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

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Frazzled
Hi all! I am in need of some advice from you guys. We are at the point of this journey where I want to push my D's weight up farther and my husband thinks she is ok where she is currently.  Her state of mind is very good.  She is happy, joking and back to herself.  Just to recap, my D is 10 (11 next month).  We started refeeding on June 22nd and since then my D has gained 18 pounds and grew 2 inches.  Pretty much all of her behaviors are gone at this point.  She no longer stands all day, does not exercise, doesn't break her food up into tiny pieces or hide food etc, doesn't want to use toddler bowls, plates and cups anymore.  She gets her snacks with supervision and finishes her meals plus a shake every day without a problem.  She is trying new things weekly.  We have a few fear foods yet to try.  I spoke with the doctor and he plotted her growth and compared it to previous years and he said she is back to the 25th percentile for height and 25th percentile for growth.  Her BMI is a little over the 50th percentile.  Her body composition is different than it was when this started. She was a competitive gymnast training 24 hours a week, which looking back is ridiculous, but she loved it and was very good at it.  She no longer does gymnastics at all and will not be going back ever. So her BMI is greater than it used to be even with less muscle mass, so that's good. Her weight gain has slowed from 2# a week to 1# and she didn't gain this past week.  She has maintained.  The question is, should I keep pushing her up in weight or go more slowly at this point?? I hate the not knowing/guessing part of this.  My husband thinks she has a lot of buffer and she is back to her normal self and I don't need to take her up anymore.  My gut instinct is to take her up more but I am traumatized by this whole thing and it may just be so I feel better about it all.  I know we have a long way to go and I am in no way backing off.  She will continue to get the 3,000 to 3,500 calories a day for years until no longer needed.  Just very uncertain about this stage because my husband and I have been on the same page until now. Sorry for the long post. I also want to add that my D had a major improvement in mood 8 pounds ago. So its confusing because her mood improved before being close to weight restored whereas a lot of others its the opposite. They have to go way over to see mood improve and ED behaviors decrease.  We also caught the restriction early so that may be a reason as well as her young age.
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HopeNZ
Hi frazzled

Congratulations on the awesome progress you've made with weight gain and returning your d to a much healthier frame of mind.

My first thoughts are that you probably need to listen to your instincts to aim for further weight gain. Your d is young and growing, and needs to continue to grow in height and also as her body changes with puberty. It seems to me that, as you only started refeeding in June, it's very early days to start thinking about maintaining rather than continuing to gradually gain weight. I hope others will chime in with their opinions.

The not knowing and uncertainty about what to do and where we are in the journey drives me nuts too! I think it's important not to let on to your d that you're anything other than supremely confident. Try to agree in private with your husband a way forward so that you continue to present a calm, confident, united parental team 😊

Warmly
Hope
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Enn

Frazzled, 
You have done and are doing so well. Your instinct to keep the calories up is a good one. We kept up 3500+ per day for one year and now I see D settling on the 62% for weight and she is staying on that curve with the higher calories.  I feel that her body is now on an equilibrium and I still want to push for weight gain. Most days D is getting over 4000 still! It is weird! Her weight gain has slowed to a more normal rate on that curve. 
Toothfairy did post about how they need a lot of calories for a long time. Keep watching her curve and that she is growing on that. 

Wow I am so pleased for you all!

My H (even this weekend said to me "She is eating all that?!!) does not get it many times, but I have told him, and he has acknowledged, that if I had not pushed the calories and held firm to the meal plan, she would not be where she is now. There are still blips I see and I am still pushing. 
Your child is young and keep going. When they have a growth spurt you really don't want a negative energy balance. The body's physiology is so smart, they will find their "sweet spot". Keep going, you got this!

XXX

Food+more food+ time+love+good professional help+ ATDT+no exercise+state not just weight (and now I will add)+/-  the "right" meds=healing--->recovery(--->life without ED)

This is becoming longer and longer the more I learn [biggrin]

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Torie
Frazzled, one thing I didn't realize for a long time is that it is normal for them to "grow out" before they "grow up."  (That is true for all kids; not just AN kids.)  They gain gain gain to fuel puberty and then shoot upward and thin back out.  So it is normal for them to look a bit chunky at ages similar to your d.  On top of that, as someone else already said, when recovering from AN the weight goes first to the face and abdomen.  So you are at an exceptionally difficult time to evaluate by appearance because of those two factors.

You and your d have done such a great job!  So pleased for you both! xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Frazzled
Thanks everyone for your replies. I am going to talk with my husband and try to explain to him that kids grow out before going up. He sees this happening with my son right now at his age going through growth spurts and puberty. So he should get it and will hopefully come around. My biggest fear is for my D to need 6,000 calories + like mamabears D. I really don’t know how she did that. So based on that fear I am going to push my D’s weight higher because who knows what’s going to happen when puberty hits!! She shows no sign of it right now so hopefully I have some time. 😊😎
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Mamaroo
Hi Frazzled, it is wonderful that you managed to get the wight on your daughter and that most of the ED behaviours are gone, well done!

Just to maintain on the 25th % curve you will need to keep on feeding her as you have done. Refeeding results in a higher metabolism, which doesn't go away just because she has reached her historical weight curve. This can last for many years. The rate of linear growth is now at its highest and will be until her period starts. Growing children need to gain 5-10 lb every year (that is without AN), so some months you will see weight gain and other months not, but be on the look out when weight gain stalls.

I'm happy to hear she won't return to gymnastics. Could it be that the strenuous exercise lowered her historic weight curve? Gymnasts in general are on the lower side of weight and height and her true historic curve could be masked by years of gymnastics. It that's the case her curve could be higher. That is something to take into account as well.
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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donotdespair
Tooth fairy linked this video last week about this and I found it really helpful

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Warrior1
Hi Frazzled,

My D’s journey to WR sounds similar to yours. Since WR we have forynightly appointments and the last three have gone - gain and growth - maintain - gain. I think following weight restoration it’s ok for weight gain to slow down a little and to maintain some weeks but over all they should be continuing to gain over all at an appropriate rate. Trust your instincts I try to make sure if D has had s busy day that I give a higher calorie dinner that evening or add a pudding to keep up the energy balance! I also hate the guessing game it’s the worst part for me xx
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Frazzled
Gymnasts in general are on the lower side of weight and height and her true historic curve could be masked by years of gymnastics. It that's the case her curve could be higher. That is something to take into account as well.


Mamaroo, This is very true and has been in the back of my mind and is probably what is causing me to be uneasy. I would like to see her gain 5-10 pounds as a cushion. I bet her curve was masked by all the intense training. Thanks for suggesting that.
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Frazzled
Thanks toothfairy!
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tdm13
Hi there, on our side we were aiming to stay on her historic BMI percentile through her growth (over 20cm in less than 2 years) without pushing further up (it also seemed hard to move her up or down from it). After about a year Ill thoughts cleared out and we stopped treatment / supervision. I d say you are the expert in your child behavior and should be her safety net! Congratulation to getting there !
tdm13
___________________________.
parents of d who started to restrict food at 11yrs in Aug2015, diagnosed as AN. Hospital resident mid-Dec to mid-Apr2016 under traditional treatment (isolation+weight contract). Total failure made us  switched successfully to FBT at home. WR in Aug 2016. No more symptoms since Jan 2018, follwoing growth & bmi percentile
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Nicstar4
Great job Frazzled, go with your instincts.
I also think that we are also used to seeing a leaner version of our kids when they have AN that we forget what they should look like if that makes sense. I know I feel that I think my d is not as low weight as she is, until I look at her identical twin and realize where she should be.
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