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KLB
Now that s is weight restored, we’ve been advised to start working on his fear foods, having re-fed pretty much entirely on limited and safe foods. The fear list is huge and I’m already worrying about how to do it right, so it doesn’t set off a downward spiral, and ruin the progress he’s made. His weight restoration is fragile and, considering how long it took us to get there, I really don’t want to mess it up. 

So, please, any tips/tricks for starting this part of the road? What worked for your kids? What do you think will work for my kid, those of you that know a bit about him? Do we tell him? Or just do it and see what happens? Where and what do you start with? How many a week? Everyday? Once a week? More than one? Or one at a time? How do you choose which one? 
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Enn
Hi KLB,
There are so many ways to tackle fear foods as you are likely aware. Gosh it is so hard to know what will work until you give it a try. 
There is flooding and just doing them regularly and then there is laddering. When I recall your history, I wonder if laddering may help. 
So for example if he does eat some fruit, like strawberries, could a bit of strawberry jam be the next step- like a taste for a few days, then adding more on a bit of toast or cracker for a few days again, then more on  proper slice of toast, then butter and jam on toast. I wonder if you could try to do it every day for a few days before you added in the next challenge.  This is of course an example. But it may be an approach that you could think about.  

Some have had a list of least to most fearful foods and picked one per week. All were fear foods at the beginning, for us and we added almost daily. 
https://www.aroundthedinnertable.org/post/fears-foods-how-do-i-tackle-them-9688719?highlight=fear+foods&pid=1303629382

 Once we got into the rhythm of feeding tackled the bigger fear foods like cakes and cheesy things. We did once per week, then, it was given a few times per month. The key to fear foods is to ensure that when you start the next fear food, don't forget to continue to have the older fear foods so they become a normal/regular part of the meal plan. For us it was Mac and cheese. We had it once then two weeks later. 
We told our d when the fear food was coming. We also had the doctor  or team tell d, that " it is time for nuts this week or cakes, ice cream" (what have you), and she sometimes would choose the day. She knew she had to have it but she felt she had some control on the day. She never tried to get out of the day. For Example donuts, she knew we had to do them that week as we told her and she decided that she would have on the Wednesday. That is what seemed to work for us. 
How do you feel he would take it if he knew it was coming? Springing it on my d, would have caused a huge fight. 
Sending my best. I do hope there is something there that resonates.
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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Kali

KLB,

How wonderful that your son has gotten to weight restoration! You have had a long hard road and it is truly amazing news to hear. 

And yes, fear foods. We also ate the same things over and over again for a very long time. After she was weight restored I focused on both broadening the every day menu as well as introducing some fear foods. So maybe once a week I would introduce a new recipe for dinner. But I took it slow and did a laddered approach. Once we reintroduced a food I made sure to serve it again the next week, and have it regularly. I never announced "now we are going to work on your fear foods" or even discussed it with her. It was easy enough to know what they were. One thing also I did during that period was to buy lots of snacks: chocolate covered almonds, tortilla chips and salsa, granola bars, cookies, etc, (whatever she had liked before) and left them strategically placed around the kitchen and when it was time for snack I would encourage her to choose one and sit and eat it with her.

The laddered approach to reintroduce desserts worked best for us. So pie could be for example:

a bowl of strawberries
then: a bowl of strawberries with some whipped cream on top
then: a bowl of strawberries with the whipped cream on top and a little tart pastry on the bottom.
Then after that was successfully eaten: Pie.!!!

Now of course, there was some complaining in my house about the pastry and the cream. And there might be in yours also. And there were a couple of setbacks where I continued to serve the blueberries or strawberries or whatever fruit I chose, with or without the cream and maybe not with the pastry on the bottom.

So really in our situation it went more like this

a bowl of strawberries
then: a bowl of strawberries with some whipped cream on top
then: a bowl of strawberries with the whipped cream on top and a little tart pastry on the bottom.
then: a bowl of strawberries with some whipped cream on top
Then some complaining that she was tired of the whipped cream and pastry.
then: a bowl of strawberries just strawberries
then: a bowl of strawberries with some whipped cream on top
then: a bowl of strawberries with the whipped cream on top and a little tart pastry on the bottom.

and eventually after what seemed like a long time, we got to the pie.

The last and most persistent fear food was ice cream and I had pretty much just given up on that one and decided that a person could totally live a happy, fulfilled life without ever eating ice cream again, when one summer evening we walked past an ice cream truck and my daughter said "I'd like some ice cream." She posed for a photo eating it. It was a big moment. 

So that one we did nothing about and then one day she was just....ready.

I might also suggest looking at the foods he is eating now and thinking about how to add some of the fear foods to them in order to morph into one of the meals he won't eat. For example: One fear food here was lasagna. So I served all the same ingredients that a vegetarian lasagna had: pasta, sauce, spinach and mushrooms on the side, and cheese. And when she was able to eat a plate of that, after awhile we tried lasagna. 

Hope this helps.

warmly,

Kali



Food=Love
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kazi67
Hi KLB
Great job on WR!!
once my d home from hospital I mainly brought all “normal” foods 
full fat everything (I’ve gained weight but so be it)
biscuits, chips, ice cream, lollies etc 
and same as above left bowls of lollies etc our on table 
Easter we broke up Easter eggs and just had them on table for all to take and I would notice her take some 👍 joy!! 
a lot of the “hard” work was done whilst she was IP then DP though so we were very fortunate in that respect 
I remember picking her up one day and she was crying and beside herself because they had “made” her eat a pie 😳
i can laugh now but this causes her to SH and it all did take a LOT of time and she is now on medication 🙁
BUT she does eat everything in the cupboard that is there, we are not out of the woods as her body burns every calorie and I still worry she is purging or secretly exersizing ?? But I just don’t know I can hardly run around after her, but I just keep putting one foot in front of the other 
and atm I am so sick that she really needs to “do it herself” right now 
i realise your s not at this point yet though 
it’s so hard all of this isnt it?
but you are amazing!! I remember your story 
x
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tina72
In your case I would do that very slow. We had one fear food day every week and we chose Sunday because that was the day we were both in for all meals.
You need to try if it is better to tell him before or to do it by surprise. Here telling her before worked better and we also gave her some possibilities to give us signs what to try next. For example when she said "I hope I must not have crisps for fear food day next week" we knew that she desperately wanted to have crisps and we did that for sure.

Reintroduce one item after the other and once it went down with success serve it again in the next weeks so it gets routine again.
There is no right or wrong, you need to try what works. Maybe after some weeks he is ready for 2 fear food days a week to get the list worked down faster.
Keep feeding. There is light at the end of the tunnel.
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Torie
KLB, I'm so proud of you and your son for getting to this point! Totally understand your concern about the need to avoid a backslide... on the other hand, you don't have an unlimited amount of time with him living there under your watchful eye so a bit of a balancing act.

I wonder what kind of backup and support you have.  Could a doctor or coach tell him he needs to eat more (nuts/yogurt/red meat/whatever)? Could his uncle join you for the fear food days?  Would it be easier if one of his friends (or other relatives) were there?  

I also wonder what would happen if you (or the doctor or coach) said he has to eat / drink (whatever the current challenge food is) BEFORE getting in the pool.  (For the vitamins/protein/fuel?)  

Another thing I might consider is: What would make the biggest difference?  Someone here (Toothfairy?) decided that smoothies were worth a battle because you can pack so many calories in a smoothie - some versions really pack a caloric punch, while appearing to be quite "healthy."  (I have come to loathe the terms "healthy foods" and "clean eating" so I cringe to write that.)  If you can get his weight up a little more, it might speed the brain healing.

The only thing I can say for sure is that I would want to pick a time he will have good supervision afterwards.  I haven't been around the forum lately - I wonder if you have one of those trackers on his phone.  Sorry if that has already been discussed and I missed it.

With you in spirit xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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KLB
Thankyou all for your your advice and input as usual. You’re all wonderful.

scaredmom wrote:

How do you feel he would take it if he knew it was coming? Springing it on my d, would have caused a huge fight. 
Sending my best.


Thanks Scaredmom for your input. I think either way is going to cause issues, but overall telling him it’s coming would be better I think. Like your d, springing it on him would end up with a potentially volatile situation. At least telling him means he can get used to it at his own pace. On the flip side we’ll have to see how bad his anxiety gets. I’ve been dreading this part of the process because the arguing and constant questioning is going to rear up like a tornado. But I know it has to be done. 

Its funny, because he absolutely insists he’s not fearful of foods, he just doesn’t want them, but you can see the anxiety building up at every meal. 

Kali wrote:
The laddered approach to reintroduce desserts worked best for us.

I might also suggest looking at the foods he is eating now and thinking about how to add some of the fear foods to them in order to morph into one of the meals he won't eat. For example: One fear food here was lasagna. So I served all the same ingredients that a vegetarian lasagna had: pasta, sauce, spinach and mushrooms on the side, and cheese. And when she was able to eat a plate of that, after awhile we tried lasagna. 

Hope this helps.



Yes, Thankyou Kali. Your explanation helps a lot. We’re definitely going to struggle with desserts etc as we only ever had them on special occasions. Morphing what he does eat into things he hasn’t yet is a good idea. I’ll have a think about that. 

kazi67 wrote:
Hi KLB
Great job on WR!!
i realise your s not at this point yet though 
it’s so hard all of this isnt it?
but you are amazing!! I remember your story 
x


It really is. The hardest thing I’ve ever had to do. I’m sorry you’re sick at the moment. Just makes everything harder doesn’t it? Thankyou for your input. I appreciate it. 

tina72 wrote:
In your case I would do that very slow. We had one fear food day every week and we chose Sunday because that was the day we were both in for all meals.
You need to try if it is better to tell him before or to do it by surprise. Here telling her before worked better and we also gave her some possibilities to give us signs what to try next. For example when she said "I hope I must not have crisps for fear food day next week" we knew that she desperately wanted to have crisps and we did that for sure.

Reintroduce one item after the other and once it went down with success serve it again in the next weeks so it gets routine again.
There is no right or wrong, you need to try what works. Maybe after some weeks he is ready for 2 fear food days a week to get the list worked down faster.


Thanks Tina. Slow and steady seems to be our motto here. He won’t be rushed. I wish s would give us some signs like that but he doesn’t. He avoids talking about it in that way at the moment. I guess we’ll sit him down and let him know the plan and then jump in. 

Torie wrote:
KLB, I'm so proud of you and your son for getting to this point! Totally understand your concern about the need to avoid a backslide... on the other hand, you don't have an unlimited amount of time with him living there under your watchful eye so a bit of a balancing act.

I wonder what kind of backup and support you have.  Could a doctor or coach tell him he needs to eat more (nuts/yogurt/red meat/whatever)? Could his uncle join you for the fear food days?  Would it be easier if one of his friends (or other relatives) were there?  

I also wonder what would happen if you (or the doctor or coach) said he has to eat / drink (whatever the current challenge food is) BEFORE getting in the pool.  (For the vitamins/protein/fuel?)  

Another thing I might consider is: What would make the biggest difference?  Someone here (Toothfairy?) decided that smoothies were worth a battle because you can pack so many calories in a smoothie - some versions really pack a caloric punch, while appearing to be quite "healthy."  (I have come to loathe the terms "healthy foods" and "clean eating" so I cringe to write that.)  If you can get his weight up a little more, it might speed the brain healing.

The only thing I can say for sure is that I would want to pick a time he will have good supervision afterwards.  I haven't been around the forum lately - I wonder if you have one of those trackers on his phone.  Sorry if that has already been discussed and I missed it.

With you in spirit xx

-Torie


Thanks Torie. Lovely to see you back on here. Yes, he turned 16 at the end of June so our time to get him truly healthy is ticking on. We’re down to seeing CAMHS once a month now but I still weigh him weekly so we can monitor whether he’s staying above his weight limit for swimming. His coaches don’t really want to get involved except to tell him he needs to do what we ask if he wants to keep swimming so although they back us up in that way they leave the detail to us. S prefers that as he finds the whole excruciatingly embarrassing. 

We have got him drinking one type of healthy smoothie but the more calorific ones will definitely be a battle. He has such rigid, black and white ideas of what is healthy enough to be ok and what isn’t. He still struggles with eating in the time limit we set too. Lunchtime at school has been a nightmare lately. 

We have a tracker on his phone and he has his Fitbit back but it’s linked to his dads phone so we can monitor his steps. He’s not allowed to do more than 8000 steps a day and if he does he gets extra food and/or misses swimming. It monitors his heart rate too so we know if he takes it off because the heart rate data goes missing. 

You're right that we need a little more weight. I do wonder sometimes if he really is truly weight restored but I know it’s early days and it takes a while after WR to see real change. He currently weighs 64.5kg (bmi 21.1). He has to stay above 64 to keep swimming. I want to get him above 66kg and then change his lower limit to that, just to give us some room for growth etc. So, although CAMHS and everybody say we’re WR I think he could afford to go a little higher.
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tina72
I just want to add that my d did not say what she "wanted" for next fear food day from the start for sure. We had a fear food list and there were items that she really did not want to eat at the start but I did feel these items would make her less anxious than others. Especially fear foods I knew that were her favourite before AN.

What we also did is serve these former fear food of her for hubby or me and serve her some safe food and see what her eyes speak. At that point her eyes often spoke more truth than her mouth.

Is there food on his list that was a former favourite? Then maybe start with that and just ignore him saying that he does not want it. ED does not want it, I am sure.
Think about what you can offer him for incentive on these fear food days. Maybe an extra round in the pool after he had eaten it.

Let him know and jump in worked up to now so seems to be a good plan. Let us know how you continue that fight! You are really a super heroe in my eyes. I am sure you will get that!
Keep feeding. There is light at the end of the tunnel.
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KLB
I can’t remember him really expressing a favourite food as a teenager. He would eat steak, and normal family meals like spag bol, curry, chilli etc, snacks like yoghurts and cereal bars which he won’t eat now. I guess I could start with those and work up to things like donuts, crisps, ice cream, desserts, fast food etc later.

I asked him earlier if he would write a list of fear foods and he rolled his eyes and refused, saying he doesn’t have any. ED logic at its finest here in our house! 
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tina72
So maybe start with that argument:
If he has no fear food at all there is no reason NOT to eat spag bol or curry now...🙂
He will then say but he does not like it and then you can say but you liked it earlier and we also eat things now and then that we are not totally fond of and it is normal to eat meals even when they are not your favourite ones just to be nice to the cook 🙂.

Here we had that argument about something I was really sure she would like to eat again and I said "but I want to eat it and its my favourite and I want us to eat it together as a family". And she ate it...(it was lasagne here)

We must write a book later: ED - english (and me ED - german)!
Keep feeding. There is light at the end of the tunnel.
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KLB
His go to argument is an athlete eats for fuel, a calorie isn’t just a calorie and it has to be worth it (ie “clean” not junk or “empty calories” - I HATE that term.....empty calories!). Eating is simply a means to swim for him still. There’s no enjoyment. When he eats it’s either robotic like or anxiety filled. Swimming is what currently keeps him eating. We have glimpses of awareness like when he phoned me from school about wanting to run sprints around the building but mostly it’s “if I do what they want I can keep swimming”. I’m a bit torn on this because whilst it keeps him eating I sometimes feel a bit scared that it all relies on swimming. I hope that as his brain heals and we start him with therapy this can be addressed and worked on. Recently he has really clammed up and won’t talk about his feelings/emotions/school etc. Everything is “fine”. Teenage boy + ED I guess.

This clean/unclean attitude has been both a help and severe hindrance. Helpful in that he’ll eat avocado, organic peanut butter, eggs, brown rice, chicken, small amounts of olive oil, salmon and oats which has helped bring up his calories but a massive hindrance in that what he deems “unclean” is bad and refuses to eat it. His “unclean” list is huge. 

Briefly it looks like this.....
Cheese
Spreads
Sauces
Dressings
Condiments
All Fast Food (pizza, burgers, fries, fried anything etc)
Desserts
Sweets/chocolate
Anything “beige” & processed
Yoghurts
Cereal
Snack Bars
Fruit Juices
White Bread / Rice
Pasta - will eat wholemeal very occasionally but not white pasta
Red Meat
Cream

You can see why I don’t really know where to start! 

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workingthrough

Do you have a contract or deal in place that he has to eat complete meals to swim?
 

I’d consider adding in that now it’s been x amount of time and he also needs to meet fear foods as well as full meals. Could that possibly work? 

We did the laddering as well. Our s was the same with “empty” calories and most of the foods you posted. We started with small steps. 

From whole wheat bread, we went to honey wheat as a challenge just one day, one meal, one week. We tried that, for example, as a weekly challenge. 

We sometimes let him choose - would you rather have yogurt or white rice and that would be our challenge the next week. We would only offer the challenge at one meal and one day. 

Our team worked with us 100% here and we decided with them before presenting to s. 

For us, we had one to two challenges a week. This continued for a long time. We then carried them week to week, so he’d have honey wheat bread one day, one meal in a week. The following week he’d have it once or twice a week in addition to another new food to add in. The next week, we might do honey wheat bread three days, etc. 

We kept taking steps. We went from honey wheat to white bread, and then we kept going back and forth for some time, just like the strawberry example. 

One day we ran out of whole wheat pasta and we told s we could use white pasta or have a meal he didn’t like - he chose the white pasta. That was monumental, because once we went with white pasta he never went back to whole wheat. 

It’s very much a week at a time; but that was our approach. We sometimes had incentives for hard challenges. We typically did harder challenges on the weekends and/or days we (as parents) were feeling strong. 


We let s eat his challenges esp. while playing video games or watching tv. In time, we needed to get back to cutting those out and eating at the table, but they helped s a lot esp. in the beginning.

If our s didn’t complete his meal with his challenge, he didn’t get his athletics that day. Our team also pushed higher level of care in a huge way. They told him they wouldn’t let him stay home if he couldn’t meet those foods. 

The fact that he’s WR is huge, you and he have been fighters through this. Adding fear foods will bring him back more and more. You’re an amazing mom. Keep holding on, I know it’s an exhausting, hard, awful trek. 

 

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Ellesmum
Hi KLB,

I just wanted to pop by to say how happy I am to read your update, you’ve done an incredible job 💪

I think you’re wise to wonder about weight ‘restored’ I’ve started to think more in terms of weight ‘regained’ as of course he needs to grow into adulthood still and I also thanks to another incredible mum,  think more of brain restoration than weight.

mental improvements although initially can be quite rapid in terms of small glimmers of change, can take a long time, my d still struggles mentally although hugely better than she was.  

I get the struggle of the athletes need for a tip-top food regime for his sport but of course he is still repairing damage done in the past, he’s been extremely unwell and still is although far better.   

I expect you’ve looked, I just wonder if such a thing as a sports therapist/coach exists, I mean someone who would have experience of ED’s.  My d saw a sports specialist for a physical problem but a very knowledgeable, empathetic person dedicated to his own sport and a ‘big brother’ type of personality who I think if needed would have helped d understand the importance of nourishment for her activity (I’m being deliberately vague as I’m worried about being followed around online)  anyway, might be worth some googling.  

I expect you bolster the oats with ground nuts and complan? this combo was a huge help to d’s health at one point. 

Anyway, I wanted to say - great job 😊
Ellesmum
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debra18
Great job with all of your progress. I understand your concern about regressing. From my experience the top priority is keeping my daughter safe medically and mentally which means continuing to eat what she needs every day. I did fear foods a variety of ways and continue to do so. Like today I offered her pancakes and she agreed. In such case I have a back up plan if she refuses and it's not a big deal. In earlier days I used a laddered approach for many foods like pizza. I think fear foods once a week and it being in the contract for swimming is a good idea. I wouldn't worry too much about the motivation. The most important thing is that he keeps eating. Over time it gets easier. My daughter still gets overcome by a look of terror halfway through often but she has learned that she can get through it. 
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Torie
KLB wrote:
Its funny, because he absolutely insists he’s not fearful of foods, he just doesn’t want them, but you can see the anxiety building up at every meal... 

 He avoids talking about it in that way at the moment....

We have got him drinking one type of healthy smoothie but the more calorific ones will definitely be a battle. He has such rigid, black and white ideas of what is healthy enough to be ok and what isn’t.



I suppose in his mind it isn't fear - it is just trying to follow the rules "everyone" says swimmers should obey regarding eating.  So personally I would drop the term "fear food."  Similarly, I would also lose the terms "healthy" and "clean eating."  Personally, I would ban them in my presence and adopt a mantra along the lines that "that is the opposite of healthy eating - it's what bought you a ticket to the hospital."  Sorry if that is too blunt or otherwise inappropriate.

Then I would (secretly) read what kind of advice swimmers hear / read about nutrition.  (I wouldn't discuss this with him - I would just be curious what information he is used to.)  From my brief perusal, it sounds like a lot of them favor yogurt, cereal, and pasta.  So I might start with those.  There seems to be advice to eat more after the practice than before.  (I had forgotten people say that about swimming.)  So maybe shortly after practice is a particularly good time to load up on calories.  I'm not saying these things because I believe the advice I'm reading - I'm saying them because I'm trying to help brainstorm ways to get through this.  Know thy enemy and all that.  Mostly the things I read made me cringe, but then there were anecdotes about a champion swimmer scarfing down pizza, another who superstitiously eats at McD's for several days before a big meet, etc. 

When my d was ill, I had very few conversations with her that pertained to ED.  ED argues like a top-notch lawyer while at the same time being irrational.  Not my idea of a good conversation partner.  There were certain things I needed to convey, and I usually thought about them pretty hard beforehand and then tried to be as brief as possible.  I adopted a number of mantras I could just repeat mindlessly for the things that kept coming up over and over.  (Sample conversation: Me: "People who have anorexia..." D: "I don't have anorexia."  Me: "People who have been DIAGNOSED with anorexia need to be sure to never skip a meal.")

Honestly, I'm not sure why I try to give you advice - I am SO impressed by all the good work you have done to drag your son back thus far.  He's YOUR son, and you will know what is best.  Me?  I'm just a well-meaning stranger on the Internet so it's a good bet my advice is worth exactly what you paid for it.

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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tina72
Wow, a huge list. And such a typical fear food list! Haha, he said he has no fear food..
But again not logical in detail and maybe you can get him with that.

For example condiments have nothing to do with fast food or are not unhealty - they just make the food taste better and I believe ED does not allow that food can taste good at the moment. There is no reason at all not to use condiments and you can just add them slowly to the food you cook.

Cereal - most sportlers eat that and there is no reason why this can be called "empty calories". Is there maybe a cereal brand that a sportler is advertising in your country? Then try to start with that.

Fruit juice - that was a big fear food here but again not logical at all. It is normal for sportlers to have a glass of orange juice for breakfast.

Joghurts are also normally called "healthy" and they have a good influence on the intestine system. This is also something I would try for a start because it would be very hard for him to argue why this should be empty calories...

If you google "sportsmen breakfast" you get a lot of pictures and recipes including cereal, yoghurt, orange juice 🙂. Maybe that helps to convince him that all normal sportlers eat that for breakfast.
Keep feeding. There is light at the end of the tunnel.
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debra18
For my daughter I found the fear foods important for social situations. When she goes to friends they eat pizza often or only have white bread sandwiches. Does the swim team go out for pizza or ice cream? Maybe you can ask his swimming friends to do this.
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workingthrough

I hesitate a little to show links/articles, because like pp we tried not to “talk to the ED” or rationalize. But lots of great links and videos with Michael Phelps in particular, 

https://www.google.com/amp/s/amp.businessinsider.com/michael-phelps-diet-for-the-rio-olympics-2016-8

Just a couple paragraphs from the article, 

He'd start off with egg sandwiches loaded up with all the fixings, ranging from cheese to fried onions to mayo. After that, he'd go for chocolate-chip pancakes, French Toast, grits, and a five-egg omelet (gotta get that protein). Lunch would include a couple ham and cheese sandwiches, energy drinks, and a pound of pasta to top it off. For dinner, he'd down a whole pizza. And yet another pound of pasta.

. . . his . . . diet has never been that  surprising, since swimmers burn crazy numbers of calories as they log hour after hour in the pool.

. . . Now he's "down" to a two-to-four hour a day training schedule. And while he didn't give an exact rundown in the video, it sounds like he's still enjoying a diet quite similar to his 2012 intake.

He's a fan of Mexican food, and also loves to grill: hamburgers, hot dogs, steak, and lots and lots of grilled chicken.

Our mantra with those foods was, “it’s a normal 14-year old thing to eat, we want you to be a normal 14 yo again.”

I’d imagine the ED is telling his he’s not “normal” and doing so well with eating clean - so saying those words might not help; but it’s so important he makes it back to those things. 


Is he getting tired of his current foods at all? I know s was getting so sick of the same/similar foods, but that darn ED is so strong.

Keep up your strength. You’ve all got this. 

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sandie
D refed on very limited diet too. We took varied approach to broaden variety and continue to do so. I had to prepare her in advance re Red meat. Took a few weeks along the lines of this is what I have bought and I need to use up what is in fridge. 
She was better able to cope with concept of needing more protein than anything else to build her muscles, so I was able to use this to encourage meat. 

i sometimes mixed white pasta in with wholewheat. Sometimes said pasta was wholewheat when it wasn’t. You know some pasta is more golden than other - or called durum I think and I would say yes that is wholewheat. I covered pasta with sauce so you couldn’t really be sure what colour it was. 

I hid cream and cheese in sauces so she had anyway. And she is ok with some cheese now. 

I laddered also to introduce things like salmon wellington, quiche on weekly basis. 

Definitely peer thing worked with us. D wants to fit in socially and will eat foods with peers that she wouldn’t eat with us. I have invited friends for tea or away on holidays and got away with serving food that she wouldn’t normally eat. 

I found Time, more time and persistence work.
what sometimes works here too is to buy things, put in fridge, eat in front of her so it becomes normalised and she can see safe. Not necessarily the first time but she will check out things in fridge and sometimes try out something eventually. 

It has taken about 10 months for me to be able to put some olive oil spread on bread in a sandwich. I think I have learnt that important not to get sucked into thinking she will never eat something. I have to keep trying. 

Good luck. Sounds like you are doing amazing. Xx
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sandie
The other thing that works here is new situations/settings. Even though has been very stressful/unenjoyable at times, going to new places or away means being presented with different food/options presented in different plates/cutlery/glasses and is opportunity to progress/ get used to change/ away from routine. 
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KLB
@workingthrough Yes, we have a deal/points system of sorts. Basically he has to maintain a weight over 64kg working towards 66kg to be able to swim at all. In addition he starts each day with 5 points and if we see ED behaviours we tell him and if he is unable to respond positively he gets a point deducted. If he finishes a day on 2 or less points his next swim session is cancelled. This works for the most part but we have had to follow through and cancel some sessions. He generally loses points because of exercising when he shouldn’t. “Fear foods” introduction will definitely mean more points being lost, and he will definitely struggle with losing his swim time. Once a week is probably going to be how we start. Anymore than that will be too much for him.

He’s really struggling to understand WHY he must eat these things, and I’m struggling to find a way to tell him. Me saying it’s what normal teenage boys eat or other athletes will eat this or everything in moderation is healthy or recovery is being able to eat anything and without conditions just doesn’t seem to compute with him. The fact we’ve never really been a family that eats desserts or fast food is definitely hindering us now. To him, he’s gained weight, he’s healthy, he’s back to normal, he’s not ill anymore and he’s eating, so we’re all making a fuss over nothing. He doesn’t seem tired of his safe foods at all. He feels mostly comfortable with them as long as it’s all how he “needs” it.

@Ellesmum Thankyou. I hope you’re feeling better? And your d is doing ok. Yes I bolster as best as I can. It’s a fine balance. He’s had nutrition talks etc from some sports nutritionists at his training but he only takes what he wants to hear.

@debra18 Thanks for your post. I like the idea of using different methods for introducing foods. A relaxed approach plus a planned more formalish approach. Regarding the other swimmers in the performance pathway group he was in they didn’t really socialise outside of the pool so group outings weren’t really a thing. His other sporty friends would eat pizza etc though. I may consider getting a few of them over at some point. 

@Torie Yes, makes sense to avoid those terms in front of him. Eating after training is a big thing. He’s always been a distance swimmer so was swimming huge distances in training. When he was 12/13 he’d be absolutely starving post training but even then would insist on “healthy” food. Obviously, he’s not doing as much mileage now but we require him to have a pre-training snack and a post training meal every session. Mantras are definitely what I need. I will use that people who have been diagnosed phrase. Thanks. I love and welcome your advice and input.

@tina72 He says condiments are full of salt and sugar and if you need to drown your food in them to make it taste good you haven’t cooked it right in the first place. Processed food, sugar and “bad” fats are the main issues for him.  

@sandie Thanks for the ideas. I think laddering for some of the major things will be the way to go. Mixing white pasta in with brown might work. Thankyou! 
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tina72
Maybe it helps if the team could simply tell him that eating a big variety of food is crucial in ED recovery and a lot of scietific studies have proofed that the outcome of patients eating a big variety of food is much better and then just let the negotiation not happen?

Here are some articles with arguments for you:
https://www.verywellmind.com/food-variety-in-eating-disorder-recovery-4159544
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083637/
https://www.huffpost.com/entry/the-problem-with-clean-eating-in-eating-disorder_b_599ea671e4b0d0ef9f1c11a7?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAEAcEntGoBsQqT7amb01UT4GFH86-CMsq5wrrR7iHjY17FVzpREY3geU_OtfljlR_KLgUiPY6Lh9mGsRr4Fk46XyWuDPOItneQoyCkjzmAlFg1KWMEzXwhQYTlm3Onlxn_qXcNyfuviHpS_abrJUjYs0TIlpv2h7mB-2zaxAMuR8
Keep feeding. There is light at the end of the tunnel.
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Mamaroo
Hi KLB, you've come so far, great job! I can only add that I told both my children that it's a good skill to be able to eat a variety of food. They don't need to like it, just be able to go into any social situation and not be anxious of what is being served. So maybe if you can phrase it as 'skill' and that you don't expect him to like it initially. Only in the last year (1 year post WR) would my d say she enjoys this or that particular food. Sometimes they need to be exposed to a certain food for a long time before enjoyment of it comes back. 
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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Foodsupport_AUS
KLB you have done an amazing job in trying circumstances. His cognitive rigidity is of course part of his ED, so of course he doesn't see a need to change. Trying to explain it to him and get his buy in is of course really hard, but ultimately he only thinks he is recovered. How does he go eating at his grandparent's house for example or if he had to travel for sport? He may need to stay in a hotel. It is highly unlikely that if he was to travel that anyone would make sure he only ate his safe foods, and further by limiting his intake he would limit his performance. Being able to eat a someone's house, go away etc. is all part of normal life for people. 

As is common his special foods may well be more expensive would insisting he start to fund them help? He may feel they are not so important. 

In terms of where to first, the snack foods, treats etc. are not where I would start first. I would be aiming to get back those foods that you know that he is missing and used to enjoy, and also getting back to what you normally eat at your house. Ironically sometimes the resistance is greatest with liked foods. My own D refused mangos for some years - her favourite food - despite being no where near what most would consider a fear food. It was the guilt associated with eating it, she could not admit she enjoyed eating for a long time. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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Torie
KLB wrote:
He’s really struggling to understand WHY he must eat these things, and I’m struggling to find a way to tell him.  
 
I think we all struggle with that.  I'm trying to remember what I said - I think at times I just said, "Because I said so."  When they are not rational, rational arguments don't work so I just tried to find something to say that would close out the discussion.  One thing she really disliked was when I would comment that it really sucks to have anorexia.  (As in, "I'm sorry this is so hard.  It really sucks to have AN.")  She definitely didn't want to talk about that and was probably glad that I then changed the subject.  (Changing the subject is a key skill I got much better at - I learned to think in advance of subject-changers: Have you seen my keys?  Do you like my new socks?  Is today Sunday?  I heard an interesting podcast about ...)
I'm sure others can help brainstorm ideas of a mantra to try xx
-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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