F.E.A.S.T's Around The Dinner Table forum

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Hope2019
Hi, All,
   
 This forum has been my savior, thanks for all encouragement, support!
 I have been officially doing refeeding with FBT for over 2 months for my 12 yeas s with AN, last Jan, IP, residential program, PHP, IOP, now FBT.

 Here are my challenging during rd, I would like to gather your ideas or tips:
1. He estimates the plate, if it is over 700 cals, he will not eat food and take Ensure plus, I have been making portion smaller and sneaking in extra oil, but for breakfast, he could easily guess: toast, bagel, muffin, he does not eat my homemade pancake (suspect extra oil), tips?
2. He planed restrictions once a week this month, I told him no restrictions allowed, or I will check him in residential program he stayed last year, this seems working for now, I am always frightened when thinking about if it does not work anymore? more tips when all incentives and IP do not work?
3. His BMI is 22 now, if he got WR in nov when he was 94lb, now he has been on WR for over 3 months, I do not see any sign of ED leaving, how many lb I should put and when I can see the light?
4. I want to close the supplement after he gains another few lb, and prepare the big fight with ED when I close the ensure plus, I think I am scared now when I am thinking of this plan, it may fail...

  I will wait for all your great tips, ED is too tough, my H always loss his patience and started yelling to my s... I told him to take a break... I know we need to keep the 4 big Cs, it is hard...
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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Havanese
Personally my daughter was still very stuck in her ed once at a healthy weight, we had her gain a few more pounds which helped a little but we decided to hold her at that weight for a while which worked for us. The only way we could get our daughter to eat in the beginning was by taking things away or rewarding her. If she didn’t eat she wasn’t allowed to exercise (only short walks or swims). We also did a sticker chart, whenever she ate a meal with little to no resistance she got a sticker and at a cartain amount she got $15-$20 to buy whatever she wanted. My guess is that since he weight restored quicker than most are able to he might just be behind in the mental aspect or recovery or experiencing a “second wave” where he is afraid of going over his goal weight.
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tina72
To 3.:
A 12 year old boy is NEVER WR. So if he is maintaining weight for 3 months now he surely has to gain this year for growing. Nobody will be able to tell you how much he needs to gain this years and how much he needs to gain to see brain recovery starting. You will know when it happens. It might happen at 2 lbs + or 5 lbs or 10 lbs.
Try to forget all numbers, feed as much as possible so he can grow and keep him on top of his healthy weight range when you see improvement with behaviour. It is really state, not weight. He will need to gain until his mid twenties as all boys and young men do. There is no target weight for a 12 year old.
Keep feeding. There is light at the end of the tunnel.
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mjkz
I found making the calories more if my daughter chose the Ensure option VS eating the food helped her opt more for the food.  You might try using two Ensure pluses for each meal he opts out of.
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Hope2019
Thanks for all your tips.
mjkz: I follow the treatment suggestion, if he does not eat meal, I give him 2 issue plus which is 700 cals, he takes ensure plus only when he thinks the meal is over 700 cals.
tina and mimi321: agree I need to keep pushing, no smaller portion means I do not give him bigger portion,I got the best tip by adding extra oil everywhere, he gained 0.5 lb last week, and I think more this week.
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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scaredmom
I love mjkz’s suggestion so if he would rather drink two ensures and miss a meal then make it three ensures so he will eat the meal. You need to outsmart ED. 
Your therapist has done you a disservice by saying he needs control. No control until ED is out and he is recovered. 
I think you need to build your confidence against ED. The only way to do that is to do it. 
You decide what he eats only not the therapist or son. You live  with him. You are giving the medicine ie food. You are the boss.
i found the blunt advice here very helpful in moving my stance to strong and able. Although at times it got me upset, I knew all the advice was coming from a loving place. 
Until you get your strength up, it will not get better. We call that putting on your big girl pants.
Sending a bag of courage.
XXX
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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tina72
I too think that is a good idea. If the meal is suggested to be more than 700 but the ensure will be much more than this he will risk to eat the meal althought it might in his eyes be more than 700. He will always chose the smaller enemy (I hope you say that in English...).
Keep feeding. There is light at the end of the tunnel.
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Hope2019
mjkz:I have been giving him 2 Ensure plus which is 700 cal if he does not eat the meal, I could not give him more than 2 Ensure plus now.

tina72: The 2 Ensure plus for a missing meal is the standard supplement from all treatment teams since my s was sick, there is no way I could give him 3 which it will be very un-reasonable for him, and I know he will not take it. I have been sneaking in cream in his Ensure plus bottle, I am planing to cut the number of Ensure plus in next few weeks once I push another 3 -5 lb.

mjkz wrote:
I found making the calories more if my daughter chose the Ensure option VS eating the food helped her opt more for the food.  You might try using two Ensure pluses for each meal he opts out of.
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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Hope2019
I was almost broken this morning, I gave him 2 small sausage (he ate a while ago), but he told me he forgot what was the serving size and said he did not think it is safe for him to have the sausage along with rest of his breakfast (which might be over 700cals), then I gave him 2 Ensure plus, he said he wanted to wait the last 5 mins before he had to leave for school, then he spilled the ensure bottle all over the table....
I lost my control, I yelled and throwing napkins and in tears... he was also in tears, his twin brother was terrified to see this scene.... I am still very mad to ED, also my son, can not keep doing this any more, so sick of the ED monster!
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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debra18
We have all been there before and can understand. It's very upsetting to see. Can you serve only meals that he can't quantify like cutting up the sausage and putting it in something? Casseroles? People have put oatmeal recipes that have high amounts of calories. Is there a way to distract him during meal times? Books saved my daughter's life. She reads books while eating and after eating. I am not sure what I will do once she has read all the books in the library. Also, I just bought her a joke book. Tell your son he is safe and he can trust you. He cannot worry about the calories. His only job is to eat what you give him. Say the same thing over and over again.
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Hope2019
thanks debra18, I will try cutting sausage or cook it with something else.
he does like reading books, and I have been using tv and reading for distraction, but in the morning before he goes to school, we do not have much time for distraction, only 30 mins for him to get up, eat breakfast and leave to school, I have been trying to make the breakfast not challenging, thought the sausage (and the quantity was not new), he still can not handle it , very very disappointed and sad..
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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debra18
Yes it is sad .But the only way through is to keep going. My daughter reads her books in the morning also. I had to take her out last year to learn to eat without the books but when we are home she still uses them. If it works try the reading or TV in the morning too.
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Hope2019
Thanks for all your love and support, everyday I was thinking when the ED leaves? how long do I have to keep doing this?  I admire all brave, smart and strong moms, thanks for being there for any of us who needs help...
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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debra18
It does take a long time. But after some time, I got into a routine where most days were good. Just take it one meal at a time. Do whatever you can to get him unstuck from this idea of 700 calories, push for more weight gain, and keep feeding. 
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Hope2019
Hi, debra18,
  Thanks, if my s could unlock idea of 700 cal, he should be in great place, 90% recover! he does not have fear food, he eats everything (bacon, ice cream, bagel, pizza...) if the total meal is less than 700 cals to his eyes.
  I will keep pushing his weight to see when I could see the light...
debra18 wrote:
It does take a long time. But after some time, I got into a routine where most days were good. Just take it one meal at a time. Do whatever you can to get him unstuck from this idea of 700 calories, push for more weight gain, and keep feeding. 
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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Mamaroo
Dear Hope2019, don't worry, we all have days like these. There is only one way through ED and that is the hard way. My d was also fixated on the amount of calories in her food. I would tell her that I calculated the calories and that it is an ensure + (we refed on ensures, so the ensures were replaced by meals with the same calories). I convinced her that I calculated the calories and that it is the right amount. I think she knew I was stretching the truth, but needed to hear it from me. After a while we / she stopped calculating and things returned to normal. 

What did you do after the spilled ensure? Did your s go to school? Can you get him up earlier in the morning so that you have more time to get food in? 

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
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Hope2019
Mamaroo,
 
  Thanks for sharing your experience, I will try to tell my s that his meal is equal to ensure plus, sometimes I told him the meal is less than Ensure, but he did not trust me.
   He drank one ensure plus and went to school, and told me he will drink the 2nd bottle after school which he did before, and he did drink the 2nd Ensure after school, he knows he can not skip meal or ensure plus now, he knows I will check him resident program like last year when he was first ill.
 How long did it take for your D stopped calculating from start to back to normal? I do not if I could see that day for my s...
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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Foodsupport_AUS
Hope2019 wrote:
Thanks for sharing your experience, I will try to tell my s that his meal is equal to ensure plus, sometimes I told him the meal is less than Ensure, but he did not trust me.


We so want to encourage our kids to trust us, but his fear and fixation on 700 calories is his eating disorder. Telling him they are the same almost reinforces this is what he needs. To recover he will need to get away from 700 calories for a meal. Sometimes it will be more , sometimes it will be less. His ill brain may not be able to process this, but this fixation on 700 calories needs to be broken. Whether you remove the containers, give larger amounts for supplements, insist on no supplements real foods only he needs to get away from "I must eat 700 calories only" . 
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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Mcmum
Absolutely agree. As a rule of thumb, if normal kids don't do it or say it,  it's ed.
I hear your anxiety about the length of this illness too and just wanted to reassure you that things can get better, bit by bit.  
So definitely put everything you've got into tackling the 700 hundred calorie fixation but the more food, the more the mood lifts and all the quirks and ocd type ed stuff recedes.
If you'd met my son 8 months ago , you would have been convinced he was depressed, anxious, had ocd and so on. He is immeasurably different now but it's very gradual.
12 year old boys in particular need a lot of (and increasing ) calories to sustain them through puberty. 
The calorie counting will stop. It's all just food. My s was obsessed by calories but now rarely looks or mentions them. On a recent day out, he read the calories on a drink bottle but got really upset with himself and apologised.  Nothing to apologise for of course but things change.  He knew it was ed. Wishing you strength.  It's literally food. I know that's easier said than done but that's the battle you're fighting . Getting the most amount of calories in his body that you humanly can. His obsession with 700 calories should not become yours I guess. 
Sending you a wave of strength, calm and resolve today xx
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mjkz
I too think the emphasis on only two Ensure plus is a disservice.  You need to break the 700 calorie mark and if he won't do it with food then you need to give him more than two Ensure plus.  It is not unreasonable at all.  I needed at one point to give my daughter 4 just to get her over the hump.  Until you make the supplement more calories than he thinks he is getting in the meal, you're stuck in the pattern you are in.

One other thing I did was make things like muffins that had over 1000 calories a piece and use those.  You can easily make breakfast muffins with over 1000 calories in them and put the sausage in those.  Another great one for getting a ton of calorie in is oatmeal.  You can use cream, oil, add dried fruit, etc. to get a lot of calories in.  Maybe do that and try not offering the supplement as an option.  If he doesn't eat, he stays home from school on bed rest until the next meal or snack.

I often say relationships are like a dance and the only way to change the dance is to do something else.  You and your son are stuck in a rut.  Change your moves so that he has to change his to keep dancing.
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Hope2019
Thank you the tips, it is all from great experience, I learned a lot!
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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Hope2019
Hi, Mcmum,

  Could you share your experience how you helped your s unlock the Ed calories count 7 cals for the meal step by step? did you give him ensure plus or other supplement in the beginning when he could not handle the meal? my s is counting all the time, and I want to push anther few lb so I let him taking ensure plus when he can not take the meal.


Mcmum Mcmum wrote:
Absolutely agree. As a rule of thumb, if normal kids don't do it or say it,  it's ed.
I hear your anxiety about the length of this illness too and just wanted to reassure you that things can get better, bit by bit.  
So definitely put everything you've got into tackling the 700 hundred calorie fixation but the more food, the more the mood lifts and all the quirks and ocd type ed stuff recedes.
If you'd met my son 8 months ago , you would have been convinced he was depressed, anxious, had ocd and so on. He is immeasurably different now but it's very gradual.
12 year old boys in particular need a lot of (and increasing ) calories to sustain them through puberty. 
The calorie counting will stop. It's all just food. My s was obsessed by calories but now rarely looks or mentions them. On a recent day out, he read the calories on a drink bottle but got really upset with himself and apologised.  Nothing to apologise for of course but things change.  He knew it was ed. Wishing you strength.  It's literally food. I know that's easier said than done but that's the battle you're fighting . Getting the most amount of calories in his body that you humanly can. His obsession with 700 calories should not become yours I guess. 
Sending you a wave of strength, calm and resolve today xx
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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scaredmom
Have you looked at Eva Musby's videos? Here is one:

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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Hope2019
Hi, scaredmum, I have watched the video couple of times, and tried to practice it during meal time, rarely working for my s...
12 years son, diagnosed AN 03/18, ip one week, residential 5 weeks, IOP 7 weeks, doing FBT since 11/18.
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scaredmom

Many of us have used Life Stops until you eat. (LSUYE). 
We plate the food and sit and sit and sit until they eat. Their lives and ours stops, cold turkey, until they eat. We take the food to them if they run away.
If the food is thrown, it is plated again (make lots of food). And keep at it until they eat. Despite the fighting and whatever comes. 
It may be best to take the other kids out of the house, or into a different room, when you feed him. 
No school, until he eats what you have plated. No friends or activities until he eats. No phone or games until he eats. These are examples of what some have tried. 
It is horrible the first few days or so, then honestly it gets better. You build your strength and resolve, and you have to wait the ED out. You need to be more stubborn than ED.  My D knew (it took awhile about 2 weeks) that I would just stand or sit there and really quietly say she would eat it all and that it was fine and OK. She knew I could sit there a long time (even if I was shaking in my boots), and then she would just eat it up quietly and angrily. She would fight and throw the first few weeks. I have chocolate milk still on the ceiling since April 2017! I lost a lot of glasses and plates and learned to use plastic everything.
My other 2 kids tried to distract her by talking but she wanted all of us to ignore her, and look away. It is like they are ashamed of eating (melstevUK, had mentioned that awhile ago on the forum and it really made sense and stuck with me). It is like they are embarrassed and so the less attention I gave to her, it worked. 

I know it may feel odd to go against your treatment team and many of us had to do that. You are trying to use any means you can to help him.

For some LSUYE does not work. Deenl one of our moderators has this great thread that discusses that too.  There are so many ways to get there. It is about finding your own path really. 
https://www.aroundthedinnertable.org/post/the-super-resistors-when-lsuye-and-magic-plate-cause-total-shut-down-8122350?highlight=life+stops+until+you+eat&pid=1297905485

The biggest change for my d and her eating came because I CHANGED. I became firm and said she had to eat it. I had to fake confidence until it came. 
I am only speaking for myself, but I felt that until I had to truly "fight the ED out of her" and I mean fight it out and demanded she eat everything. It did not get better. I did it with kindness and calmness and yes I blew up many times too. It is a learning process. I see all the people here cheering you on to do it. When you take over I know your son will fight, be prepared for it. It makes it a bit easier to know it is coming. Be ready with words.
"It is fine, it is ok," " Mom knows what you need" " it is not more or less than what you need " (No calorie talk here at all) 
Mjkz also discussed changing the dance. What  a beautiful illustration of what happens and may need to happen. 
To be honest what you are doing, although it feels safe for you and son, it is an ED trick and you will not get out of it until you become "unsafe", challenge yourself first and your son will follow. 

I think the consensus I see here for you, based on  everyone's replies is that:

1) YOU are the one that will need to break that 700 cal rule. He cannot and will not. You need to get rid of the ensures ASAP. If not in the house he cannot have it. It is a crutch for both of you and keeping you stuck, I am afraid. 
2) You are strong enough and can do it. 
3) You will conquer this. 
4) you have all of us.
 
We have been there in your shoes, scared to death. And we too have gone through it. It is not easy but it is worth it. 
There is no easy way out, I am afraid.

I hope some of this helps you. 
XXX

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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