie talk or portion size talk. This is your meal. I know what you need. Trust me. The broken record.

At the beginning most calories get in with "safe" food + "specials". Rice with oil, Joghurt with cream, fruit shakes with oil, milkshakes with cream, mashed potatoes with butter and so on. See what she would eat and then make it a caloric bomb. Small footprint.

Then you can start to re-introduce fear food. There is no golden rule. You can do it all at once or slowly one thing after the other. One small cookie for afternoon snack. Then a bigger one. Then two cookies.

mfab12,
hi and welcome from Germany! Great that you found us here! We can help you a lot.

"Chocolate and cakes have been a complete refusal and I get the response of 'of course I am not going to eat that'. Do I enforce this?"
Yes. You need to re-introduce that because it is normal to eat chocolate and cake and fats and sugar are very important for brain recovery (the brain runs on fat and glucose). You can do it slowly and one after another but you need to do it. Make a fear food list and think about working on that at least once a week (depends on how long your list is).
If I had got an € for every time my d did say "I will never eat that again" or "I will never do that again" and then she did it I would be a rich woman now [wink].
It took us 18 months to work that fear food list down (in fact it took us 8 months and 10 months for the last 3 things) but now she is eating all that she ate before WITH PLEASURE.

Tina72
Keep feeding. There is light at the end of the tunnel.
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Foodsupport_AUS
mfab12 welcome to the forum. 

Getting enough calories in is one of the hardest things to do in early treatment. What is going to work for some is not going to work for others. 

As much as possible it is best to avoid negotiation with the eating disorder - so easily said but not so easily done. Hmm and Uh huh are good options when the topic comes up. Or something along the lines of "I know this is hard for you but this is not up for discussion" 

After that try your best. It is a balancing act of the degree of resistance - sometimes enormous vs. the what you feel you can cope with too. This guide gives some great advice http://ceed.org.au/sites/default/files/resources/documents/FamilyLedRefeedingRecoveryResourcePartA_Nov_2017.pdf

If you are going to have a battle make it worthwhile. 

For my D we didn't have fear foods, just fear calories. Calories from fats were also of concern but it made no difference to D if it was icecream, biscuit, or broccoli. For D it was all what it was and how many calories were in the serve. Some kids have distinct fear foods others their food list is not as narrow. We couldn't use mixed foods early on. My D was able to sit at the table until she had to be taken to hospital - this meant that initially it was better to use foods she would eat rather than challenge the behaviour.

I would suggest that until you have enough calories going in consistently there is no point in having big battles over "particular foods" If nuts go in but biscuits don't then add the nuts. Better still powder almonds and add them to all sorts of things. If all foods are beige early on it is OK too. Some people have managed to do everything at once but overall that is the exception than the rule. 
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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Nicstar4
Welcome!
Early in the renourishing process too. Just figuring out what is going to work. Some excellent points of advice here.
I Never know what is going to work. No rhyme or reason, some days I have to dodge the flying food and feel like I have done a whole week before I get to work, other days go ok. Crazy making stuff!
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mfab12
Foodsupport_AUS wrote:
mfab12 welcome to the forum. 

Getting enough calories in is one of the hardest things to do in early treatment. What is going to work for some is not going to work for others. 

As much as possible it is best to avoid negotiation with the eating disorder - so easily said but not so easily done. Hmm and Uh huh are good options when the topic comes up. Or something along the lines of "I know this is hard for you but this is not up for discussion" 

After that try your best. It is a balancing act of the degree of resistance - sometimes enormous vs. the what you feel you can cope with too. This guide gives some great advice http://ceed.org.au/sites/default/files/resources/documents/FamilyLedRefeedingRecoveryResourcePartA_Nov_2017.pdf

If you are going to have a battle make it worthwhile. 

For my D we didn't have fear foods, just fear calories. Calories from fats were also of concern but it made no difference to D if it was icecream, biscuit, or broccoli. For D it was all what it was and how many calories were in the serve. Some kids have distinct fear foods others their food list is not as narrow. We couldn't use mixed foods early on. My D was able to sit at the table until she had to be taken to hospital - this meant that initially it was better to use foods she would eat rather than challenge the behaviour.

I would suggest that until you have enough calories going in consistently there is no point in having big battles over "particular foods" If nuts go in but biscuits don't then add the nuts. Better still powder almonds and add them to all sorts of things. If all foods are beige early on it is OK too. Some people have managed to do everything at once but overall that is the exception than the rule. 


Thanks, this is very helpful.
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Enn

Dear mfab12,
Welcome, although it is sad that you needed to be here.
Please ask all the questions you have. We are all ears.
There is always someone around that has literally been in your shoes, and your house and knows what is going on.
XXX

food+more food+time+love+ good professional help+ATDT+no exercise+state not just weight +/- the "right" meds= 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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Torie
Greetings, and welcome.  So sorry you needed to join us here.

I agree with the others that the top priority at the moment is increasing caloric intake.  Honestly, I didn't much care WHAT my d ate in the early days as long as she ate ENOUGH to gain weight at a good clip.  I learned here that I could add canola oil (rapeseed in UK) to soups, yogurt, smoothies, etc. and that it would disappear without changing flavor or texture if I gave it a brisk stir.   A little experimentation is needed to learn how much you can add, and then you can gradually increase it.  If your kid will eat grilled cheese, butter both sides of the bread.  Grind nuts to a powder and add them to everything you can.  Check the labels and find the most caloric versions possible of bread, snacks, yogurt etc. and make sure all beverages have as many calories as possible.  For example, full fat milk and then you can add cream to it.  Grape juice is much more caloric than apple.  Premium ice cream and yogurt are much more caloric.  

Once things have settled a bit, you can worry about things like chocolate.  

I am always surprised when scaredmom says, "She would gobble it down."   That is not how I would describe my experience!!!  In the early days, my d ate slowly, weirdly, extremely sadly, and with a terrifying vacant look in her eyes.  I think that is much more typical.  It is also common to have screaming, food throwing, food refusal, and running away.  Even violence.  If you can tell us exactly what you are faced with, we can help brainstorm ideas to help you through.

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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Enn
Sorry for seeming as if it was easy and d gobbled it up. She would eat the food quickly to get it done. It was done in a hostile way. She and I did not enjoy it. She would be angry look down at her plate and ate as fast as she could. Thanks Torie for bringing that up. I don’t want anyone here to think it was easy at all.
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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mfab12
Thank you. I have never spent so much time looking at calories on the back of yoghurts. Yesterday she told me she 'gives up and will eat it so she can get back to running'. today I faced her with nuts, flapjack and full fat milk as a snack, and she did just eat it without comment. I am not sure her motivation is healthy, but if it helps her consume the food, then I will go with it. I will look into the oil. She doesn't eat butter or cheese (before the restricting) which makes it harder.

Hearing success stories really helps to keep me strong and take that deep breath before giving food.

Thanks for the support x
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ValentinaGermania
What I had to learn in the early days:
1. There is no healthy or unheathy food for my d. All food is healthy because it will keep her from dying. So it is not important what she eats as long as she eats at all.
2. It is not worth to fight over 5 cranberrys or a half banana. If you need to fight for food intake, make the fight worth it. It is the same fight about 100 calories as about 500 calories.
3. You can load your basket in the supermarket with the same products of different brands and it can change 1000 calories easily. After 2 weeks I knew what was the highest caloric yoghurt and bread and cookie in my supermarket.
4. If you need to hide fats in food to help her brain recover do that. She may not eat butter when you serve it visible. But she will eat butter if you hide it in mashed potatoes or in rice because she does not see it and if she does not know it she can eat it. If she was a baby and had to take pills you would hide them in a teaspoon of pudding. Do the same now. Food and fat and sugar is her medicine. Her brain needs that medicine to recover.

This is just a small part of my learning list [wink]. You will find out what works for your family, too.
"I was not prepared for the first week and as a parent it is a lonely battle"
NONE OF US WAS. Somebody here said recently "that was not in the baby books!". But it is no lonely battle any more now. We are here to help you. We have been in your shoes. We are open 24/7.


Tina72
Keep feeding. There is light at the end of the tunnel.
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ValentinaGermania
"Unfortunately after a nights sleep and no doubt 10 hours of 'Ed' re-hijacking the brain we were back to square one. It seems that mealtimes and snack times are such a lengthy trauma that they jist merge into one and we spend what seems all like all day, preparing food, fighting, fighting, winning and then starting all over again."

That is the start of refeeding. I cannot hide it in nice words. I was cooking and cleaning and feeding and cooking and feeding. The whole day. But when ED saw that there is no possibility to NOT eat that food any more it got better. Suddenly we had one day with no complaining about food. We realised it 2 days later [wink]. Then we had two days without complaining about food. Then a week. It does get better if you stay strict like a brick wall now. Not tomorrow and not next week. But I would dare to promise you you can eat some cookies with her under the christmas tree this year.

"D is obsessed with knowing the calorie value before she eats anything but CAMhS have told us not to discuss calories or grams or anything similar, just reassure her that she is having exactly what she needs."
That is exactly the right thing to do now. Get rid of the numbers if possible. Throw away packages. Take off banderols. Serve joghurt in a plastic bowl (no numbers on that). Put high caloric food in low caloric packages if that helps her to eat it. Some here filled ful fat milk in low fat containers at the supermarket parking. Normal coke in coke zero bottles. Everything is allowed but the food must go in.

Tina72
Keep feeding. There is light at the end of the tunnel.
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Mcmum
Hello all, we were diagnosed in August and although my son is only 9 he's a calorie expert so I ended up making a lot of my own food. Flapjacks loaded with butter and ground almonds, streaky bacon and rape seed oil in everything savoury, cheese, cheese sauce or cream in everything... We had 8 weeks of full on cooking with some meals taking forever. The morning seemed best for getting food in so if there is a time when your child is slightly more receptive, load the calories in then. At times we had to just sit with our son and tell him like a broken record at we loved him but we're not backing down and that the food on the plate had to be eaten. Much drama - it's really tough early on but gets better. The 3 meals, 3 snacks means that your entire day revolves around ed but it's not forever. Granola is packed full of calories. Good luck!
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mfab12
it is soooooo difficult. you have a good snack session, then dinner is 'too greasy' and then refusing everything else, including the yoghurt smashed all over hall floor. sometimes I feel strong and other times, I don't feel I have the energy to fight it

I suppose tomorrow is always the opportunity to be better.

x
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Enn

mfab12,

This is a difficult process. It is a like a tug of war, literally. There will be times when you can move it forward and bit then it goes back. Yes we had some chocolate milk stains still (1.5 yrs later) on the ceiling. I consider it a "battle scar" I will keep it there as it reminds how far we have come. There is a steep learning curve on what and how you will do things. You may feel that X would work today but no Y is what it takes. You will build your repertoire of skills very quickly. 
It is ok to feel less strong, it is hard, hard work to be constantly on top of it. Please be kind to yourself. Let us know how we may help!

It is hard to see now but it does get better. Feed, feed ,feed.
You got this
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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mjkz
I did the rip the bandaid off and threw everything at my daughter.  I did not make her eat things that I knew she hated i.e. she has always hated green peas, apples, bananas, etc. so I stuck with her pre-ED disliked foods but she ate everything I gave her other than that.

To keep meal times and snack times separate, I did a time limit on the amount of time I waited and what she did not eat, she drank in a supplement.  If she refused, she was on complete bed rest in  her room with nothing to do at all and that included reading, internet, her phone, computer, etc.  She did absolutely nothing but lay on her bed until her next snack or meal time. 

I was pretty strict at meal times in that I didn't allow food to be thrown, no abusive stuff, etc.  My daughter had been inpatient before and I had seen the fact that they don't allow that kind of stuff in the hospitals so I just continued that at home.

ED will be like a brick wall so you have to the brick wall that is stronger.  Smoothies were our best friend because you can get a lot of calories in a smoothie.  Oatmeal too is a great one that you can get a lot of calories in.  There is a muffin mix on the high calorie thread that you can get 1000-1200 calories per muffin in and I used a lot of those.

My daughter did have some dietary restrictions like the fact that she is completely lactose intolerant which really sucked because I couldn't use heavy whipping cream, full fat milk, etc. but I was still able to do smoothies and yogurt with active cultures.  She tolerated that much better than any other dairy product and I still use Lact-aid pills with it.  She was able to do yogurt but any other dairy was a no go.
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mfab12
I need to build my brick wall a bit stronger! And after this evening I've now removed all bathroom door locks.

Thanks for everyone's support. It really is helpful knowing people understand. X
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mjkz
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And after this evening I've now removed all bathroom door locks.


Ha!!  That was one of the first things I did was remove all the locks except on the doors going outside and the doors to the bathroom she used.  My daughter would purge at any time-even hours after meals and you know how I found that out?  I have an older house with metal pipes and the acid from her stomach ate a hole in one of the pipes from the toilet.  The plumber thought I was using drain cleaner in the toilet or disposing of chemicals down the toilet. 
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Enn
mjkz wrote:


  The plumber thought I was using drain cleaner in the toilet or disposing of chemicals down the toilet. 


That is incredible! I did know that stomach acid is quite caustic- but to affect the pipes?! WOW!!
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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Frazzled
scaredmom wrote:
Sorry for seeming as if it was easy and d gobbled it up. She would eat the food quickly to get it done. It was done in a hostile way. She and I did not enjoy it. She would be angry look down at her plate and ate as fast as she could. Thanks Torie for bringing that up. I don’t want anyone here to think it was easy at all.
XXX


My D did the same thing. She would make a huge fuss and then get mad and stuff huge mouthfuls in her mouth and would be done very quickly. Then the guilt set in and then she would run to her room and cry.
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amirak
So helpful to read all these posts. I've been wondering about 'fear foods' (but didn't know it was called that) -- now (after reading these posts), I feel more clear on prioritizing the caloric intake.


Canada
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Enn

Hey amirak, 
How is it going?

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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amirak
scaredmom wrote:

Hey amirak, 
How is it going?

XXX



Yesterday was rough. D woke up, cried for over an hour. Sobbing. "I wish I could eat anything I wanted and not feel horrible". Which, later that night I felt gratitude wasn't "I don't want to eat anything, screw off".  By mid-day, things were better.  
I've booked a massage for later this week. A bit of self-care...
Thank you so much for checking in.
xx
Canada
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Mamaroo
You've already received great tips. The only thing I can add is if you like baking you can bake our own bread. The bread I bake is a lot denser and I can cut it thicker as well. Supplements such as Ensures have a lot of calories in a very small package. Nuts are also calorie dense. I don't really bother with salad and fish anymore as it contain very little calories (except salmon and tuna in oil). 
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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