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.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

Need to talk with another parent? F.E.A.S.T. parents offer peer support via:

cnkinnh
The daily milkshake of over 1000 calories is the thing that D hates absolutely the most in all of this. She has no fear foods, but finds drinking fluids harder than eating. "I'm full." "My stomach hurts."

"I'm sick of it" - to which I responded that I can look for a different recipe if she wants. "It's not just the taste" was her answer - which basically means that she's not going to be any happier with anything else.

"I'm not going to be able to sleep" (due to stomach pain) - to which I responded that we could do it in the afternoon instead of the evening if she wants. (Though this will be difficult logistically since nobody is home in the afternoon to make it for her, but if necessary we'll find a way.)

It used to take her about 20 minutes to finish it. Nowadays it's taking her well over an hour, and it's getting worse, not better. No incentives have worked to push her to drink it faster. I've told her that I'm not going to back off on this until it gets easier for her...but she's been getting this shake on and off for over a year now and it's gotten harder, not easier.

I guess this is just another post of utter frustration on my part. We've been at this for over a year, she's gained over 45lbs, she's well out of danger physically but her mental state isn't any better than day 1. If anything, it's worse. We've put her on Prozac but it's not helping. Increased the dose, still nothing.
15yo D, first diagnosed 2015 with RAN. Diagnosis changed several times along the way, they are currently saying lifelong mild ARFID, complicated by major depression and AN starting age 13. Everything is atypical with her. FBT less and less effective after 2+ years. 
Quote
Torie
Hmmm ... have you tried waking her up an hour early with milkshake in hand ("Here, drink this") and she can roll over and go back to sleep after?  A number here have had good success with this, although of course it does require the milkshake preparer to wake up too early in the morning.

It really sucks how long and difficult the path is. But it does get better. Really. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Quote
mamabear
What about switching out the shake for oatmeal every other day?

1 cup heavy cream
Boil and add 1/2 cup oats
Add butter, brown sugar,dried fruits,raisins....

Easily over 1000 cals. I woke my D up at like 5:30 am and spoon fed her this during the summer for a few years. She would eat it and go back to sleep.

Just an idea. I'm the queen of shakes. I get it. My d had a 2000 plus. Al shake daily for 2.5 years after school.

Believe it or not she does now occasionally have a shake in recovery which always blows my mind! I can hardly look at one! Lol

Persistent, consistent vigilance!
Quote
mdmama
When my D was having a daily shake, we used milkshake straws (I found them at IKEA)-- very wide straws that made the drink go down quicker than a skinny straw or drinking straight from a cup. So that's one idea.

Also, along the lines of mamabear's suggestion-- if you wanted to to come up with another high-calorie offering to alternate with shakes-- one thing that my D enjoyed last winter was "hot cocoa" or "hot chai". I would melt a cup of premium vanilla ice cream (520 calories/cup) and add another cup or so of heavy cream (800 calories/cup); then if it was to be chocolate I'd whisk in chocolate syrup, or if it was chai I'd whisk in a powdered chai mix (from Trader Joe's in the U.S.; I can't remember where you are). Again, well over 1,000 calories here, and it's warm instead of cold, which might go down quicker? Although I know your D has troubles with beverages.

Perhaps if she really hates the shake and you offer this every-other-day alternative, it can be an option as long as she doesn't complain about it-- otherwise it's back to daily milkshakes.

Good luck. I think the shake is worthwhile despite the misery it's causing. They pack such a great caloric punch. 

_______
D diagnosed with AN November 2015 , the week she turned 12. Gaining slowly but steadily, fingers crossed...
Quote
cnkinnh
mdmama wrote:

Perhaps if she really hates the shake and you offer this every-other-day alternative, it can be an option as long as she doesn't complain about it-- otherwise it's back to daily milkshakes.

Good luck. I think the shake is worthwhile despite the misery it's causing. They pack such a great caloric punch. 


I also see it as her version of a fear food - any liquid, really. She drinks enough to stay hydrated, but she hates every bit of it, and even an extra ounce will face resistance from her, which is one reason I'm pushing the shake. For the calories, yes, but also because I feel like it's where we're butting against ED most directly. And, judging from the fact that it's getting harder for her, it seems that we're losing.

Although tonight I did find one thing that will motivate her - she's watching a TV show with her brother on DVD, so I pulled a "finish the shake in 5 minutes and you can watch an episode." (She'd already been at it for a half hour, so it's not like I was expecting her to finish the whole thing in 5 minutes.)  It took her more like 7-10 minutes, but it was still much faster than she's done it lately, and it's close enough as far as I'm concerned, so they are watching the episode right now.

Logistically it won't be possible to do this every day, however.

If you think of it as a fear food, does it make sense to offer the every-other-day option?
15yo D, first diagnosed 2015 with RAN. Diagnosis changed several times along the way, they are currently saying lifelong mild ARFID, complicated by major depression and AN starting age 13. Everything is atypical with her. FBT less and less effective after 2+ years. 
Quote
Psycho_Mom
Hi,

"...I feel like it's where we're butting against ED most directly. ..."

You go! Butt against that ed. I know it's completely counter intuitive, and I repeatedly, for like two years, had to say to myself "when you're getting flack you're over the target, when you're getting flack you're over the target. when you're getting flack you're over the target." 

Seriously. If you are confronting your d with something that is difficult, and she is able (although not easily) to do it, that is exactly progress! 

I will tell you that at about one year post wr, my d was still resisting fear foods, and I was still giving them to her on a daily basis and steeling myself for the reaction. Which, with repetition, was less and less violent.

Now tho.
I guess this is just another post of utter frustration on my part. We've been at this for over a year, she's gained over 45lbs, she's well out of danger physically but her mental state isn't any better than day 1."

OK, perhaps time to look at a historic growth chart. Do you have one for her whole life? 45 lbs may seem like a lot, but then again she is a growing girl, and she was severely ill when diagnosed, and so you may be just hitting extinction burst. Hard to know, so this is where a growth chart can help. Feel free to post one (taking out all identifying markers of course) if you like. Sometimes they can be confusing, and advice can help. 

Also, re: the shake. There was a time, I remember, when my d started to figure out that the smoothie I gave her daily had a TON of calories in it. I never said so, but after a while it became obvious I suppose by the fact that I always insisted she have it, and by what I said was equivalent to it (two meals!). So there was a kind of in between time when she didn't actually mind having it, but she coulnd't bear the idea that she was having it because there was a ton of calories in it. IF that makes any sense. She wasn't afraid of actually eating it, in fact she liked it, IF she didn't think about what was in it.
I'd just say, in the way of advice, to start to remind her that different bodies need different things, that she has a body recovering from a serious illness and because of that she needs a smoothie every day. And it's OK. She'll recover, and it won't be forever. 

And if she's still resisting even an extra ounce of liquid, then you know what I prescribe: an extra ounce of liquid.
And then half a TV show.
And another ounce!
And then the TV show conclusion.

Keep going. Keep gradually challenging that darn ed.
best wishes,


D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
Quote
sahmmy
Well, there is such a thing as burn out from eating the same food every day.
Ask her what she would like to eat instead of the shake, maybe a protein bar and a soda? Trail mix and an Ensure? Boost pudding and vanilla wafers?

Then take the calorie deficit and add it to the other meals and snacks - add an extra ounce of cheese, guacamole, humus, or slightly larger servings throughout the day.
d=18, R-AN, Generalized Anxiety Disorder. Refed at home with information gathered from this forum and lots of books. Relapsed. Refed. Relapsed. Refed. 17 sessions with an excellent individual therapist. 19 sessions with unhelpful dietician. 3 sessions of DBT (didn't like it). Psychiatrist available if needed. Prozac - fail. Lexapro - fail. 5HTP - fail. Clorazepam/Klonopin = major improvement, only used when necessary. Genomind SLC6A4 short/short - not able to process SSRI's.
d=15, lost 14 lbs in 8 months, Ped [nono]diagnosed as a crystal on a hair in the ear canal
Quote
crystal
if she has such a hard time with liquids and its getting worse you might want to take a step back. Make the shake smaller or replace it with juice and increase food intake. If she is weight restored or very close you might want to start teaching her to eat more normally. I absolutely agree that she needs to conquer her fear foods but taking it step by step instead of chugging it down all at once might make the transition easier on both of you. If she is not WR then you could gradually increase the shake again. Try to avoid force-feeding her anything or making her eat a large amount over a doctors recommended amount of kcal. If you do not have access to a doctor you can always look up online how much she should eat if she was at a healthy weight and add maybe 200. And absolutely do not sneak extra kcal into her food, if she finds out she will lose trust in you and will most likely relapse. Not to mention you might make her put a previous safe food on the fear foods list and she will take another step backwards, further away from recovering. Just be careful, gentle but persistent. Don't let frustration over her illness take over, in worst case it will hurt you both.
Quote
Torie
crystal wrote:
If you do not have access to a doctor you can always look up online how much she should eat if she was at a healthy weight and add maybe 200.


Many / most here have found that that is NOT NEARLY enough during weight restoration.

crystal wrote:
And absolutely do not sneak extra kcal into her food, if she finds out she will lose trust in you and will most likely relapse.


I'm not sure what you mean by "extra."  Giving them the amount they need to regain weight at a decent pace is not giving them "extra" - it is simply giving them what they need so that they aren't tortured by this vile illness any longer than necessary.

Restaurants do not "sneak" butter, cream, etc. into the meals they serve - they add them because doing so enhances the flavor and texture.  We add them because 1)  plenty of fats are needed during recovery and 2) otherwise the volume of food needed would be larger.

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

        

WTadmin