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.

ytamar
My DD, age 13, was recently diagnosed with anorexia. We are so worried for her.
For about 2 months she has been gradually curtailing her caloric intake. During the summer, it was just a few junk food items she decided she didn't want to eat anymore and seemed very reasonable. But after the school year started, in September, she started limiting carbs such as pasta and bread gradually but noticeably. By October she refused all carbs, cheese and anything she perceived to have "fat" in it such as butter. We estimate that at her worst, she was probably getting only 700 or 800 calories. She has never been overweight but it started with being self conscious about her mid-section and I also think being miserable in school is another factor. With her calorie intake, she has lost weight. At first we took her to an outpatient therapist and also dietician who both work with patients with eating disorders. After being given some guide lines and trying to institute them, our DD has gotten worse in regards to even limiting her "safe" foods. So by the 2nd appointment with the dietician we knew our DD needed a higher level of care. She didn't make it to her 2nd appointment with the therapist. And we are still awaiting an appointment with the psychiatrist. 
So, we have already had an intake with an intensive outpatient program. She will be starting tomorrow.
So this is what I want to know.  Is the following part of the process or not. Is it normal? Will things turn around most likely? She is so angry with us when the subject of eating a meal comes up. She says she doesn't care whether she dies. She would rather be thin and die than be "fat". She has been given instructions by the dieticians and therapist where she will start tomorrow to get a certain number of snacks per day and certain amount of entrees with carbs, fats, etc. But she refuses. We take away electronics and other things when she does not comply but she is so miserable. When she eats, we give her back her things. She says the most horrible things to us. I don't react because I know it's the disease talking but still this can't make things any easier for her. Not only does she feel guilty about eating, she feels guilty about how horrible she is to us in her moments of relative calm.
Quote
debra18
Hi and welcome. Her reactions are all normal for having an eating disorder. Read Eva Musby's book and watch her videos. Do not get into a discussion with your daughter. Tell her to trust you. She needs to eat 3 meals and 3 snacks a day. Each meal should include carbs, fats, and proteins. You need to increase gradually until she is eating enough to gain 1-2 pounds a week. Your daughter will fight back. Stay calm and confident. Use distractions and help her get engaged in other activities.
Quote
Kali

Dear Ytamar,

Welcome to ATDT. I am sorry you need to be here however I hope that you will feel supported and be able to learn how to help your daughter from some of the carers here who have walked in your shoes before you. I am glad you have reached out and am sure other parents will be along soon to welcome you and see if they can mention any things which may be of help to you.

There are some books that it might help you to read.

Help your teenager beat and eating disorder, by James Lock and Daniel LeGrange.

Anorexia and other eating disorders: how to help your child eat well and be well by Eva Musby (this has practical tips about how to become an effective meal support and feed your child) Her website also has some helpful videos 

https://anorexiafamily.com/

When Your Teen has an eating disorder by Dr. Lauren Mulheim.

Quote:
So this is what I want to know.  Is the following part of the process or not. Is it normal? Will things turn around most likely? She is so angry with us when the subject of eating a meal comes up. She says she doesn't care whether she dies. She would rather be thin and die than be "fat". 


Yes unfortunately this is quite typical. It can help to try and separate your daughter from the illness and understand when the illness is speaking. It can help to work on remaining calm. The good news is that your daughter does not have to want to get well in order for you and your family to learn how to make sure she is fully nourished. And recovery is possible. It may take some time and yes it is a horrible journey. But hopefully you will be able to learn effective ways of managing it and helping her be able to eat.

Eating disorders are not caused by families or parenting, and your daughter has not chosen to have an eating disorder. She will need you to be strong and to stand up to the eating disorder and help make sure she eats again but she doesn't yet know that. Instead, she will most likely be angry about eating, and try her hardest to push you away, and that is one of the puzzling and paradoxical things about eating disorders. 

You can also visit the FEAST website which is packed with useful information:

https://www.feast-ed.org/default.aspx

Please ask all the questions you would like to and don't be shy about letting us know how we can help support you.

warmly,

Kali





Food=Love
Quote
Foodsupport_AUS
Welcome to the forum

Unfortunately this does sound really normal and common. It is normal for someone newly diagnosed with an eating disorder and particularly AN to behave just like this. It is miserable and frightening for all concerned. 

I see from your profile that you are in the US. There is an excellent new book explaining how FBT works and more to the point gives some practical tips on re-feeding - https://smile.amazon.com/When-Your-Teen-Eating-Disorder-ebook/dp/B07B91Q551/ref=smi_www_rco2_go_smi_1405964225?_encoding=UTF8&ie=UTF8&qid=&sr=

It will give you some great ideas about how to get her eating again.

The shift that all of us need to make is moving from asking her to eat or wanting her to eat to requiring her to eat - that is she has no choice. This is how good inpatient units work and we should require no less at home. 




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.
Quote
Torie
ytamar wrote:
She would rather be thin and die than be "fat".


I know this might not make sense, but the only way for her to get over that is for her to regain the weight she has lost (all of it).  This vile illness does the strangest things to their minds, but luckily their brains can heal when they get to a proper weight.  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 
Quote
Mamaroo
Hi Ytamar

Welcome from me as well and I'm so sorry to hear your d is ill.

What you've described sounds very typical. They tend to eat less when the illness is confronted. My d was eating 3 times a day and it went down to a muffin a day. The anxiety and anger will unfortunately stay a while. My d was very upset and cried almost constantly the first couple of weeks. Her anxiety became less for a couple of weeks, but as soon as she noticed the weight around her face and stomach the anxiety came roaring back. It takes a couple of weeks to redistribute the weight to the arms and legs and then the anxiety became less again. Then when she was close to her proper weight (95% of weight restoration) her anxiety spiked again, this is referred to extinction burst. I'm telling you all this not to discourage you, but to prepare you. It helped me a lot to know that her periods of anxiety are normal and to stay the course and get her to better health. 

As for all the things your d is saying, let it go in one ear and out another. Most of the times I didn't even acknowledge it, but a quick "I'm sorry this is so hard for you" is all you need to say. 

Good luck with the intensive program tomorrow. My d spent 2 weeks in inpatient care to kick start her recovery. Please take care of yourself, this is a marathon, unfortunately. 

Sending you lots of hugs!
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
Quote
ytamar
Thank you for all the helpful comments. Knowing that all of this is expected (in an unexpected mind-boggling illness) helps.
Another topic I’m not sure about is school. My daughter disliked school last year due to boredom (to oversimplify it). She absolutely loathes it this year. Her friends graduated last year as they were all a year older. She goes to a religious school and she finds the religious classes trite and useless and boring and accuses some of her teachers of being hippocritical. The secular studies teachers she feels many are low quality. This all adds to her unhappiness.But I assume part of it is the illness talking though I can’t help but wonder whether her unhappiness with school triggered the illness. It’s almost too much that not only does she face the anxiety of eating but also the anxiety of being so unsatisfied at school. Mondays are a horrible day for us. She graduates 8th grade this year and moved on a public high school next year. Im not sure what to do, if anything.
Quote
tina72
Hi and a very warm welcome from Germany. Sorry that you have to be here.

To answer your first post, all you describe is totally normal in this state of ED and it will only get better with weight gain and brain fully nurished.

School is not your first topic at the moment but I understand your question. Many (if not to say most) kids with ED are highly intelligent or even gifted. So it might be possible that she needs a special treatment to feel not bored. BUT: at the moment her brain is not working normal and so it would be useless to do any intelligence tests with her. But after some recovery time when her brain is working again I would give that a try.

My d finished school this year and although she missed 4 months in the last year before A levels she did very well with that. She had very good results on ALL subjects.
She did very hard with school because she found it hard to socialise (and not because she felt bored because the teachers gave her special things to do).
So maybe you can ask if this public high school has any programs for gifted kids or look for another more special school for her?

Tina72
Keep feeding. There is light at the end of the tunnel.
Quote
Foodsupport_AUS
Given you are in the US I think that means you have six months of the school year left? That could be a very long time if D continues to dislike being at school. Her attitude does however sound very typical for a teen, I can remember having the same feelings about the religious classes at my school. It is also a time when teens learn to question authority as they learn to become adults. Unfortunately they often are idealistic and not realistic. 

Your options would seem to be to continue as is, and looking for special programs other activities or considering changing school or home schooling both of which could also work. There are benefits in persevering in demonstrating that we don't always have to agree with what others do or say, and we also have to learn to tolerate times of adversity. 
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.
Quote
ytamar
Yes, I am of the thought that it would be best if she just gets through the rest of the school year. It might not be pretty. On the other hand, I just don't want school to be a major stressor that impacts her recovery. I just don't know. I don't blame her for being questioning. I get it. She was like that last year and we did figure it was part of being a teenager and puberty. This year is a whole other level. 

We took her to her first intensive outpatient therapy session tonight. She called us such vial names on the way. Names she would have never used before. She is still at the session now. We had a peaceful dinner at home with our other 2 kids who are younger. One is 11 and one is 9. They don't understand what is happening or why we are so worried about our DD and why lately we have been spending so much time at appointments. They do realize there is a shift in the house though and it's unsettling to them. I guess we will all need therapy to get through this. 
Quote
scaredmom

ytamar,
I too welcome you here. Although I am sorry you needed to find us. As for your younger children, have you discussed with them that their sister is ill? Children are so intuitive, they already know that something is really wrong and that they are likely worried/scared. I would urge you with H, to discuss it with them openly. But pay particular attention to their questions. 
Something along the lines that "sister is not well and Mom and Dad need to help her eat. She will need our support and help, but that does not mean mom and dad can't help you too. If you need us , we are still your parents and are here for you. Sister will get better, but it may take some time.Do you have any questions?" I am sure there are other approaches, but the main thing here is that they already know something serious is going on and are likely making more of it in their heads. What they imagine is likely worse than the truth. 
Please take the younger ones out on their own too. They need quality mom and dad time.ED takes its toll on everyone in the home.  It does get better, but you have to get through it, and that is the hardest thing.
Wishing you well, 
XXX

Food+more food+time+love+good professional help+ATDT+no exercise+state not just weight+/- the "right" medicine=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)
Quote
Mamaroo
ytamar wrote:

Another topic I’m not sure about is school. My daughter disliked school last year due to boredom (to oversimplify it).


When ill, my d also experienced school as very boring. As a matter of fact that was one of the first symptoms that something was wrong. I actually put her in a highly academic school (that was before any restriction took place). The school had extension classes for Maths and English, but it did not alleviate her boredom. Turns out that her dopamine system in her brain didn't work very well. Dopamine is the reward system in the brain, it makes one feel good or excited when doing something. So when that doesn't work, there is no reward for doing school work and my d experienced this as boredom. It is the same with eating, a dysfunctional dopamine system in the brain causes eating to be not rewarding any more. I've attached an article from Scientific American Mind which explains this very nicely. 

My d is recovered now, but it did not happen overnight. First she needed to eat and gain weight, during that time her anxiety was sky high. When she reached her WR weight we still had to supervise most meals (and plate it). Only after 6 months after WR did her anxiety START to decrease and her boredom start to disappear. 

I would not worry about school too much now. Focus your energy on getting the weight up. If you think school stress prevents her from eating and gaining weight, you might want to consider other options, like the others have said there are other schools or homeschooling. We moved my d back to her old, small school after most of the refeeding was done. At that school nobody knew she was sick and only remembered her as being well. It did her a world of good. 

I'm sorry this illness is impacting on your younger children. You can just tell them that she is ill and that her rude behaviour is due to the illness. Try and make some time of the other siblings even if it means taking turns with your hubby to look after your d. 

Sending you lots of warm hugs!!!!!
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
Quote
tina72
I would have prefered home schooling if possible but we are not allowed to do that here.

Try to get the younger children out of the line. Ask friends or family if they can eat with them some days in the week or seperate and have you eaten with ED d and hubby eats with the little ones in another room or at another time. It is very stressy for them.
Keep feeding. There is light at the end of the tunnel.
Quote
deenl
Hi ytamar,

ytamar wrote:
One is 11 and one is 9. They don't understand what is happening or why we are so worried about our DD and why lately we have been spending so much time at appointments. They do realize there is a shift in the house though and it's unsettling to them. I guess we will all need therapy to get through this. 


My son was 12 when he got ill, his brother was 14 and his other brother was 9. In spite of the older one hearing our ED son's suicidal plans and the horrors of refeeding, they are both happy and well and have not needed any therapy.

I am just going to say some of the things we did, not that you have to copy them, but to inspire you to think of ideas and tweaks that may work in your home.

  • We always knew that ED was an illness. No one is to blame for getting an illness and it is totally normal for the family to rally around and support the person who is ill. We emphasisied that we would do all this for any of the family who got a terrible illness.
  • We talked openly about the elephant in the room but at an age appropriate level. There is nothing scarier for kids than a feeling of tension and not understanding. We had no choice anyway as ED son expressed his suidal plans in front of oldest and youngest overhead discussions.
  • This also helped to convey the idea that the hell we were in was temporary. It may go on for a long time but it will get better.
  • Our 2 other boys wanted nothing more than to help their ill brother. They didn't have the life experience to know what to do. So we guided them in exactly how to help. Mostly we told them to just be his brother. The eldest one got a new computer game and just chatted to ED son about it even though he didn't respond initially. Eventually, he started engaging in the conversation, watching older son play, began playing himself, began playing on-line, began actually talking to people on-line. I love that computer game. [biggrin] Younger son is more cuddly and would just sit right down beside ED son on the sofa and helped ED son to get used to being touched with affection again.
  • We emphasised that they were not to engage with any talk or put any pressure on ED son around food. That is the job of the adults.
  • They were free to tell us anything they wanted, even feelings they felt guilty about. Everything they felt was a NORMAL reaction to a really, really difficult situation. They were not responsible for catching any ED or self harm behaviour but if they noticed they could and should tell us. It was not ratting, it was necessary info to help us to help ED son.
  • We had a plan in advance for when the $#! hit the fan. This often happened in the evening or at night. Youngest would crawl into oldest bed and both would put on their headphones. Hubby and I would take turns to go into them every so often to tell them what was going on and to guide them in feeling sympathetic to their brother for having such an awful illness and having a tough time. If it was daytime, they would disappear upstairs with their iPads and headphones. They knew that if I was alone, I could not leave ED son so could not update them as much. But I always did so as soon as the incident was over.
  • We were in emotional chaos, for months we had no clear path to help our son (poor professional care) but all our kids knew that we were not going to give up, we were not going to let him die and we were going to find something that worked. These were 100% truths and the kids knew that deep down in their hearts and souls. However, during the period where we were figuring the details out Mom and Dad desperately practiced 'Fake it until you make it'. And also an acknowledgement that there was no prescription so we needed some trial and error.
  • We used many stories to help, especially the youngest. His favourite was that ED was a Gremlin in the brain. He liked that because it helped explain crazy, out of control behaviour that used his brother's voice and his brother's face. Sometimes when ED son was mean to him he would whisper to me that he knew it was just the Gremlin. We also used a Star Wars analogy that Darth Vader had the good and dark side within him, as we all do but when ED showed it's face the dark side had taken over. We were the Jedi and we would squash the dark side. We also used Harry Potter stories, especially the Dementors and Boggarts and would think up spells. Edit: and of course eating chocolate to feel better after a run in with the Dementors always seemed like a good idea to us.[wink]
  • We did not eat as a family. One parent stayed with ED son in the living room where he ate. The other ate with the other two kids.

Hope you can find some hope and ideas for the little ones. People all react differently but on the whole kids are pretty resiliant.

Wishing you continued strength and courage,

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
Quote

        

WTadmin